Predominant Staphylococcus aureus isolated from various skin diseases

Global Antimicrobial Susceptibility Patterns of Staphylococcus aureus in Atopic Dermatitis: A Systematic Review and Meta-Analysis

Importance

Individuals with atopic dermatitis are frequently colonized and infected with Staphylococcus aureus. Empirical antibiotic therapy for individuals with atopic dermatitis is common, but data about the antimicrobial susceptibility profiles of S aureus strains isolated from these individuals are scarce for those living in particular geographic areas.

Objective

To determine the antimicrobial susceptibility of S aureus from individuals with atopic dermatitis and analyze differences according to the income level of the country of origin and the data collection period.

Data Sources

A meta-analysis of the literature was performed from the inception of the included databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane) to June 20, 2023, using predetermined Medical Subject Headings.

Study Selection

Studies were included if they reported antibiotic susceptibility profiles of 1 or more S aureus cutaneous isolates from individuals with atopic dermatitis. Articles written in English, Spanish, French, or German were included.

Data Extraction and Synthesis

Working in pairs, 6 of the authors conducted the data extraction. The guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed.

Main Outcomes and Measures

The outcome of interest was antimicrobial susceptibility.

Results

A total of 61 studies reported 4091 S aureus isolates from individuals with atopic dermatitis. For 4 of the 11 commonly used antibiotics (36.4%), antimicrobial susceptibility was 85% or less, including for methicillin (binomial proportion, 0.85 [95% CI, 0.76-0.91]), erythromycin (binomial proportion, 0.73 [95% CI, 0.61-0.83]), fusidic acid (binomial proportion, 0.80 [95% CI, 0.62-0.91]), and clindamycin (binomial proportion, 0.79 [95% CI, 0.65-0.89]). Most studies (46; 75.4%) were conducted in high-income countries. Antimicrobial susceptibility to erythromycin, methicillin, and trimethoprim and sulfamethoxazole was significantly lower in lower middle-income countries and upper middle-income countries. Regarding the temporal trends, 33 studies (54.1%) reported data collected from 1998 to 2010. Antimicrobial susceptibility patterns have not changed over time.

Conclusions and Relevance

In this systematic review and meta-analysis, antimicrobial susceptibility of S aureus to β-lactams, erythromycin, clindamycin, and fusidic acid may be suboptimal for empirical use in individuals with atopic dermatitis. Significant differences in antimicrobial susceptibility patterns were found in high-income countries and in lower middle-income countries and upper middle-income countries for some antibiotics.

Potential Therapeutic Skin Microbiomes Suppressing Staphylococcus aureus-Derived Immune Responses and Upregulating Skin Barrier Function-Related Genes via the AhR Signaling Pathway

Disruption of the skin microbial balance can exacerbate certain skin diseases and affect prognosis and treatment. Changes in the distribution and prevalence of certain microbial species on the skin, such as Staphylococcus aureus (SA), can impact the development of severe atopic dermatitis (AD) or psoriasis (Pso). A dysfunctional skin barrier develops in AD and Pso due to SA colonization, resulting in keratinization and chronic or progressive chronic inflammation. Disruption of the skin barrier following SA colonization can elevate the production of T helper 2 (Th2)-derived cytokines, which can cause an imbalance in Th1, Th2, and Th17 cells. This study examined the ability of potential therapeutic skin microbiomes, such as Cutibacterium avidum R-CH3 and Staphylococcus hominis R9, to inhibit SA biofilm formation and restore skin barrier function-related genes through the activation of the aryl hydrocarbon receptor (AhR) and the nuclear factor erythroid-2-related factor 2 (Nrf2) downstream target. We observed that IL-4/IL-13-induced downregulation of FLG, LOR, and IVL induced by SA colonization could be reversed by dual AhR/Nrf2 activation. Further, OVOL1 expression may be modulated by functional microbiomes via dual AhR/Nrf2 activation. Our results suggest that our potential therapeutic skin microbiomes can prevent SA-derived Th2-biased skin barrier disruption via IL-13 and IL-4-dependent FLG deregulation, STAT3 activation, and AhR-mediated STAT6 expression.

Antimicrobial activity of Centella asiatica and Gigantochloa apus

OBJECTIVES

Antibiotic treatments can create multi-drug resistance among several pathogens. There is a need for an antibiotic alternative to overcome this problem. In Indonesia, Centella asiatica (Asiatic pennywort) and Gigantochloa apus (string bamboo) are two common medicinal plants used to treat tuberculosis, diarrhea, and other symptoms. This study was done to compare the antimicrobial activity of C. asiatica and G. apus against five pathogenic bacteria, i.e., Mycobacterium tuberculosis H37Rv strain, Escherichia coli, Staphylococcus aureus, Bacillus subtilis, and Salmonella typhi.

METHODS

The ethanol extracts of C. asiatica, and G. apus shoot were obtained by using speed extractor, pressure, and temperature extraction. The phytochemical contents of each extract were screened. The ethanol extract's antimycobacterial activity was determined using Lowenstein Jensen (LJ) medium and antibacterial activity was determined using Kirby-Bauer methods on Mueller Hinton agar (MHA).

RESULTS

The phytochemical analysis showed that G. apus extract contains alkaloids and tannins, whereas C. asiatica extract contains flavonoids, alkaloids, saponins, and tannins. This study showed that G. apus inhibited the growth of M. tuberculosis H37Rv strain and S. typhi. C. asiatica showed antimicrobial activity against all pathogenic bacteria tested, except B. subtilis.

CONCLUSIONS

Both medicinal plants extract can inhibit the growth of five pathogenic bacteria tested, thus, have the potential as an alternative treatment, or complementary, to treat the pathogenic bacterial infection.

Influence of Extraction Solvent on the Phenolic Profile and Bioactivity of Two Achillea Species

The phenolic composition, as well as the antioxidant and antimicrobial activities of two poorly investigated Achillea species, Achillea lingulata Waldst. and the endemic Achillea abrotanoides Vis., were studied. To obtain a more detailed phytochemical profile, four solvents with different polarities were used for the preparation of the plant extracts whose phenolic composition was analyzed using UHPLC-MS/MS (ultra-high performance liquid chromatography-tandem mass spectrometry). The results indicate that both of the investigated Achillea species are very rich in both phenolic acids and flavonoids, but that their profiles differ significantly. Chloroform extracts from both species had the highest yields and were the most chemically versatile. The majority of the examined extracts showed antimicrobial activity, while ethanolic extracts from both species were potent against all tested microorganisms. Furthermore, the antioxidant activity of the extracts was evaluated. It was found that the ethanolic extracts possessed the strongest antioxidant activities, although these extracts did not contain the highest amounts of detected phenolic compounds. In addition, several representatives of phenolic compounds were also assayed for these biological activities. Results suggest that ethanol is a sufficient solvent for the isolation of biologically active compounds from both Achillea species. Moreover, it was shown that the flavonoids naringenin and morin are mainly responsible for these antimicrobial activities, while caffeic, salicylic, chlorogenic, p-coumaric, p-hydroxybenzoic, and rosmarinic acid are responsible for the antioxidant activities of the Achillea extracts.

Chemical Characterization and Antibacterial Activity of Essential Oil of Medicinal Plants from Eastern Serbia

The objective of this study was to evaluate wild growing Satureja kitaibelii, Thymus serpyllum, Origanum vulgare, Achillea millefolium and Achillea clypeolata with respect to their essential oil (EO) content, composition and antimicrobial activity. The five species were collected at Mt. Rtanj and the village of Sesalac, Eastern Serbia. The main EO constituents of Lamiaceae plants were p-cymene (24.4%), geraniol (63.4%) and germacrene D (21.5%) in Satureja kitaibelii, Thymus serpyllum and Origanum vulgare ssp. vulgare, respectively. A. millefolium EO had multiple constituents with major ones being camphor (9.8%), caryophyllene oxide (6.5%), terpinen-4-ol (6.3%) and 1,8-cineole (5.6%), while the main EO constituents of A. clypeolata were 1,8-cineole (45.1%) and camphor (18.2%). Antimicrobial testing of the EO showed that Staphylococcus aureus (Gram-positive) was more sensitive to all of the tested EOs than Escherichia coli (Gram-negative). S. kitaibelii EO showed the highest antimicrobial activity against both tested bacterial strains. This is the first study to characterize the EO composition and antimicrobial activity of these five medicinal species from Eastern Serbia in comparison with comprehensive literature data. The results can be utilized by the perfumery, cosmetics, food and pharmaceutical industries, but also for healing purposes in self-medication.

The Antimicrobial Activity of Herbal Soaps Against Selected Human Pathogens

Antioxidant substances are used not only in food and beverages, but also in soap formulations which are known to be effective in skin cleansing, and are also used as ingredients in the detergent and cosmetics market. The aim of this study was to determine the bactericidal effects of plain and antibacterial soaps containing Punica granatum flower (PGF), Carrot seed (CS, Daucus carota), Lavender (LV, Lavandula officinalis L.) extracts which are known for their high antioxidant activity. Antioxidant properties were determined by using the cupric ion reducing antioxidant capacity (CUPRAC) and Ferric reducing antioxidant power (FRAP) for all soap samples. The effectiveness of soaps which are prepared using PGF, CS and LV extracts on gram positive and gram negative bacteria was investigated. From the findings obtained, all plant extracted soaps had antibacterial activity and it was determined that soap containing carrot extract caused a significant decrease in bacterial levels compared to other soaps. As a result, it has been concluded that the use of antimicrobial and antioxidant compounds as soap formulation components is extremely important for increasing the effectiveness of soap against bacteria.

The effect of clary sage oil on staphylococci responsible for wound infections

INTRODUCTION

The spreading of bacterial antibiotic resistance among clinical strains of pathogenic bacteria has made investigators to search for other active antibacterial agents which could provide a valuable complement to the existing therapies.

AIM

To determine the antibacterial activity of clary sage oil (Salvia sclarea L.) against Staphylococcus clinical strains which were isolated from patients with wound infections.

MATERIAL AND METHODS

A comprehensive evaluation of Staphylococcus clinical strain resistance to antibiotics was performed. The constituents of clary sage oil were assayed by GC-FID-MS analysis. The minimal inhibitory concentration (MIC) of the tested essential oil against staphylococci by the micro-dilution broth method was determined.

RESULTS

The clary sage oil was active against Staphylococcus aureus, S. epidermidis and S. xylosus with MIC values ranging from 3.75 to 7.00 µl/ml.

CONCLUSIONS

The results of the in vitro tests encourage to use formulations containing sage oil as the active natural antimicrobial agent. Because of its antimicrobial properties clary sage oil may be applied to treat wounds and skin infections.

In vitro activity of tea-tree oil against clinical skin isolates of meticillin-resistant and -sensitive Staphylococcus aureus and coagulase-negative staphylococci growing planktonically and as biofilms

The susceptibility of Staphylococcus aureus [meticillin-resistant (MRSA) and meticillin-sensitive (MSSA)] and coagulase-negative staphylococci (CoNS), which respectively form part of the transient and commensal skin flora, to tea-tree oil (TTO) was compared using broth microdilution and quantitative in vitro time–kill test methods. MRSA and MSSA isolates were significantly less susceptible than CoNS isolates, as measured by both MIC and minimum bactericidal concentration. A significant decrease in the mean viable count of all isolates in comparison with the control was seen at each time interval in time–kill assays. However, the only significant difference in the overall mean log10 reduction in viable count between the groups of isolates was between CoNS and MSSA at 3 h, with CoNS isolates demonstrating a significantly lower mean reduction. To provide a better simulation of in vivo conditions on the skin, where bacteria are reported to grow as microcolonies encased in glycocalyx, the bactericidal activity of TTO against isolates grown as biofilms was also compared. Biofilms formed by MSSA and MRSA isolates were completely eradicated following exposure to 5 % TTO for 1 h. In contrast, of the biofilms formed by the nine CoNS isolates tested, only five were completely killed, although a reduction in viable count was apparent for the other four isolates. These results suggest that TTO exerts a greater bactericidal activity against biofilm-grown MRSA and MSSA isolates than against some biofilm-grown CoNS isolates.

Comparative susceptibility of resident and transient hand bacteria to para-chloro-meta-xylenol and triclosan

AIMS

To determine the susceptibility of planktonic and biofilm-grown strains of resident and transient skin bacteria to the liquid hand soap biocides para-chloro-meta-xylenol (PCMX) and triclosan.

METHODS AND RESULTS

Freshly isolated hand bacteria were identified by partial 16S rRNA gene sequencing. Two resident and three transient strains, as well as four exogenous potential transient strains, were selected for biocide susceptibility testing. The minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of planktonic cells were determined. Resident and transient strains showed a range of susceptibilities to both biocides (PCMX, MIC 12.5-200 mg x l(-1), MBC 100-400 mg x l(-1); triclosan, MIC 0.6- > 40 mg x l(-1), MBC 1.3- > 40 mg x l(-1)). Strains were attached to polystyrene plates for 65 h in 96-well microtitre plates and challenged with biocide to determine the biofilm inhibitory concentration and biofilm eradicating concentration. For all strains tested, biofilms were two- to eightfold less susceptible than planktonic cells to PCMX.

CONCLUSIONS

Very few transients were detected on the hand. Transients were not more sensitive than residents to the biocides and susceptibility to PCMX and triclosan was strain dependent. Biofilm-grown strains were less susceptible to PCMX than planktonic cells.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study provides increased knowledge about the susceptibility of skin bacteria to biocides present in typical liquid antibacterial hand soaps and suggests that the concentration of biocide employed in such products is in excess of that required to kill the low numbers of transient bacteria typically found on skin.