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Kassa HY, Belete MA, Yihunie FB, Bayu A, Demlie TB, Tassew H. Occurrence of Methicillin-Resistant Staphylococcus aureus (MRSA) in Bovine Bulk Milk and Farm Workers in Smallholder Dairy Farming Systems in Northwestern Ethiopia. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2024; 15:71-80. [PMID: 38496263 PMCID: PMC10942014 DOI: 10.2147/vmrr.s454193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
Background and Purpose Staphylococcus aureus is a common pathogen responsible for causing various human and animal infections and is well known for its ability to develop resistance to multiple antibiotics. This study aimed to evaluate the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) in bulk milk and dairy farms in northwestern Ethiopia and to determine their phenotypic and genotypic antimicrobial susceptibility patterns. Methods We collected 50 bulk milk samples from 50 dairy farms and 50 hand swabs from dairy milkers. The cefoxitin disk diffusion test and PCR-based assays were used to identify MRSA isolates. In addition, cefoxitin-resistant isolates were tested for susceptibility to other antibiotics using the Kirby-Bauer disk diffusion method. Results The results showed that MRSA was detected in 8 samples: 6 from bulk milk samples (12%) and 2 from hand swabs (4%). All MRSA isolates exhibited a high resistance rate to penicillin (100%), followed by tetracycline (75%), ciprofloxacin (25%), chloramphenicol (25%), erythromycin (25%), gentamycin (12.5%), and trimethoprim-sulfamethoxazole (12.5%). Moreover, 72% of the isolates showed resistance to three or more antibiotic classes and were classified as multidrug-resistant. Conclusion This study identified methicillin-resistant Staphylococcus aureus and multidrug-resistant MRSA in bulk milk and dairy farms in northwestern Ethiopia. These findings highlight the potential risk of transmission of these antibiotic-resistant bacteria to humans and the need for improved antibiotic stewardship in the dairy sector using the One Health approach.
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Affiliation(s)
- Haregua Yesigat Kassa
- Department of Veterinary Laboratory Technology, College of Agriculture and Natural Resource, Debre Markos University, Debre Markos, Ethiopia
| | - Mequanint Addisu Belete
- Department of Veterinary Laboratory Technology, College of Agriculture and Natural Resource, Debre Markos University, Debre Markos, Ethiopia
| | | | - Azeb Bayu
- Department of Veterinary Science, College of Agriculture and Environmental Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tiliksew Bialfew Demlie
- Department of Veterinary Science, College of Agriculture and Environmental Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habtamu Tassew
- Department of Veterinary Science, College of Agriculture and Environmental Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Bale BI, Elebesunu EE, Manikavasagar P, Agwuna FO, Ogunkola IO, Sow AU, Lucero-Prisno DE. Antibiotic resistance in ocular bacterial infections: an integrative review of ophthalmic chloramphenicol. Trop Med Health 2023; 51:15. [PMID: 36895063 PMCID: PMC9996861 DOI: 10.1186/s41182-023-00496-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/01/2023] [Indexed: 03/11/2023] Open
Abstract
INTRODUCTION Chloramphenicol is a broad-spectrum antibiotic widely used for treating ophthalmic infections, but concerns about rising bacterial resistance to chloramphenicol have been observed due to its frequent use as an over-the-counter medication. This review assessed the common ophthalmic bacterial pathogens, their chloramphenicol resistance mechanisms, and rates of drug resistance. METHODS PubMed and Google Scholar databases were searched for relevant publications from the years 2000 to 2022, bordering on ophthalmic bacterial infections, chloramphenicol susceptibility profiles, and drug resistance mechanisms against chloramphenicol. A total of 53 journal publications met the inclusion criteria, with data on the antibiotic susceptibility profiles available in 44 of the reviewed studies, which were extracted and analyzed. RESULTS The mean resistance rates to chloramphenicol from antibiotic susceptibility profiles varied between 0% and 74.1%, with the majority of the studies (86.4%) showing chloramphenicol resistance rates below 50%, and more than half (23 out of 44) of the studies showed resistance rates lower than 20%. The majority of the publications (n = 27; 61.4%) were from developed nations, compared to developing nations (n = 14; 31.8%), while a fraction (n = 3; 6.8%) of the studies were regional cohort studies in Europe, with no country-specific drug resistance rates. No pattern of cumulative increase or decrease in ophthalmic bacterial resistance to chloramphenicol was observed. CONCLUSIONS Chloramphenicol is still active against ophthalmic bacterial infections and is suitable as a topical antibiotic for ophthalmic infections. However, concerns remain about the drug becoming unsuitable in the long run due to some proof of high drug resistance rates.
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Affiliation(s)
| | | | | | | | | | - Alhaji Umar Sow
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Reduced Posology of an Ophthalmic Hydrogel Containing Dexamethasone/Netilmicin to Prevent and Treat Ocular Inflammation After Cataract Surgery: Efficacy and Tolerability. Adv Ther 2022; 39:5474-5486. [PMID: 36203046 PMCID: PMC9618540 DOI: 10.1007/s12325-022-02295-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/03/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION To demonstrate efficacy and safety of an ophthalmic hydrogel formulation of netilmicin/dexamethasone, containing xanthan gum twice a day (b.i.d.) versus netilmicin/dexamethasone eye drops four times a day (q.i.d) to treat inflammation and prevention of infection after cataract surgery. METHODS Patients undergoing phacoemulsification with intraocular lens implantation (IOL) were randomised in two groups: group 1, twice daily (b.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) ophthalmic gel; group 2, four times daily (q.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) eye drops. Both treatments were administered for 14 days after surgery. Patients were evaluated before surgery, on the day of surgery and at 1, 7, 15 and 60 postoperative days. The primary efficacy endpoint was evaluation of cellularity and flare in the anterior chamber through slit-lamp biomicroscopy 7 days after surgery. Secondary endpoints included: presence of signs/symptoms of postoperative ocular inflammation and incidence of infection. RESULTS One hundred seventy-three patients were randomised and 168 were evaluable. Flare and cellularity were resolved at day 7 in 92.5% of patients and almost completely by day 15. In both intent to treat (ITT) and per-protocol (PP) populations, the efficacy analysis demonstrated that the gel formulation administered twice a day was non-inferior to the eye drops administered four times a day. For ITT analysis, the lower limit of the 97.5% confidence interval (- 0.0535) was greater than the non-inferiority limit of -0.10. For the PP analysis, the lower limit of the 97.5% confidence interval (- 0.0526) was greater than the non-inferiority limit of - 0.10. The patient's global tolerability and reported symptoms were similar between treatment groups. No microbial load and no safety events were observed. CONCLUSIONS Efficacy of the gel reduced posology (twice a day) is not inferior to four times a day eye drops. Both treatments were well tolerated and efficacious. The new reduced posology hydrogel formulation may improve patient compliance and quality of life. TRIAL REGISTRATION Eudract: 2016-0021138-63; ClinicalTrial.gov: NCT029738880.
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Caporossi A, Alessio G, Fasce F, Marchini G, Rapisarda A, Papa V. Short-Term Use of Dexamethasone/Netilmicin Fixed Combination in Controlling Ocular Inflammation After Uncomplicated Cataract Surgery. Clin Ophthalmol 2021; 15:2847-2854. [PMID: 34234407 PMCID: PMC8256380 DOI: 10.2147/opth.s311846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/04/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the short-term anti-inflammatory effect of dexamethasone/netilmicin fixed combination in the management of ocular inflammation after cataract surgery. Patients and Methods Open-label, randomized, active-controlled, clinical study conducted in 6 sites in Italy; 238 patients were randomized 2:1 to dexamethasone/netilmicin (dexa/net, n=158) or betamethasone/chloramphenicol (beta/chl, n=80). Treatment started the day of surgery and continued 4 times daily for 7 days. The primary efficacy parameter was the anterior chamber (AC) flare. The percentage of patients displaying none or mild (ie, only barely detectable) AC flare was defined as “efficacy rate”, whereas the percentage of patients showing a decrease of AC flare score from baseline was defined as “percentage of responders”. Additional parameters evaluated were AC cells, conjunctival hyperaemia, corneal and lid oedema, symptoms of ocular discomfort, visual acuity, and intraocular pressure. Dexa/net was considered effective if the efficacy rate was not inferior (by means of 97.5% confidence interval) to that of beta/chl. Results After 7 days of treatment, no AC flare was observed in 92.8% (dexa/net) and 92.3% (beta/chl) of patients, whereas no AC cells were observed in 91.5% (dexa/net) and 93.6% (beta/chl) of patients, respectively. The “efficacy rate” was 100% in both groups, whereas the “percentage of responders” was 94.1% in the dexa/net and 93.6% in the beta/chl group. The p-value to reject the null hypothesis of inferiority was <0.001. Other efficacy parameters confirmed both treatments as highly effective, despite their difference in steroid content (2 mg/mL for beta/chl vs 1 mg/mL for dexa/net). IOP and visual acuity at the end of the study were comparable. Two cases of allergic conjunctivitis were considered adverse events and were both related to dexa/net. Conclusion Short-term use of dexa/net fixed combination is safe and effective in the control of post-operative inflammation following uncomplicated cataract surgery.
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Affiliation(s)
- Aldo Caporossi
- Department of Ophthalmology, Policlinico Universitario A. Gemelli IRCSS Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giovanni Alessio
- Ophthalmology Unit, Dipartimento di Scienze mediche di base, Neuroscienze e Organi di Senso Università di Bari, Azienda Ospedaliera Policlinico Consorziale, Bari, Italy
| | | | - Giorgio Marchini
- Ophthalmology Unit, Ospedale Policlinico G.B. Rossi, Università di Verona, Verona, Italy
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Rapisarda A, Arpa P, Fantaguzzi PM, Faraldi F, Ratiglia R, Rizzo S, Vaona P, Iannacone C, Papa V. Dexamethasone/Netilmicin Eye Drops and Eye Gel for the Treatment of Ocular Inflammation After Micro-Incisional Vitreoretinal Surgery. Clin Ophthalmol 2020; 14:3297-3303. [PMID: 33116381 PMCID: PMC7569042 DOI: 10.2147/opth.s257541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate the effect of dexamethasone/netilmicin (dexa/net) fixed combination in the treatment of ocular inflammation after sutureless micro-incisional vitreoretinal surgery (MIVS). PATIENTS AND METHODS This multicenter, open, randomized, active-controlled, parallel-group, clinical trial was run in 6 sites in Italy. Treatment started the day of surgery and continued 4 times daily for 14 days. Patients were 1:1 randomized to dexa/net (eyedrops solution and eye gel) or dexamethasone/tobramycin (dexa/tobra) eyedrops suspension and ointment. Viscous formulations (gel or ointment) were used alone during the early post-operative phase; afterwards, a combination of eye drops during daytime and viscous formulations at bedtime was adopted. The primary efficacy parameter evaluated was bulbar conjunctival hyperemia. Additional efficacy and safety parameters (palpebral conjunctival hyperemia, anterior chamber flare and cells, symptoms of ocular discomfort and ocular tolerance, adverse events and intraocular pressure) were also evaluated. Control visits were performed at day 1, day 4 and day 14 after surgery; the endpoint of the study was set at 14±2 days after surgery. RESULTS A complete resolution of bulbar conjunctiva hyperaemia at the study end point was reached in 92.9% of patients treated with dexa/net and 75.0% of those treated with dexa/tobra (p=0.02, Fisher's exact test). No differences were observed between treatments for other efficacy parameters. Statistically significant differences in favour of dexa/net (p< 0.0001, ANOVA) were observed for most of subjective tolerance variables examined (blurred vision, foreign body sensation, stickiness, burning) starting day 1 after surgery when only the viscous formulations were used. No increase in intraocular pressure or adverse events was observed during the study. CONCLUSION The combination dexa/net is safe and effective in the treatment of post-operative inflammation following sutureless MIVS. In particular, the use of eye gel formulation is characterized by a great tolerability.
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Affiliation(s)
- Antonio Rapisarda
- Department of Ophthalmology, Azienda Ospedaliera Garibaldi, Catania, Italy
| | - Paolo Arpa
- Department of Ophthalmology, Ospedale San Gerardo, Monza, Italy
| | | | - Francesco Faraldi
- Department of Ophthalmology, Presidio Ospedaliero Oftalmico, Torino, Italy
| | - Roberto Ratiglia
- Department of Ophthalmology, Policlinico Mangiagalli Regina Elena, Milano, Italy
| | - Stanislao Rizzo
- Department of Ophthalmology, Azienda Ospedaliera Pisana, Pisa, Italy
| | - Paola Vaona
- Department of Ophthalmology, Presidio Ospedaliero Oftalmico, Torino, Italy
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Microorganism detection and contamination rate of donor eyes in Japan. Jpn J Ophthalmol 2020; 64:577-584. [PMID: 32924083 DOI: 10.1007/s10384-020-00772-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/14/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the microorganism detection and contamination rate of donor eyes. STUDY DESIGN Retrospective study. METHODS In this retrospective study, we reviewed all donor cornea data collected from Kyoto Prefectural University of Medicine (KPUM) Eye Bank, Kyoto, Japan from April 2015 to June 2018, including microbiologic data obtained from conjunctival swabs and preservation medium and findings of postoperative infection from the medical records. RESULTS During the study period, 77 eyes from 44 deceased individuals (mean age at time of death: 75 ± 17.3 years [range, 30-102 years]) were donated to the KPUM Eye Bank after being harvested using standard safety precautions and disinfection procedures. In 49 of the 77 eyes (63.6%), the conjunctival-swab culture revealed microorganisms, with the 3 most commonly detected being methicillin-resistant Staphylococcus epidermidis (MRSE), methicillin-sensitive S aureus (MSSA), and methicillin-resistant S aureus (MRSA). The data revealed positive microorganism detection in only 4 (5.2%) of the 77 donor-cornea storage-medium cultures. Positive microorganism detection was found in all the age groups, with no statistical difference between the groups (P > .05). In the eyes enucleated ≥ 2.5 h postmortem, a higher positive microorganism detection occurred (P = .03). During the postoperative follow-up period, there was no record of corneal infection. CONCLUSIONS The preenucleation conjunctival-swab-culture findings revealed that the rate of positive microorganism detection was similar for advanced-age and younger-age donors and that a shorter elapsed time from donor death to postmortem enucleation resulted in less donor-microorganism contamination.
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Kłos M, Pomorska-Wesołowska M, Romaniszyn D, Chmielarczyk A, Wójkowska-Mach J. Epidemiology, Drug Resistance, and Virulence of Staphylococcus aureus Isolated from Ocular Infections in Polish Patients. Pol J Microbiol 2019; 68:541-548. [PMID: 31880897 PMCID: PMC7260701 DOI: 10.33073/pjm-2019-056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 12/19/2022] Open
Abstract
Analysis of the epidemiology of Staphylococcus aureus (SA) ocular infections and virulence factors of the isolates with a special emphasis on their drug resistance, and the ability of biofilm formation. In a period from 2009 to 2013, 83 isolates of SA were prospectively collected and preserved in a multicenter laboratory-based study carried out in southern Poland. Epidemiological, phenotypic, and genotypic analyses were performed. The resistance and virulence genes were analyzed. Screening for the biofilm formation was provided. Among the materials derived from ocular infections from 456 patients, SA was found in 18.2% (n = 83) of cases (one SA isolate per one patient). Most infections were identified in the age group of over 65 years (OR 8.4 95%CI; 1.03-68.49). The majority of patients (73.4%) were hospitalized. Among the virulence and resistance genes, the most frequently detected were the lukE (72.2%, n = 60) and ermA (15.6%, n = 13) genes. A positive result of the CRA test (the ability of biofilm formation) was found in 66.2% (n = 55) of isolates. Among the strains under study, 6.0% (n = 5) had the methicillin-resistant Staphylococcus aureus phenotype, and 26.5% (n = 22) had the macrolide-lincosamide-streptogramin B phenotype. In 48 (57.8%) isolates the neomycin resistance was revealed. All isolates under study were sensitive to vancomycin. The population most susceptible to ocular SA infections consists of hospitalized patients aged 65 and more. The SA strains under study showed the increased ability to biofilm formation. In the strains tested, high susceptibility to chloramphenicol and fluoroquinolones was demonstrated. However, the high level of drug resistance to neomycin detected in this study among SA isolates and the blood-ocular barrier makes it difficult to treat ocular infections.
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Affiliation(s)
- Marta Kłos
- Faculty of Health Sciences, Jagiellonian University Medical College , Kraków , Poland
| | | | - Dorota Romaniszyn
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College , Kraków , Poland
| | - Agnieszka Chmielarczyk
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College , Kraków , Poland
| | - Jadwiga Wójkowska-Mach
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College , Kraków , Poland
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Choi N, Cho CH, Lee SB. Clinical Analysis of StaphylococcusKeratitis According to Coagulase Positivity. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.10.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Namhyeon Choi
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - Chan Ho Cho
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang-Bumm Lee
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
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Papa V, Blanco AR, Santocono M. Ocular flora and their antibiotic susceptibility in patients having cataract surgery in Italy. J Cataract Refract Surg 2018; 42:1312-1317. [PMID: 27697249 DOI: 10.1016/j.jcrs.2016.07.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/13/2016] [Accepted: 07/13/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To characterize the ocular flora in a consecutive group of patients having cataract surgery and to determine the antibiotic susceptibility profile of isolates to several ophthalmic antibiotics. SETTING Hospital Di Stefano, Catania, Italy. DESIGN Observational case series. METHODS Conjunctival and eyelid cultures from patients were obtained 14 days before surgery and, if positive, repeated the day of the surgery. Antimicrobial susceptibility for aminoglycosides (netilmicin and tobramycin), fluoroquinolones (ofloxacin, levofloxacin, and moxifloxacin), chloramphenicol, and azithromycin was tested using the Kirby-Bauer disk diffusion method. Susceptibility was also tested for oxacillin, cefuroxime, and vancomycin. All positive patients received a 2-day preoperative course of 3 mg/mL netilmicin ophthalmic solution 4 times a day. The recovery rate of microorganisms after antibiotic treatment compared with baseline was calculated. RESULTS One hundred twenty consecutive patients were included in the study. Cultures were positive in 72.5% of patients; 131 isolates, mainly gram-positive, were identified. Staphylococcus epidermidis (58.0%) and Staphylococcus aureus (15.3%) were the most frequently isolated microorganisms. Methicillin-resistant staphylococci accounted for 3.8% of S epidermidis and 20.0% of S aureus. A high in vitro susceptibility (>90%) for all isolates, including multiresistant coagulase-negative Staphylococcus, was obtained for netilmicin, vancomycin, and cefuroxime. The recovery rate of isolates before surgery was reduced by 93.9% (P < .001). CONCLUSIONS Conjunctival and lid margin isolates were sensitive to netilmicin, vancomycin, and cefuroxime. Microorganisms were less susceptible to other ophthalmic antibiotics, with the exception of moxifloxacin. A 2-day preoperative course with topical netilmicin reduced most bacteria identified on the conjunctiva and eyelids. FINANCIAL DISCLOSURE Dr. Papa and Ms. Blanco are employees of Società Industria Farmaceutica Italiana SpA. Dr. Santocono has no financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Vincenzo Papa
- From Medical Affairs (Papa, Blanco), Società Industria Farmaceutica Italiana SpA, and the Ophthalmology Unit (Santocono), Hospital Di Stefano, Catania, Italy.
| | - Anna Rita Blanco
- From Medical Affairs (Papa, Blanco), Società Industria Farmaceutica Italiana SpA, and the Ophthalmology Unit (Santocono), Hospital Di Stefano, Catania, Italy
| | - Marcello Santocono
- From Medical Affairs (Papa, Blanco), Società Industria Farmaceutica Italiana SpA, and the Ophthalmology Unit (Santocono), Hospital Di Stefano, Catania, Italy
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Oydanich M, Dingle TC, Hamula CL, Ghisa C, Asbell P. Retrospective report of antimicrobial susceptibility observed in bacterial pathogens isolated from ocular samples at Mount Sinai Hospital, 2010 to 2015. Antimicrob Resist Infect Control 2017; 6:29. [PMID: 28344783 PMCID: PMC5360068 DOI: 10.1186/s13756-017-0185-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antimicrobial resistance has emerged as a major threat to global public health. Thus, the surveillance of changes in antimicrobial resistance in local and global settings is a paramount necessity. While many studies have tracked antimicrobial resistance, only a small percentage surveyed ocular isolates. The purpose of this study was to report the in vitro susceptibility of bacterial pathogens isolated from ocular samples in New York, NY from 2010 to 2015. METHODS A retrospective review of ocular isolates was conducted. All organisms were collected by 25 separate inpatient wards and outpatient clinics, and were analyzed by the clinical microbiology laboratory at Mount Sinai Hospital. Clinical Laboratory and Standards Institute (CLSI) guidelines were followed for susceptibility testing and breakpoint interpretations. RESULTS A total of 549 bacterial organisms were isolated from 1664 cultures (33%) during the 6-year study period. Of these, 358 isolates (65.2%) underwent susceptibility testing. 182 (50.8%) isolates were Gram-positive. The most common Gram-positive bacterium was Staphylococcus aureus (62.1%). Methicillin-resistance decreased in S. aureus isolates (31.3% in 2010, 14.1% in 2015) but was without significant change (p = 0.25). When analyzing all S. aureus isolates recovered during the study period, there were significantly more methicillin-resistant S. aureus (MRSA) isolates resistant to fluoroquinolones (p <0.0001), erythromycin (p <0.0001), and trimethoprim/sulfamethoxazole (TMP/SMZ; p <0.05). Overall, Streptococcus pneumoniae isolates showed reduced susceptibility to erythromycin, but were otherwise susceptible to the other antimicrobials tested. Haemophilus influenzae (26.1%) and Pseudomonas aeruginosa (23.9%) were the most common Gram-negative bacteria isolated. Resistance to ampicillin and TMP/SMZ was observed in several of the H. influenzae isolates. P. aeruginosa isolates did not show high resistance overall, however, it was noted that isolates resistant to meropenem were also resistant to other antimicrobials (p < 0.01). CONCLUSION Overall, antimicrobial resistance was infrequent for the Gram-negative and Gram-positive bacteria analyzed. While the MRSA isolates demonstrated increased resistance to multiple antimicrobial classes, this is expected for this pathogen. Due to the continued use of broad-spectrum oral and systemic antimicrobials to treat ocular infections, findings of this study and other surveillance studies specific to ocular isolates should be used as resources in effective decision making in the treatment of ocular disease.
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Affiliation(s)
- Marko Oydanich
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Tanis C Dingle
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Camille L Hamula
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY 10029 USA
| | - Claudia Ghisa
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Penny Asbell
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY USA
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Synthesis and antibacterial activity of novel 11-[3-[(arylcarbamoyl)oxy]propylamino]-11-deoxy-6-O-methyl-3-oxoerythromycin A 11-N,12-O-cyclic carbamate derivatives. J Antibiot (Tokyo) 2016; 69:811-817. [PMID: 27118243 DOI: 10.1038/ja.2016.42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 02/24/2016] [Accepted: 03/14/2016] [Indexed: 11/08/2022]
Abstract
A series of novel 11-[3-[(arylcarbamoyl)oxy]propylamino]-11-deoxy-6-O-methyl-3-oxoerythromycin A 11-N,12-O-cyclic carbamate derivatives (6a-h) were designed, synthesized and evaluated for their antibacterial activities in vitro. Most of these compounds had significant antibacterial activity against two groups of pathogens of Methicillin-sensitive Staphylococcus aureus (MIC50=0.031-2 μg ml-1) except 6g and Methicillin-sensitive S. epidermidis (MIC50=0.031-0.5 μg ml-1). MIC90 of 6d against Methicillin-resistant S. epidermidis was at least 16-fold better than that of erythromycin (EMA), azithromycin (AZM) and ABT-773. 6d and 6e had more potent antibacterial activity against S. pneumoniae than EMA, AZM and ABT-773. In particular, compounds 6d and 6e also showed relatively potent activity against Haemophilus influenzae and Streptococcus hemolyticus.
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Pansegrau ML, Mengarelli E, Dersu II. Complication of an Ahmed glaucoma valve implant: tube exposure with methicillin-resistant Staphylococcus aureus infection. Digit J Ophthalmol 2015; 21:1-9. [PMID: 27330471 DOI: 10.5693/djo.02.2015.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neovascular glaucoma is commonly treated surgically with implantation of glaucoma drainage devices. We report the case of a 57-year-old man who underwent an uneventful Ahmed glaucoma valve (AGV) placement for radiation-induced neovascular glaucoma but later developed early postoperative infection with tube exposure. The infection was identified 3 weeks postoperatively and antibiotic treatment was immediately initiated. However, the conjunctival melt progressed, and the AGV had to be removed. Culture of the device revealed methicillin-resistant Staphylococcus aureus (MRSA). There is a potential increased risk of postoperative infection and tube exposure following glaucoma valve implantation in patients with previous radiation therapy. To our knowledge, this is the second case in the literature of MRSA causing early postoperative infection following drainage device placement that required explantation.
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Affiliation(s)
- Morgan L Pansegrau
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Eddie Mengarelli
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Inci Irak Dersu
- Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York
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Xu J, Liu Z, Mashaghi A, Sun X, Lu Y, Li Y, Wu D, Yang Y, Wei A, Zhao Y, Lu C, Hong J. Novel Therapy for Primary Canaliculitis: A Pilot Study of Intracanalicular Ophthalmic Corticosteroid/Antibiotic Combination Ointment Infiltration. Medicine (Baltimore) 2015; 94:e1611. [PMID: 26426646 PMCID: PMC4616879 DOI: 10.1097/md.0000000000001611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In patients with primary canaliculitis, conservative medical therapy is associated with a high recurrence rate. Surgical treatments carry a great resolution rate but sometimes can result in the lacrimal pump dysfunction and canalicular scarring. The aim of this study is to introduce a minimally invasive approach, intracanalicular ophthalmic corticosteroid/antibiotic combination ointment infiltration (IOI, intracanalicular ointment infiltration), and to report our preliminary results for treating primary canaliculitis. In this retrospective, interventional case series, 68 consecutive patients with newly developed primary canaliculitis at a major tertiary eye center between January 2012 and January 2015. Thirty-six patients received conservative medical treatment alone (group 1; 36 eyes). Twenty-two patients and 10 medically uncontrolled patients from group 1 underwent IOI therapy (group 2; 32 eyes). Ten patients and 26 recurrent patients from group 1 and group 2 underwent surgery (group 3; 36 eyes). Patients were followed-up for at least 8 weeks. Clinical characteristics and outcomes were analyzed and compared. In this study, patients' age, sex, onset location, and durations of disease among 3 groups showed no significant difference. The resolution rate in group 2 was 72.7% (16/22) for new patients and 68.8% (22/32) for gross patients, respectively, both of which are higher than that of group 1 (22.2%, 10/36) but lower than that of group 3 (100%, 36/36). Of group 3, 2 patients received 2 surgical interventions and resolved finally. Microbiological workup was available in 51 patients. The most common isolates were staphylococcus species (27.9%) and streptococcus species (20%). Canalicular laceration developed in 1 patient during the IOI procedure and 1 patient undergoing surgery. Only 2 had postoperative lacrimal pump dysfunction and 1 had canalicular scarring in group 3. The IOI may be an effective and minimally invasive technique for treating primary canaliculitis and obviate the need for further intensive surgery.
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Affiliation(s)
- Jianjiang Xu
- From the Department of Ophthalmology and Visual Science, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai (JX, XS, YL, YL, DW, YY, AW, YZ, CL, JH); School of Life Sciences, Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian, China (ZL, JH); Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA (AM, JH); and China State Key Laboratory of Medical Neurobiology, Institutes of Brain Science (XS); Key Laboratory of Myopia, National Health and Family Planning Commission, Shanghai, China (XS)
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Ocular flora and their antibiotic resistance patterns in the midwest: a prospective study of patients undergoing cataract surgery. Am J Ophthalmol 2013; 156:623-624. [PMID: 23953154 DOI: 10.1016/j.ajo.2013.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 04/22/2013] [Indexed: 11/23/2022]
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Galvis V, Tello A, Guerra AR, Acuña MF, Villarreal D. Fluoroquinolones in Corneal Ulcers. Ophthalmology 2013; 120:e61-2. [DOI: 10.1016/j.ophtha.2013.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 06/04/2013] [Indexed: 11/30/2022] Open
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Faraldi F, Papa V, Rasà D, Santoro D, Russo S. Netilmicin/dexamethasone fixed combination in the treatment of conjunctival inflammation. Clin Ophthalmol 2013; 7:1239-44. [PMID: 23836952 PMCID: PMC3699304 DOI: 10.2147/opth.s44455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To compare the efficacy and safety of 0.1% dexamethasone/0.3% netilmicin (Netildex), with that of 0.1% dexamethasone/0.3% tobramycin (Tobradex) in the treatment of external ocular inflammation requiring antibiotic therapy. Methods In this randomized, double-blind study, 139 subjects with conjunctival inflammation associated with signs of ocular infection were treated with Netildex (n = 71) or Tobradex (n = 68) four times daily for 6 days. The primary efficacy analysis was based on the percentage of patients with at least a 50% decrease in conjunctival hyperemia at the endpoint visit (Day 6 [± 1]) with respect to baseline (responder rate). An equivalence margin of 20% was set for this study. A follow-up visit was performed at Day 14 (± 1). Other efficacy parameters were: conjunctival edema, conjunctival discharge, lid hyperemia, lid edema, presence of ocular infection, and symptoms of ocular discomfort. Safety evaluations included intraocular pressure, visual acuity, and adverse events. Results At Day 6, a decrease of conjunctival hyperemia was observed in 87.3% and 90.9% of the patients treated with Netildex and Tobradex, respectively. The 95% confidence interval for the difference between groups (−15.3 ÷ 8.0) satisfied the equivalence hypothesis. Subjects treated with Netildex had a better control of lid hyperemia (P = 0.016), tearing (P = 0.001), burning (P = 0.007), and stinging (P = 0.004). No adverse reactions were observed during the study except one case of keratitis in the Tobradex group. Conclusion Netildex was as effective and safe as Tobradex in reducing signs and symptoms in patients with conjunctival inflammation when ocular infection was suspected.
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Affiliation(s)
- Francesco Faraldi
- Struttura Complessa Oculistica III, Presidio Ospedaliero Oftalmico, Torino, Italy
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