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Tsai Y, Chang CH, Lin YC, Lee SH, Hsieh PH, Chang Y. Different microbiological profiles between hip and knee prosthetic joint infections. J Orthop Surg (Hong Kong) 2020; 27:2309499019847768. [PMID: 31117922 DOI: 10.1177/2309499019847768] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The study aims to analyze the demographics and microbiological profiles of hip and knee prosthetic joint infection (PJI) and to compare the microbiological differences between hip and knee PJI. METHODS We performed a retrospective study of all PJI cases between January 2006 and December 2014 at a referral medical center in Taiwan. RESULTS A total of 294 PJI cases were collected: 159 were identified as hip PJI and 135 as knee PJI. The most common causative pathogen was Staphylococcus aureus (78 cases, 27%), followed by coagulase-negative staphylococci (CoNS, 42 cases, 14%). Methicillin-resistant staphylococci (MRS) accounted for 21% of all PJI cases. Fungus and mycobacterium were only involved in 12 cases (4.1%) of all PJI cases. Polymicrobial pathogens, anaerobes, and enteric gram-negative bacilli (GNB) were more likely to occur in hip joint prostheses than in knee joint prostheses (22 vs. 6 cases, p = 0.006; 11 vs. 0 cases; p = 0.002; 20 vs. 6 cases; p = 0.014, respectively). CONCLUSION The prevalence of polymicrobial pathogens, anaerobes, and enteric GNB was higher in the prosthetic hip infection than in the prosthetic knee infection. The high prevalence of MRS, including Methicillin-resistant (MR) S. aureus and MR-CoNS in PJI, may warrant the need for empiric antibiotic therapy with broader coverage while pending the culture result of PJI. Although fungal and mycobacterial PJI cases are rare, the incidence of these infections is relatively high in Taiwan. Fungus and mycobacterium should also be taken into consideration whenever a persistent PJI case is encountered.
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Affiliation(s)
- Yifang Tsai
- 1 Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan.,2 School of Medicine, Chang Gung University, Taoyuan
| | - Chih-Hsiang Chang
- 1 Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan.,2 School of Medicine, Chang Gung University, Taoyuan
| | - Yu-Chih Lin
- 1 Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan.,2 School of Medicine, Chang Gung University, Taoyuan
| | - Sheng-Hsun Lee
- 1 Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan.,2 School of Medicine, Chang Gung University, Taoyuan
| | - Pang-Hsin Hsieh
- 1 Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan.,2 School of Medicine, Chang Gung University, Taoyuan
| | - Yuhan Chang
- 1 Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan.,2 School of Medicine, Chang Gung University, Taoyuan.,3 Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan
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Prevalence and Antimicrobial Susceptibility of Methicillin-Resistant Staphylococcus aureus in an Egyptian University Hospital. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.4.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Velasco J, Rojas J, Salazar P, Rodríguez M, Díaz T, Morales A, Rondón M. Antibacterial Activity of the Essential Oil of Lippia oreganoides against Multiresistant Bacterial Strains of Nosocomial Origin. Nat Prod Commun 2019. [DOI: 10.1177/1934578x0700200117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Antibacterial activity of the essential oil of Lippia oreganoides was evaluated against thirty-nine multiresistant bacterial strains of nosocomial origin and five reference bacterial strains using the disk diffusion agar method. The results obtained have revealed strong antibacterial activity against methicillin resistant Staphylococcus aureus, extended spectrum β-lactamase producing Klebsiella pneumoniae, and multiresistant Acinetobacter baumannii with MIC values ranging from 20 to 40 μg/mL. The low dose antibacterial activity observed in this investigation suggested that the essential oil of L. oreganoides could be used in pharmaceutical preparations for the treatment of infections caused by multiresistant bacteria. According to the literature consulted, this is the first time that antibacterial activity of this species against multiresistant bacterial strains of nosocomial origin has been reported.
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Affiliation(s)
- Judith Velasco
- Microbiology and Parasitology Department, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - Janne Rojas
- Organic Biomolecular Research Group, Research Institute, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - Poema Salazar
- Microbiology and Parasitology Department, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - Mariseg Rodríguez
- Microbiology and Parasitology Department, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - Tulia Díaz
- Microbiology and Parasitology Department, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - Antonio Morales
- Organic Biomolecular Research Group, Research Institute, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - María Rondón
- Organic Biomolecular Research Group, Research Institute, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
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Rojas J, Velasco J, Rojas LB, Díaz T, Carmona J, Morales A. Chemical Composition and Antibacterial Activity of the Essential Oil of Baccharis latifolia Pers. and B. Prunifolia H. B. &K. (Asteraceae). Nat Prod Commun 2019. [DOI: 10.1177/1934578x0700201211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The essential oils from leaves of Baccharis latifolia and B. prunifolia collected in January 2006 were analyzed by GC/MS. The yields of oils extracted by hydrodistillation were 0.27 and 0.29% for B. latifolia and B. prunifolia, respectively. Sixteen (B. latifolia) and twenty nine (B. prunifolia) components were identified by comparison of their mass spectra with the Wiley GC-MS Library data and by their retention indices (RI). The identified products may be divided into four different groups: monoterpenes (9.0% B. latifolia; 43.9% B. prunifolia), oxygenated monoterpenes (0.8% B. latifolia; 5.4% B. prunifolia), sesquiterpenes (20.4% B. latifolia; 45.9% B. prunifolia) and oxygenated sesquiterpenes (69.8% B. latifolia; 1.9% B. prunifolia). The oils showed antibacterial activity only against Gram positive bacteria, with MIC values for Staphylococcus aureus (ATCC 25923) of 80 μg/mL (B. latifolia) and Enterococcus faecalis (ATCC 29212) of 90 μg/mL and 260 μg/mL (B latifolia and B. prunifolia, respectively).
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Affiliation(s)
- Janne Rojas
- Organic Biomolecular Research Group, Research Institute, Faculty of Pharmacy and Bioanalysis, University of Los Andes, Mérida, ZP-5101-A, Venezuela
| | - Judith Velasco
- Microbiology and Parasitology Department, Faculty of Pharmacy and Bioanalysis, University of Los Andes, Mérida, ZP-5101-A, Venezuela
| | - Luis B. Rojas
- Organic Biomolecular Research Group, Research Institute, Faculty of Pharmacy and Bioanalysis, University of Los Andes, Mérida, ZP-5101-A, Venezuela
| | - Tulia Díaz
- Microbiology and Parasitology Department, Faculty of Pharmacy and Bioanalysis, University of Los Andes, Mérida, ZP-5101-A, Venezuela
| | - Juan Carmona
- Pharmacognosy Department, Faculty of Pharmacy and Biomedical Sciences, University of Los Andes, Mérida, Venezuela
| | - Antonio Morales
- Organic Biomolecular Research Group, Research Institute, Faculty of Pharmacy and Bioanalysis, University of Los Andes, Mérida, ZP-5101-A, Venezuela
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Tseng SP, Hung WC, Chen HJ, Lin YT, Jiang HS, Chiu HC, Hsueh PR, Teng LJ, Tsai JC. Effects of toluidine blue O (TBO)-photodynamic inactivation on community-associated methicillin-resistant Staphylococcus aureus isolates. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2017; 50:46-54. [DOI: 10.1016/j.jmii.2014.12.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 12/25/2014] [Accepted: 12/26/2014] [Indexed: 12/13/2022]
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Xie X, Bao Y, Ouyang N, Dai X, Pan K, Chen B, Deng Y, Wu X, Xu F, Li H, Huang S. Molecular epidemiology and characteristic of virulence gene of community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus isolates in Sun Yat-sen Memorial hospital, Guangzhou, Southern China. BMC Infect Dis 2016; 16:339. [PMID: 27450316 PMCID: PMC4957337 DOI: 10.1186/s12879-016-1684-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of both hospital and community infections globally. It’s important to illuminate the differences between community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA), but there have been confusions on the definition, especially for the MRSA isolates identified within 48 h of admission. This study aimed to determine the molecular characteristics and virulence genes profile of CA and HA-MRSA isolates identified less than 48 h after hospital admission in our region. Methods A total 62 MRSA isolates identified within 48 h after admission and the clinical data were collected. Antimicrobial susceptibility test (AST) of collected isolates were performed according to the guidelines of Clinical and Laboratory Standards Institute (CLSI) 2015, and staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and virulence gene profiling were performed to explore the molecular diversity. Results SCCmec III and sequence type (ST) 239 were the most prevalent SCCmec type and ST in both CA and HA-MRSA groups. HA-MRSA group had higher prevalence of SCCmec III (87.2 %) and ST239 (79.5 %) compared with CA-MRSA (60.9 and 43.4 %, both P < 0.001), while the frequency of SCCmec IV (26.0 %) and ST59 (21.7 %) were higher in CA-MRSA than its counterpart (P < 0.001 and P = 0.003). MRSA-ST239-III was the predominant type in this study (61.3 %, 38/62), especially in HA-MRSA group (76.9 %, 30/39). However, CA-MRSA strains exhibited more diversity in genotypes in this study. Meanwhile, CA-MRSA tended to have lower resistant percentage to non-β-lactams antibiotics but more virulence genes carriage, especially the staphylococcal enterotoxins (SE) genes. Notably, seb gene was only detected in CA-MRSA isolates (52.2 %), likely a significant marker for CA-MRSA isolates. Panton-Valentine leukocidin gene (PVL) was highly detected in both groups, while appeared no significantly different between CA-MRSA (47.8 %) and HA-MRSA (43.6 %). Conclusions Our findings support a difference in the molecular epidemiology and virulence genes profile of CA-MRSA and HA-MRSA. Furthermore, this study indicates a possible transmission from HA-MRSA to CA-MRSA, which may cause the overlap of the definition. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1684-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoying Xie
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yunwen Bao
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Nengyong Ouyang
- Department of Gynaecology and Obstetrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xinlu Dai
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Kunyi Pan
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Baiji Chen
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Yawen Deng
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Xiquan Wu
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Fengqin Xu
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Hongyu Li
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
| | - Songyin Huang
- Department of Laboratory, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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Antimicrobial Resistance Patterns of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus Isolated From Patients With Nosocomial Infections Admitted to Tehran Hospitals. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2015. [DOI: 10.5812/pedinfect.32554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The Mechanism Underlying the Antibacterial Activity of Shikonin against Methicillin-Resistant Staphylococcus aureus. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:520578. [PMID: 26265924 PMCID: PMC4523682 DOI: 10.1155/2015/520578] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/02/2015] [Indexed: 11/29/2022]
Abstract
Shikonin (SKN), a highly liposoluble naphthoquinone pigment isolated from the roots of Lithospermum erythrorhizon, is known to exert antibacterial, wound-healing, anti-inflammatory, antithrombotic, and antitumor effects. The aim of this study was to examine SKN antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA). The SKN was analyzed in combination with membrane-permeabilizing agents Tris and Triton X-100, ATPase inhibitors sodium azide and N,N′-dicyclohexylcarbodiimide, and S. aureus-derived peptidoglycan; the effects on MRSA viability were evaluated by the broth microdilution method, time-kill test, and transmission electron microscopy. Addition of membrane-permeabilizing agents or ATPase inhibitors together with a low dose of SKN potentiated SKN anti-MRSA activity, as evidenced by the reduction of MRSA cell density by 75% compared to that observed when SKN was used alone; in contrast, addition of peptidoglycan blocked the antibacterial activity of SKN. The results indicate that the anti-MRSA effect of SKN is associated with its affinity to peptidoglycan, the permeability of the cytoplasmic membrane, and the activity of ATP-binding cassette (ABC) transporters. This study revealed the potential of SKN as an effective natural antibiotic and of its possible use to substantially reduce the use of existing antibiotic may also be important for understanding the mechanism underlying the antibacterial activity of natural compounds.
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Lee TM, Yang MC, Yang TF, Lee PL, Chien HI, Hsueh JC, Chang SH, Hsu CH, Chien ST. Molecular Characterization of Community- and Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Isolates in Southern Taiwan. Microb Drug Resist 2015; 21:610-21. [PMID: 26167865 DOI: 10.1089/mdr.2015.0020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A growing tendency for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) to be involved in nosocomial infections was reported. The predominance of SCCmec type IV or V CA-MRSA in soft tissue infection has also been indicated in Northern Taiwan. To establish basic information about the molecular characteristics of MRSA in our region, a total of 102 MRSA isolates were collected and characterized by an array of typing methods. Healthcare-associated MRSA (HA-MRSA) were found to be more resistant to levofloxacin (p=0.016) and moxifloxacin (p=0.015) than CA-MRSA. However, no difference was found in each and overall SCCmec type distribution between the two MRSA groups. Type I (8.7% vs. 2.6%) was more frequently found in CA-MRSA, whereas type V was more often observed in HA-MRSA (24.4% vs. 8.7%). No difference was found in the dichotomous group of PVL, SCCmec type IV, V, and IV/V between the two MRSA groups. Twenty-seven distinct spa types were identified; t437 and t1081 were the predominant types in our isolates. Moreover, 12 novel spa types with extremely low global frequency were detected in our isolates. SCCmec type III and IV were the major subtypes in the MRSA we collected. The t1081 clones all belonged to HA-MRSA and mostly to SCCmec type V (71.4%). CA-MRSA t437 clones were mostly SCCmec type IV strains (71.4%), but HA-MRSA t437 clones were predominantly SCCmec type IV (42.1%) and III (36.8%). Our findings support a difference in the molecular characteristics of CA-MRSA and HA-MRSA that may reflect various clonal origins in our isolates.
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Affiliation(s)
- Tai-Min Lee
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Ming-Chang Yang
- 2 Department of Biological Sciences, National Sun Yat-sen University , Kaohsiung, Taiwan .,3 Laboratory of Medical Research, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Tzu-Feng Yang
- 2 Department of Biological Sciences, National Sun Yat-sen University , Kaohsiung, Taiwan .,4 Department of Psychiatry, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Pei-Ling Lee
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Hsin-I Chien
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Jui-Chen Hsueh
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Shiou-Hui Chang
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Chao-Hsun Hsu
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan
| | - Shang-Tao Chien
- 1 Department of Pathology, Kaohsiung Armed Forces General Hospital , Kaohsiung, Taiwan .,5 Department of Medical Laboratory Sciences and Biotechnology, Fooyin University , Kaohsiung, Taiwan
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Wu CC, Shen LJ, Hsu LF, Ko WJ, Wu FLL. Pharmacokinetics of vancomycin in adults receiving extracorporeal membrane oxygenation. J Formos Med Assoc 2015; 115:560-70. [PMID: 26123638 DOI: 10.1016/j.jfma.2015.05.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 05/17/2015] [Accepted: 05/20/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/PURPOSE Extracorporeal membrane oxygenation (ECMO) alters the pharmacokinetics (PK) of vancomycin in neonates; but data on adults is limited. METHODS This is a prospective, matched cohort, single center, pharmacokinetic study. For each adult patient who received vancomycin therapy in the ECMO group (with either centrifugal pump or roller pump), a control patient was matched by age (≥ 60 years or < 60 years), gender, and creatinine clearance (CLCr) in intensive care units. After vancomycin was administered for at least four doses, serial blood samples were drawn at 0.5 hours, 1 hour, 2 hours, 3 hours, 5 hours, 7 hours, 11 hours, 23 hours, 35 hours, and 47 hours post vancomycin infusion according to the dosing intervals. The serum concentration-time profile was fitted to a noncompartment model and a nonlinear mixed effect model to determine the PK parameters. RESULTS Twenty-two critically ill adults without renal replacement therapy were enrolled. There were no significant differences between the ECMO group and the matched group in demographics, renal function, and PK parameters. However, vancomycin clearance in the roller pump group was significantly lower than that in the matched control (0.83 ± 0.43 mL/min/kg vs. 0.97 ± 0.43 mL/min/kg, p = 0.002). CONCLUSION Vancomycin clearance in patients receiving ECMO with a roller pump was significantly lower than that in the matched cohort. Vancomycin PK parameters in patients on ECMO with a centrifugal pump were comparable to those in the matched control group.
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Affiliation(s)
- Chien-Chih Wu
- Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Jiuan Shen
- Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Wen-Je Ko
- Department of Traumatology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fe-Lin Lin Wu
- Department of Pharmacy, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Zaidi T, Zaidi T, Cywes-Bentley C, Lu R, Priebe GP, Pier GB. Microbiota-driven immune cellular maturation is essential for antibody-mediated adaptive immunity to Staphylococcus aureus infection in the eye. Infect Immun 2014; 82:3483-91. [PMID: 24914214 PMCID: PMC4136232 DOI: 10.1128/iai.01951-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 05/29/2014] [Indexed: 11/20/2022] Open
Abstract
As an immune-privileged site, the eye, and particularly the outer corneal surface, lacks resident mature immune effector cells. Physical barriers and innate mediators are the best-described effectors of immunity in the cornea. When the barriers are breached, infection can result in rapid tissue destruction, leading to loss of visual acuity and frank blindness. To determine the cellular and molecular components needed for effective adaptive immunity on the corneal surface, we investigated which immune system effectors were required for protection against Staphylococcus aureus corneal infections in mice, which are a serious cause of human eye infections. Both systemically injected and topically applied antibodies to the conserved cell surface polysaccharide poly-N-acetylglucosamine (PNAG) were effective at mediating reductions in corneal pathology and bacterial levels. Additional host factors impacting protection included intercellular adhesion molecule 1 (ICAM-1)-dependent polymorphonuclear leukocyte (PMN) recruitment, functional CD4(+) T cells, signaling via the interleukin-17 (IL-17) receptor, and IL-22 production. In germfree mice, there was no protective efficacy of antibody to PNAG due to the lack of LY6G(+) inflammatory cell coeffector recruitment to the cornea. Protection was manifest after 3 weeks of exposure to conventional mice and acquisition of a resident microbiota. We conclude that in the anterior eye, ICAM-1-mediated PMN recruitment to the infected cornea along with endogenous microbiota-matured CD4(+) T cells producing both IL-17 and IL-22 is required for antibody to PNAG to protect against S. aureus infection.
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Affiliation(s)
- Tanweer Zaidi
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tauqeer Zaidi
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Colette Cywes-Bentley
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Roger Lu
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory P Priebe
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Divisions of Critical Care Medicine (Department of Anesthesiology, Perioperative and Pain Medicine) and Infectious Diseases (Department of Medicine), Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gerald B Pier
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Li X, Qiu Y, Yu A, Shi W, Chen G, Zhang Z, Liu D. Characteristics of airborne Staphylococcus aureus (including MRSA) in Chinese public buildings. AEROBIOLOGIA 2014; 31:11-19. [PMID: 32214628 PMCID: PMC7088031 DOI: 10.1007/s10453-014-9342-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 04/22/2014] [Indexed: 05/24/2023]
Abstract
The aim of this study was to evaluate the concentration and size distribution of airborne culturable Staphylococcus aureus (S. aureus) (including MRSA) in Chinese public buildings. Air samples were collected, using six-stage Andersen sampler from five different public buildings in one large Chinese community. The mean indoor concentrations of the total and respirable airborne S. aureus were 72 and 50 CFU/m3 in the general hospital, 72 and 49 CFU/m3 in the kindergarten, 76 and 52 CFU/m3 in the hotel, 84 and 57 CFU/m3 in the movie theater, and 55 and 40 CFU/m3 in the university classroom. Respirable S. aureus amounted to approximately 57-73 % of the total S. aureus concentrations. Mean total and respirable concentrations of airborne MRSA were 32 and 20 CFU/m3 in the general hospital, 20 and 13 CFU/m3 in the kindergarten, 23 and 16 CFU/m3 in the hotel, 33 and 20 CFU/m3 in the movie theater, and 24 and 17 CFU/m3 in the university classroom. Respirable MRSA amounted to approximately 61-72 % of the total MRSA concentrations. The ratios of indoor and outdoor concentration for airborne S. aureus and MRSA were more than 1.0 in all the investigated public buildings. The size distribution results showed relatively high collection rates on stage 4 (2.1-3.3 μm) for both airborne culturable S. aureus and MRSA regardless of the type of public buildings.
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Affiliation(s)
- Xiaoxia Li
- College of Basic Medicine, Taishan Medical University, Tai’an, 271000 China
| | - Yuyu Qiu
- College of Basic Medicine, Taishan Medical University, Tai’an, 271000 China
| | - Ailian Yu
- College of Basic Medicine, Taishan Medical University, Tai’an, 271000 China
| | - Weifeng Shi
- College of Basic Medicine, Taishan Medical University, Tai’an, 271000 China
| | - Guomin Chen
- 88th Hospital Clinical Laboratory, Chinese People’s Liberation Army, Tai’an, 271001 Shandong China
| | - Zhong Zhang
- College of Basic Medicine, Taishan Medical University, Tai’an, 271000 China
| | - Dunjiang Liu
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Tai’an, 271018 China
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SABOUNI F, RANJBARI R, POURAKBARI B, MAHMOUDI S, TEYMURI M, TAGHI HAGHI ASHTIANI M, MOVAHEDI Z, MAMISHI S. Staphylococcus aureus infections in children in an Iranian referral pediatric hospital. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2013; 54:205-7. [PMID: 24779281 PMCID: PMC4718318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Staphylococcus aureus is associated with various infections ranging from skin and soft tissues such as surgical site infections and abscesses to lower respiratory tracts and bloodstream. The aim of this study was to evaluate underlying condition of patients with S. aureus infections in an Iranian referral pediatric Hospital. MATERIAL AND METHODS Information was extracted retrospectively from the medical records of patients who were diagnosed with S. aureus infections. Data obtained about the study subjects included basic demographics, reason for admission, culture site, length of hospital stay, and methicillin susceptibility. RESULTS The underlyning condition of of patients with S. aureus infection during November 2011 and March 2013 were included in the study. The most frequent diagnosis in patients with S. aureus infection was jaundice (12%), abscess (10%), cellulitis (10%), wound infection (8%), septic arthritis (7%) and sezeire (5%). Wound was the most common infection sites among all subjects 34/98 (35%) following by blood (20/98, 20%) as well as skin and soft tissue (19/98, 19%). The proportion of MRSA infections among all S. aureus isolates was 79% (77/98) during the study period. In addition, 58/74 (78%) met the definition of Hospital-Associated Methicillin-Resistant S. aureus (HA-MRSA) infections and the rest; 20/24 patients (83%), were classified as Community-Associated Methicillin-Resistant S. aureus (CA- MRSA). CONCLUSION In our study, the high frequency of MRSA was found not only in HA S. aureus but also in CA S. aureus isolates; therefore, the strategic goals to optimize antimicrobial use including
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Affiliation(s)
- F. SABOUNI
- Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - R. RANJBARI
- Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - B. POURAKBARI
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - S. MAHMOUDI
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - M. TEYMURI
- Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - M. TAGHI HAGHI ASHTIANI
- Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Z. MOVAHEDI
- Department of Pediatric Infectious Diseases, Qom University of Medical Sciences and Health Services School of Medicine, Qom, Iran
| | - S. MAMISHI
- Department of Infectious Disease, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;, Pediatrics Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran;,Correspondence: Setareh Mamishi, Department of Pediatric Infectious Disease, Children Medical Center Hospital, School of Medicine, Tehran University of Medical Sciences, No.62, Gharib St., Keshavarz Blvd., Tehran, Iran. Tel. +98 021 66428996 - Fax +98 021 66428996 - E-mail:
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Su CH, Chang SC, Yan JJ, Tseng SH, Chien LJ, Fang CT. Excess mortality and long-term disability from healthcare-associated staphylococcus aureus infections: a population-based matched cohort study. PLoS One 2013; 8:e71055. [PMID: 23940689 PMCID: PMC3735502 DOI: 10.1371/journal.pone.0071055] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/24/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Staphylococcus aureus is a leading cause of healthcare-associated infections (HAIs), but the impact of S. aureus HAIs on the long-term survival and functional status of hospitalized patients remain unknown. This study aimed to examine whether S. aureus HAIs increase the risks for long-term mortality and disability. METHODS We conducted a retrospective population-based matched cohort study of inpatients at 8 medical centers, 43 regional hospitals, and 63 local hospitals which participated in the Taiwan Nosocomial Infection Surveillance (TNIS). We individually matched 3070 patients with S. aureus HAIs to 6140 inpatients without HAIs at a 1∶2 ratio by age, gender, hospital, specialty, underlying diseases, and the length of stay before onset of the S. aureus HAI. Main outcome measures are one-year excess risks for mortality, new-onset chronic ventilator dependence, and new-onset dialysis-dependent end-stage renal disease. RESULTS We found that patients with S. aureus HAIs had an excess one-year mortality of 20.2% compared with matched uninfected inpatients (P<0.001). The excess risk for new-onset chronic ventilator dependence and dialysis-dependent end-stage renal disease was 7.3% and 2.6%, respectively (Ps<0.001). S. aureus HAIs were also associated with an excess hospital stay of 12 days and an extra cost of $5978 (Ps<0.001). CONCLUSION S. aureus HAIs have substantial negative effect on the long-term outcome of hospitalized patients in terms of both mortality and disability, which should be taken into consideration in future cost-effectiveness studies of the control and prevention interventions for S. aureus HAIs.
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Affiliation(s)
- Chiu-Hsia Su
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Fifth division, Centers for Disease Control, Taipei, Taiwan
| | - Shan-Chwen Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jer-Jea Yan
- Fifth division, Centers for Disease Control, Taipei, Taiwan
| | - Shu-Hui Tseng
- Fifth division, Centers for Disease Control, Taipei, Taiwan
| | - Li-Jung Chien
- Fifth division, Centers for Disease Control, Taipei, Taiwan
- * E-mail: (LJC); (CTF)
| | - Chi-Tai Fang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (LJC); (CTF)
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Characterization and complete genome sequence analysis of Staphylococcus aureus bacteriophage SA12. Virus Genes 2013; 47:389-93. [PMID: 23775760 DOI: 10.1007/s11262-013-0938-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022]
Abstract
Staphylococcus aureus is a well-known pathogen that causes several serious diseases in humans and animals. As part of the efforts to control this pathogen, a newly isolated bacteriophage, SA12, which specifically targets S. aureus, was characterized, and its genome was completely sequenced. Host range and bacteriophage challenge tests demonstrated its specific and efficient host lysis of S. aureus. The genome of phage SA12 consists of 42,902 bp length double-stranded DNA with 58 predicted ORFs-encoding phage structure, DNA manipulation, packaging, host lysis, and regulation proteins. The characterization and genome study of phage SA12 in this report is useful for understanding S. aureus-targeting bacteriophages and provides basic information for the further development of phage-based biocontrol agents against S. aureus.
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Aydiner A, Lüsebrink J, Schildgen V, Winterfeld I, Knüver O, Schwarz K, Messler S, Schildgen O, Mattner F. Comparison of two commercial PCR methods for methicillin-resistant Staphylococcus aureus (MRSA) screening in a tertiary care hospital. PLoS One 2012; 7:e43935. [PMID: 23028480 PMCID: PMC3446963 DOI: 10.1371/journal.pone.0043935] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 07/27/2012] [Indexed: 01/08/2023] Open
Abstract
Nose/throat-swabs from 1049 patients were screened for MRSA using CHROMagar MRSA, LightCycler Advanced MRSA, and Detect-Ready MRSA. Results were compared to the CHROMagar MRSA results, which was set as reference system. MRSA was detected in 3.05% of the patients with CHROMagar MRSA. LightCycler MRSA Advanced showed a higher clinical sensitivity (84.38%) than Detect-Ready MRSA (57.69%).The negative predictive values were high for both tests (>98%). The specificity and the positive predictive value were higher for the Detect-Ready MRSA test than for the LightCycler MRSA test (99.59% and 78.95% versus 98.52% and 64.29%). For routine screening LightCycler MRSA Advanced proved to be more efficient in our clinical setting as the clinical sensitivity was much higher than the sensitivity of Detect-Ready MRSA. CHROMagar MRSA detected more MRSA positive samples than both PCR methods, leading to the conclusion that the combination of PCR with cultural screening is still the most reliable way for the detection of MRSA. LightCycler MRSA Advanced was faster and needed less hands-on time. The advantage of Detect-Ready MRSA was the additional identification of methicillin-sensitive S.aureus (here in 34.63% of the samples), an information which can be possibly used for reducing the risk of postoperative infections in surgical patients in future.
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Affiliation(s)
- Aylin Aydiner
- Institut für Pathologie, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Jessica Lüsebrink
- Institut für Pathologie, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Verena Schildgen
- Institut für Pathologie, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Ingo Winterfeld
- Institut für Hygiene, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Oliver Knüver
- Institut für Pathologie, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Katja Schwarz
- Institut für Hygiene, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Sabine Messler
- Institut für Hygiene, Kliniken der Stadt Köln gGmbH, Köln, Germany
| | - Oliver Schildgen
- Institut für Pathologie, Kliniken der Stadt Köln gGmbH, Köln, Germany
- * E-mail: (OS); (FM)
| | - Frauke Mattner
- Institut für Hygiene, Kliniken der Stadt Köln gGmbH, Köln, Germany
- * E-mail: (OS); (FM)
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Comparison of the WST-8 colorimetric method and the CLSI broth microdilution method for susceptibility testing against drug-resistant bacteria. J Microbiol Methods 2012; 90:160-6. [DOI: 10.1016/j.mimet.2012.05.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 05/01/2012] [Accepted: 05/04/2012] [Indexed: 11/20/2022]
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Chen SY, Chiang WC, Ma MHM, Hsueh PR, Chang SC, Fang CC, Chen SC, Chen WJ, Chie WC, Lai MS. Predicting methicillin resistance among community-onset Staphylococcus aureus bacteremia patients with prior healthcare-associated exposure. Eur J Clin Microbiol Infect Dis 2012; 31:2727-36. [PMID: 22610613 DOI: 10.1007/s10096-012-1621-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
Abstract
To develop and validate prediction rules to identify the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection among community patients who have healthcare-associated (HA) exposure and S. aureus bacteremia. A total of 1,166 adults with community-onset S. aureus bacteremia were retrospectively enrolled. The background prevalence of community MRSA infection was extrapolated from 392 community-associated S. aureus bacteremia (CA-SAB) patients without HA exposure. Complete and clinical risk scores were derived and tested using data from 774 healthcare-associated S. aureus bacteremia (HA-SAB) patients. The risk scores were modeled with and without incorporating previous microbiological data as a model predictor and stratified patients to low-, intermediate-, and high-risk groups for MRSA infection. The clinical risk score included five independent predictors and the complete risk score included six independent predictors. The clinical and complete risk scores stratified 32.7 % and 42.0 % of HA-SAB patients to the low-risk group for MRSA infection respectively. The prevalence of MRSA infection in score-stratified low-risk groups ranged from 16.3 % to 23.3 %, comparable to that of CA-SAB patients (13.8 %). Simple decision rules allow physicians to stratify the risk of MRSA infection when treating community patients with prior HA exposure and possible S. aureus infection.
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Affiliation(s)
- S-Y Chen
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xuzhou Road, Zhongzheng District, Taipei 100, Taiwan
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Bergström K, Aspan A, Landén A, Johnston C, Grönlund-Andersson U. The first nosocomial outbreak of methicillin-resistant Staphylococcus aureus in horses in Sweden. Acta Vet Scand 2012; 54:11. [PMID: 22316072 PMCID: PMC3348035 DOI: 10.1186/1751-0147-54-11] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 02/08/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) in animals is a rare finding in Sweden. In horses, MRSA was first detected in a screening survey in 2007. In 2008, six clinical cases occurred in an equine hospital, indicating an outbreak. METHOD All MRSA isolates detected, 11 spa-type t011 and one t064 (n = 12), in infected horses (n = 10) and screening of horses (n = 2) in Sweden from December 2007 to March 2010 were retrospectively analysed with pulsed-field gel electrophoresis (PFGE) using Cfr9I and ApaI restriction enzymes, to study relationship between the isolates. Medical records of infected horses and outbreak investigation notes were scrutinised to monitor the clinical outcome and other aspects of the outbreak. RESULTS Eight of the 10 infected horses were linked to one equine hospital and two to another hospital in the same region. The six horses infected with MRSA in 2008 underwent surgery during the period 22 May-7 July in one of the hospitals. Four more infections linked to the two hospitals were notified between 2009 and March 2010.Nine of the 11 spa-type t011 isolates had identical Cfr9I and ApaI PFGE pattern. All six infected horses from 2008 presented with this MRSA. Two t011 isolates differed in one and two bands, respectively, in PFGE.Nine horses suffered from surgical site infections (SSI). No antimicrobials were used following the MRSA diagnosis and the infections cleared. The time from surgery to MRSA diagnosis differed greatly between the horses (range 15-52 days). CONCLUSIONS Association in time and space of six horses infected with an identical MRSA strain of spa-type t011 confirmed an outbreak. Two isolates found in 2009 and 2010 in the outbreak hospital were closely related to the outbreak strain, indicating one circulating strain. Both spa-type t011 and t064 have been reported in horses in Europe prior to these findings. The observation that the infections cleared although antimicrobials were not used is encouraging for future prudent use of antimicrobials. The time from surgery to bacteriological diagnosis was not acceptable in most cases, as contagious spread was a risk. Sampling when symptoms of infection are noticed and accurate analysis are thus important.
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Affiliation(s)
- Karin Bergström
- Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
- Department of Animal Health and Antimicrobial Strategies, SVA, 750 89 Uppsala, Sweden
| | - Anna Aspan
- Department of Bacteriology, SVA, 751 89 Uppsala, Sweden
| | - Annica Landén
- Department of Animal Health and Antimicrobial Strategies, SVA, 750 89 Uppsala, Sweden
| | - Christopher Johnston
- Equine Clinics, University Animal Hospital, University of Agricultural Sciences, 750 07 Uppsala, Sweden
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Wide host range and strong lytic activity of Staphylococcus aureus lytic phage Stau2. Appl Environ Microbiol 2010; 77:756-61. [PMID: 21148689 DOI: 10.1128/aem.01848-10] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
In searching for an alternative antibacterial agent against multidrug-resistant Staphylococcus aureus, we have isolated and characterized a lytic staphylophage, Stau2. It possesses a double-stranded DNA genome estimated to be about 134.5 kb and a morphology resembling that of members of the family Myoviridae. With an estimated latency period of 25 min and a burst size of 100 PFU/infected cell, propagation of Stau2 in liquid culture gave a lysate of ca. 6 × 10(10) PFU/ml. It was stable at pH 5 to 13 in normal saline at room temperature for at least 4 weeks and at -85°C for more than 2 years, while 1 × 10(9) out of 2 × 10(12) PFU/ml retained infectivity after 36 months at 4°C. Stau2 could lyse 80% of the S. aureus isolates (164/205) obtained from hospitals in Taiwan, with complete lysis of most of the isolates tested within 3 h; however, it was an S. aureus-specific phage because no lytic infection could be found in the coagulase-negative staphylococci tested. Its host range among S. aureus isolates was wider than that of polyvalent phage K (47%), which can also lyse many other staphylococcal species. Experiments with mice demonstrated that Stau2 could provide 100% protection from lethal infection when a multiplicity of infection of 10 was administered immediately after a challenge with S. aureus S23. Considering these results, Stau2 could be considered at least as a candidate for topical phage therapy or an additive in the food industry.
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Clonal dissemination of meticillin-resistant and vancomycin-intermediate Staphylococcus aureus in a Taiwanese hospital. Int J Antimicrob Agents 2010; 36:307-12. [DOI: 10.1016/j.ijantimicag.2010.06.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2010] [Revised: 06/14/2010] [Accepted: 06/14/2010] [Indexed: 11/18/2022]
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Lin SH, Liao WH, Lai CC, Liao CH, Tan CK, Wang CY, Huang YT, Hsueh PR. Risk factors for mortality in patients with persistent methicillin-resistant Staphylococcus aureus bacteraemia in a tertiary care hospital in Taiwan. J Antimicrob Chemother 2010; 65:1792-8. [DOI: 10.1093/jac/dkq188] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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In vitro activity of ceftobiprole, linezolid, tigecycline, and 23 other antimicrobial agents against Staphylococcus aureus isolates in China. Diagn Microbiol Infect Dis 2008; 62:226-9. [DOI: 10.1016/j.diagmicrobio.2008.06.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 05/27/2008] [Accepted: 06/01/2008] [Indexed: 11/18/2022]
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Hsu CC, Lin YE, Chen YS, Liu YC, Muder RR. Validation study of artificial neural network models for prediction of methicillin-resistant Staphylococcus aureus carriage. Infect Control Hosp Epidemiol 2008; 29:607-14. [PMID: 18549315 DOI: 10.1086/588588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Use of active surveillance cultures for methicillin-resistant Staphylococcus aureus (MRSA) for all patients admitted to the intensive care unit has been shown to reduce nosocomial transmission. However, the cost-effectiveness and the utility of implementing use of active surveillance cultures nationwide remain controversial. We sought to develop an artificial neural network (ANN) model that would predict the likelihood of MRSA colonization. SETTING Two acute care hospitals, one in Pittsburgh (hospital A) and one in Kaohsiung, Taiwan (hospital B). METHODS Nasal cultures were performed for all patients admitted to the hospitals. A total of 46 potential risk factors in hospital A and 86 potential risk factors in hospital B associated with MRSA colonization were assessed. Culture results were obtained; 75% of the data were used for training our ANN model, and the remaining 25% were used for validating our ANN model. The culture results were the "gold standard" for determining the accuracy of the model predictions. RESULTS The ANN model predictions were accurate 95.2% of the time for hospital A (sensitivity, 94.3%; specificity, 96.0%) and 94.2% of the time for hospital B (sensitivity, 96.6%; specificity, 91.8%), integrating all potential risk factors into the model. Only 17 potential risk factors were needed for the hospital A ANN model (accuracy, 90.9%; sensitivity, 98.5%; specificity, 83.4%), and only 20 potential risk factors were needed for the hospital B ANN model (accuracy, 90.5%; sensitivity, 96.6%; specificity, 84.3%), if the minimal risk factor method was used. Cross-validation analysis showed an average accuracy of 85.6% (sensitivity, 91.3%; specificity, 80.0%). CONCLUSION Our ANN model can be used to predict with an accuracy of more than 90% which patients carry MRSA. The false-negative rates were significantly lower than the false-positive rates in the ANN predictions, which can serve as a safety buffer in case of patient misclassification.
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Affiliation(s)
- Cheng-Chuan Hsu
- Graduate Institute of Environmental Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
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Huang YT, Liao CH, Teng LJ, Hsueh PR. Comparative bactericidal activities of daptomycin, glycopeptides, linezolid and tigecycline against blood isolates of Gram-positive bacteria in Taiwan. Clin Microbiol Infect 2008; 14:124-9. [DOI: 10.1111/j.1469-0691.2007.01888.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brady AJ, Kearney P, Tunney MM. Comparative evaluation of 2,3-bis [2-methyloxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxanilide (XTT) and 2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2, 4-disulfophenyl)-2H-tetrazolium, monosodium salt (WST-8) rapid colorimetric assays for antimicrobial susceptibility testing of staphylococci and ESBL-producing clinical isolates. J Microbiol Methods 2007; 71:305-11. [DOI: 10.1016/j.mimet.2007.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 09/20/2007] [Indexed: 10/22/2022]
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Arslan S, Ozkardes F. Slime production and antibiotic susceptibility in staphylococci isolated from clinical samples. Mem Inst Oswaldo Cruz 2007; 102:29-33. [PMID: 17293995 DOI: 10.1590/s0074-02762007000100004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2006] [Accepted: 11/29/2006] [Indexed: 11/22/2022] Open
Abstract
A total of 187 isolates from several clinical specimens were identified to species level as 129 Staphylococcus aureus strains and 58 coagulase-negative staphylococci (CNS) strains by the API Staph System (Biomerieux). Slime production was detected both by the conventional Christensen's method as well as by the Congo red agar method. Seventy-two strains of staphylococci isolates (38.5%) were found to be slime producers by Christensen's test tube method whereas 58 strains (31%) were slime positive with Congo red agar method. There was no statistically significant difference between the two methods for the detection of slime production (P > 0.05). Susceptibility of isolates against antimicrobial agents was tested by the disk diffusion method. Staphylococcal species had resistance to one or more antibiotics. Among the various antimicrobial agents, oxacillin (71.1%) and erythromycin (47.1%) showed higher resistance than most of the agents used against all isolates. Oxacillin resistant S. aureus (ORSA) and oxacillin resistant coagulase-negative staphylococci (ORCNS), 97 (75.2%) and 36 (62.1%) respectively were frequently observed in strains isolated from clinical materials. Among the ORSA strains, two strains were resistant to vancomycin. Moreover, 96 (74.4%) of 129 S. aureus strains were positive for beta-lactamase enzyme. However, 78 (81.25%) of 96 beta-lactamase positive S. aureus strains were beta-lactamase positive ORSA isolates, but none of them had vancomycin resistance.
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Affiliation(s)
- Seza Arslan
- Department of Biology, Faculty of Arts and Sciences, Abant Izzet Baysal University, Turkey.
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Huang YH, Tseng SP, Hu JM, Tsai JC, Hsueh PR, Teng LJ. Clonal spread of SCCmec type IV methicillin-resistant Staphylococcus aureus between community and hospital. Clin Microbiol Infect 2007; 13:717-24. [PMID: 17403129 DOI: 10.1111/j.1469-0691.2007.01718.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The staphylococcal chromosome cassette (SCC)mec types of 382 hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) isolates in Taiwan were analysed over a 7-year period (1999-2005). There was an abrupt increase in SCCmec type IV in HA-MRSA during 2005. The molecular epidemiology of a subset (n = 69) of HA-MRSA isolates with SCCmec types III, IV or V was characterised and compared with that of community-acquired MRSA (CA-MRSA) (n = 26, collected during 2005). Pulsed-field gel electrophoresis revealed three major pulsotypes (A, B and C) and 15 minor clones. Pulsotypes B and C, which contained isolates carrying SCCmec types IV and V, respectively, included both CA-MRSA and HA-MRSA isolates. Among 24 toxin genes analysed, five genes had significant differential distribution between CA-MRSA and SCCmec type III HA-MRSA. Furthermore, among SCCmec type IV isolates, the seb gene was detected more commonly in HA-MRSA. Analysis of representative members of the three major pulsotypes by multilocus sequence typing revealed two sequence types (STs), namely ST239 (SCCmecIII) and ST59 (SCCmecIV or SCCmecV). This suggests that ST59:SCCmecIV, which is usually community-acquired, has become an important nosocomial pathogen in the hospital studied.
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Affiliation(s)
- Y H Huang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
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Abstract
The prevalence of antimicrobial resistance for both Gram-positive and Gram-negative pathogens is escalating worldwide. Outbreaks of community- and hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) are being reported more frequently. Although antimicrobial resistance is well recognised as a global problem, decisions about appropriate intervention and treatment should be made at the level of the local hospital or healthcare system. Thus, local surveillance to identify prevalent pathogens, detect bacterial resistance and identify particular strains is necessary for selecting optimal treatment regimens. In addition, bactericidal antimicrobial agents with novel mechanisms of action and activity against multidrug-resistant bacteria, together with improved infection control measures, are needed to address this growing medical problem more effectively.
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Affiliation(s)
- F W Goldstein
- Fondation Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75014 Paris, France.
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Gould IM, MacKenzie FM, MacLennan G, Pacitti D, Watson EJ, Noble DW. Topical antimicrobials in combination with admission screening and barrier precautions to control endemic methicillin-resistant Staphylococcus aureus in an Intensive Care Unit. Int J Antimicrob Agents 2007; 29:536-43. [PMID: 17337163 DOI: 10.1016/j.ijantimicag.2006.12.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Accepted: 12/23/2006] [Indexed: 11/20/2022]
Abstract
We aimed to establish whether screening for methicillin-resistant Staphylococcus aureus (MRSA) and body decontamination upon admission to an Intensive Care Unit (ICU), in combination with barrier precautions, reduced rates of MRSA infection acquired on the unit. This was an interrupted time series study employing segmented regression analysis of data collected for all patients admitted to a 16-bed adult ICU over 48 months. Before the intervention (24 months; 1232 patients (44% female)), MRSA was sought from clinical cultures only and positive patients were barrier nursed in isolation. During the intervention (24 months; 1421 patients (54% female)), all ICU patients were screened for MRSA on admission and were barrier nursed in single rooms when established as MRSA-positive; all were given topical nasal anti-MRSA preparations and daily bed baths with 4% chlorhexidine throughout their stay. Changes in the proportion of patients colonised or infected with MRSA in the ICU were assessed. Before the intervention, 193 new MRSA cases (16%) were identified from 1232 ICU admissions; during the intervention, this was reduced to 92 cases (6%) of 1421 admissions. By time series regression analysis, the proportion of patients with MRSA decreased by 11.38% from ca. 15% to ca. 5% (ca. three-fold reduction) (95% confidence interval 3.5-19.3%; P=0.005). Thus, treatment of 11 patients prevented 1 clinical case of MRSA. Mean length of stay decreased significantly (P<0.001). Although MRSA and methicillin-susceptible S. aureus bacteraemia rates dropped, the changes detected were not statistically significant. The proportion of patients with coagulase-negative staphylococcal bacteraemia decreased significantly (P<0.001) and the trend changed from increasing to decreasing (P<0.001), as did the trend in glycopeptide use (P=0.014). An inexpensive and easy to implement intervention to control MRSA in the ICU was highly successful without compromising antimicrobial susceptibility.
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Affiliation(s)
- Ian M Gould
- Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK.
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Orrett FA, Land M. Methicillin-resistant Staphylococcus aureus prevalence: current susceptibility patterns in Trinidad. BMC Infect Dis 2006; 6:83. [PMID: 16677377 PMCID: PMC1468416 DOI: 10.1186/1471-2334-6-83] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Accepted: 05/05/2006] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) has become one of the most widespread causes of nosocomial infections worldwide. Recently, reports have emerged that S. aureus strains recovered from community-acquired infections are also methicillin-resistant. This study was undertaken to analyze the prevalence of methicillin resistance among isolates at a regional hospital in Trinidad, and document the current resistance profile of MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) to the commonly used anti-staphylococcal agents. METHODS Over a 6-year period we analyzed 2430 isolates of S. aureus strains recovered from various clinical sources, from hospital and community practices. Antimicrobial susceptibility testing was done according to guideline recommendations of the National Committee for Clinical Laboratory Standards. RESULTS The prevalence of MRSA from surgical/burn wounds, urine and pus/abscess were 60.1%, 15.5% and 6.6%, respectively. The major sources of MSSA were surgical/burn wounds, pus/abscess and upper respiratory tract specimens with rates of 32.9%, 17.1% and 14.3%, respectively. The greatest prevalence of resistance of MRSA was seen for erythromycin (86.7%), and clindamycin (75.3%). Resistance rates among MSSA were highest for ampicillin (70%). Resistance rates for tetracycline were similar among both MRSA (78.7%) and MSSA (73.5%). The MRSA recovery rates from nosocomial sources (20.8%) was significantly higher than that of previous years (12.5%) (p < 0.001), whereas rates among community isolates were relatively similar for the same period (4.1% versus 8.1%). CONCLUSION The prevalence of MRSA in the hospital increased from 12.5% in 1999 to 20.8% in 2004. Most isolates were associated with infected surgical/burn wounds which may have become infected via the hands of HCPs during dressing exercises. Infection control measures aimed at the proper hand hygiene procedures may interrupt the spread of MRSA. HCPs may also be carriers of MRSA in their anterior nares. Surveillance cultures of both patients and HCPs may help to identify carriers who would be offered antibiotics to eradicate the organisms. Most MRSA are resistant to several non-beta-lactam antibiotics. Frequent monitoring of susceptibility patterns of MRSA and the formulation of a definite antibiotic policy maybe helpful in decreasing the incidence of MRSA infection.
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Affiliation(s)
- Fitzroy A Orrett
- The Department of Paraclinical Sciences, Faculty of Medical Sciences, University of the West Indies, Eric Williams Medical Sciences, Complex Champs Fleurs, Trinidad and Tobago, West Indies
| | - Michael Land
- Department of Biological, Sciences, Northwestern State University, Natchitoches, LA 71497, USA
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Cheng NC, Hsueh PR, Liu YC, Shyr JM, Huang WK, Teng LJ, Liu CY. In vitro activities of tigecycline, ertapenem, isepamicin, and other antimicrobial agents against clinically isolated organisms in Taiwan. Microb Drug Resist 2006; 11:330-41. [PMID: 16359192 DOI: 10.1089/mdr.2005.11.330] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study evaluated the in vitro activities of tigecycline, ertapenem, isepamicin, and other comparators against 861 bacterial isolates recovered from patients treated in three major teaching hospitals in 2003. MICs to antimicrobial agents were determined by the agar dilution method. High rates of oxacillin resistance (58%) in Staphylococcus aureus (60 isolates), and vancomycin resistance (21%) and quinupristin-dalfopristin non-susceptibility (39%) in Enterococcus faecium (34 isolates) were found. Carbapenems had excellent in vitro activities (>or=98% susceptibility) against the 419 isolates of Enterobacteriaceae, with the MIC(50) and MIC(90) of imipenem, meropenem, and ertapenem being 0.25 and 4 mg/L, 0.03 and 0.12 mg/L, and 0.03 and 0.5 mg/L, respectively. For, Pseudomonas aeruginosa (74 isolates) and Burkholderia cepacia (21 isolates), meropenem (MIC(90), 0.25, 2, and 4 mg/L, respectively) had better in vitro activities than imipenem (MIC(90), 8, 4, and 32 mg/L, respectively) and ertapenem (MIC(90), 0.5, >32, and 32 mg/L, respectively). Isepamicin had a similar activity with amikacin against all Enterobacteriaceae, Pseudomonas aeruginosa, B. cepacia, and Acinetobacter baumannii, except for C. freundii isolates in which isepamicin had an eight-fold activity better than amikacin. Tigecycline had excellent in vitro activities against all isolates tested (MIC(90), <or=1 mg/L) including 14 pandrugresistant A. baumannii isolates (MICs, 1-4 mg/L), except for Proteus mirabilis (59 isolates; MIC(90), 8 mg/L), Bacteroides fragilis (60 isolates; MIC(90), 8 mg/L), P. aeruginosa (MIC(90), 16 mg/L), and B. cepacia (21 isolates; MIC(90), 16 mg/L). Tigecycline, carbapenems, and isepamicin exhibited better or comparable in vitro activities against a wide spectrum of commonly encountered bacteria than other comparator antimicrobials and may represent therapeutic options for infections due to multidrug-resistant pathogens.
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Affiliation(s)
- Nai-Cheng Cheng
- Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Fang CT, Shau WY, Hsueh PR, Chen YC, Wang JT, Hung CC, Huang LYL, Chang SC. Early empirical glycopeptide therapy for patients with methicillin-resistant Staphylococcus aureus bacteraemia: impact on the outcome. J Antimicrob Chemother 2006; 57:511-9. [PMID: 16443700 DOI: 10.1093/jac/dkl006] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To evaluate whether appropriate early empirical glycopeptide therapy improves outcomes of patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. METHODS We retrospectively collected the data for all adult patients with confirmed MRSA bacteraemia diagnosed and treated at National Taiwan University Hospital during the period 1 April 1997-31 March 2001, and followed their survival up to three years. The main outcome measures were MRSA-related death and all-cause mortality. RESULTS There were 77 MRSA-related deaths among 162 patients. There was no statistically significant difference in MRSA-related deaths between patients receiving glycopeptides before or within 48 h after blood culture (n = 43) (55%, 18/33, non-septic shock group; 90%, 9/10, septic shock group) or those whose glycopeptide therapy was begun more than 48 h after blood culture (n = 119) (37%, 40/107, non-septic shock group; 83%, 10/12, septic shock group) (P = 0.11 and 1.00, respectively). The outcome measure of all-cause mortality from 30 days to 3 years yields similar results. Multivariate logistic regression analysis and Cox analysis showed that the length of delay (daily increment) between blood culture sampling and start of glycopeptide therapy did not have a statistically significant impact on MRSA-related death or all-cause 30-day mortality after adjusting for the effect of other variables [adjusted odds ratio 0.99, 95% confidence interval (95% CI) 0.88-1.12; adjusted hazard ratio 0.87, 95% CI 0.74-1.02, respectively). CONCLUSIONS The hypothesis that earlier empirical use of glycopeptide therapy reduces mortality in patients with hospital-acquired MRSA bacteraemia was not supported.
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Affiliation(s)
- Chi-Tai Fang
- Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) strains cause serious nosocomial infections all over the world. Overall, approximately 20% of S. aureus isolates in Europe are reported as methicillin-resistant, whereas in US hospitals the prevalence ranges from 33% to 55%. The past few years have also witnessed an increase in life-threatening community-acquired infections caused by Panton-Valentine leukocidin-producing MRSA in the USA. Increasing use of glycopeptides for treatment of community-acquired MRSA infections may result in higher rates of glycopeptide resistance. Since 1996, five vancomycin-intermediate S. aureus (VISA; vancomycin MIC = 8-16 mg/L) strains have been identified in Europe, Asia and the USA, and vancomycin-resistant S. aureus (VRSA) strains (vancomycin MIC > or = 32 mg/L) have also been reported in the USA between 2002 and 2005. Most infections with VISA and VRSA have occurred in a setting of heavy prior use of glycopeptides and other antimicrobial agents. Emergence of reduced vancomycin susceptibility in S. aureus increases the possibility that currently available antimicrobial agents may become ineffective for treating systemic infections, especially bacteraemia, endocarditis and osteomyelitis. Ceftobiprole is a novel broad-spectrum cephalosporin with expanded activity against Gram-positive bacteria, including MRSA. Ceftobiprole is refractory to the development of endogenous resistance both in vitro and in vivo. The additional activity of ceftobiprole against MRSA strains makes it a potentially important addition to currently available agents.
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Affiliation(s)
- P C Appelbaum
- Pennsylvania State College of Medicine, Hershey, Pennsylvania 17033-0850, USA.
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Weese J, Rousseau J, Willey B, Archambault M, McGeer A, Low D. Methicillin-ResistantStaphylococcus aureusin Horses at a Veterinary Teaching Hospital: Frequency, Characterization, and Association with Clinical Disease. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb02839.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hsueh PR, Chen WH, Teng LJ, Luh KT. Nosocomial infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci at a university hospital in Taiwan from 1991 to 2003: resistance trends, antibiotic usage and in vitro activities of newer antimicrobial agents. Int J Antimicrob Agents 2005; 26:43-9. [PMID: 15975769 PMCID: PMC7126964 DOI: 10.1016/j.ijantimicag.2005.04.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Accepted: 04/06/2005] [Indexed: 11/10/2022]
Abstract
A rapid increase of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection (from 39% in 1991 to 75% in 2003) and vancomycin-resistant enterococci (VRE) (from 1.2% in 1996 to 6.1% in 2003) at a university hospital in Taiwan was found. The noticeable rise of MRSA and VRE was significantly correlated with the increased consumption of glycopeptides, β-lactam–β-lactamase inhibitor combinations, extended-spectrum cephalosporins, carbapenems and fluoroquinolones (Pearson's correlation coefficient, P < 0.05). Minimum inhibitory concentrations (MICs) of 100 non-duplicate blood isolates of MRSA (in 2003) and of 25 non-duplicate isolates of vancomycin-resistant Enterococcus faecalis and 172 vancomycin-resistant Enterococcus faecium (in 1996–2003) causing nosocomial infection recovered from various clinical specimens of patients treated at the hospital to nine antimicrobial agents were determined by the agar dilution method. All of these isolates were susceptible to linezolid and were inhibited by 0.5 mg/L of tigecycline, and all MRSA isolates were inhibited by daptomycin 1 mg/L, including two isolates of MRSA with heteroresistance to vancomycin. Daptomycin had two-fold better activity against vancomycin-resistant E. faecalis (MIC90, 2 mg/L) than against vancomycin-resistant E. faecium (MIC90, 4 mg/L). Decreased susceptibilities of vancomycin-resistant E. faecium and MRSA to quinupristin/dalfopristin (non-susceptibility 25% and 8%, respectively) were found. Telithromycin had poor activity against the isolates tested (MIC90, 8 mg/L). Linezolid, daptomycin and tigecycline may represent therapeutic options for infections caused by these resistant Gram-positive organisms.
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Affiliation(s)
- Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.
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Wang JL, Tseng SP, Hsueh PR, Hiramatsu K. Vancomycin heteroresistance in methicillin-resistant Staphylococcus aureus, Taiwan. Emerg Infect Dis 2004; 10:1702-4. [PMID: 15503416 PMCID: PMC3320303 DOI: 10.3201/eid1009.040239] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | | | - Po-Ren Hsueh
- National Taiwan University Hospital, Taipei, Taiwan
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