Distribution by Scientific Domains
Distribution within Medical Sciences

Terms modified by MRSA

  • mrsa bacteraemia
  • mrsa control
  • mrsa infection
  • mrsa infections
  • mrsa strain

  • Selected Abstracts

    Prevalence of Methicillin-Resistant Staphylococcus aureus in the Setting of Dermatologic Surgery

    BACKGROUND The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the postoperative setting of dermatologic surgery is unknown. Such data could influence the empirical treatment of suspected infections. OBJECTIVE To examine the period prevalence of MRSA infections in the postoperative setting of dermatologic surgery. METHODS We performed chart reviews of 70 patients who had bacterial cultures taken from January 2007 to December 2007. In the 21 postsurgical cases, we analyzed age, risk factors, sites of predilection, method of repair, and pathogen of growth. RESULTS The mean age of the overall study population was 57, with the mean age of postsurgical MRSA-positive cases being 75.5. Of the 21 postsurgical cultures taken, 16 cultures grew pathogen, and two of the 16 (13%) pathogen-positive cultures grew MRSA. LIMITATIONS This is a retrospective chart review of a relatively small sample size in one geographic location. Our patient population is known to contain a large number of retirees. CONCLUSION The increasing prevalence of MRSA skin and soft tissue infections and recommendation to modify empirical antibiotic therapy have been well documented in particular patient populations, but we caution against the empirical use of MRSA-sensitive antibiotics in the postoperative setting of dermatologic surgery. We advocate culturing all infectious lesions upon presentation and reserve empirical use of MRSA-sensitive antibiotics for high-risk patients or locations. [source]

    Cutaneous infections in the elderly: diagnosis and management

    Jeffrey M. Weinberg
    ABSTRACT:, Over the past several years there have been many advances in the diagnosis and treatment of cutaneous infectious diseases. This review focuses on the three major topics of interest in the geriatric population: herpes zoster and postherpetic neuralgia (PHN), onychomycosis, and recent advances in antibacterial therapy. Herpes zoster in adults is caused by reactivation of the varicella-zoster virus (VZV) that causes chickenpox in children. For many years acyclovir was the gold standard of antiviral therapy for the treatment of patients with herpes zoster. Famciclovir and valacyclovir, newer antivirals for herpes zoster, offer less frequent dosing. PHN refers to pain lasting ,2 months after an acute attack of herpes zoster. The pain may be constant or intermittent and may occur spontaneously or be caused by seemingly innocuous stimuli such as a light touch. Treatment of established PHN through pharmacologic and nonpharmacologic therapy will be discussed. In addition, therapeutic strategies to prevent PHN will be reviewed. These include the use of oral corticosteroids, nerve blocks, and treatment with standard antiviral therapy. Onychomycosis, or tinea unguium, is caused by dermatophytes in the majority of cases, but can also be caused by Candida and nondermatophyte molds. Onychomycosis is found more frequently in the elderly and in more males than females. There are four types of onychomycosis: distal subungual onychomycosis, proximal subungual onychomycosis, white superficial onychomycosis, and candidal onychomycosis. Over the past several years, new treatments for this disorder have emerged which offer shorter courses of therapy and greater efficacy than previous therapies. The treatment of bacterial skin and skin structure infections in the elderly is an important issue. There has been an alarming increase in the incidence of gram-positive infections, including resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and drug-resistant pneumococci. While vancomycin has been considered the drug of last defense against gram-positive multidrug-resistant bacteria, the late 1980s saw an increase in vancomycin-resistant bacteria, including vancomycin-resistant enterococci (VRE). More recently, strains of vancomycin-intermediate resistant S. aureus (VISA) have been isolated. Gram-positive bacteria, such as S. aureus and Streptococcus pyogenes are often the cause of skin and skin structure infections, ranging from mild pyodermas to complicated infections including postsurgical wound infections, severe carbunculosis, and erysipelas. With limited treatment options, it has become critical to identify antibiotics with novel mechanisms of activity. Several new drugs have emerged as possible therapeutic alternatives, including linezolid and quinupristin/dalfopristin. [source]


    Iruru Maetani
    Percutaneous endoscopic gastrostomy (PEG) was first described in 1980 as an effective means of enteral nutrition where oral intake is not possible. PEG placement is safe and has now replaced the nasogastric tube in patients who need long-term feeding. Although it is relatively safe with a very low associated mortality, minor complications, especially local and systemic infection, remain a problem. Of these, peristomal wound infections are the most common complication of PEG. In patients indicated for this procedure who are aged and/or frail, this complication may pose a critical problem. In the commonly used pull or push methods for PEG placement, the PEG tube is readily colonized by oropharyngeal bacteria. Infection of the PEG site is considered to be associated with contamination of the PEG catheter. There are important measures that should be taken to prevent peristomal infection. A number of rigorous studies have shown that prophylactic antibiotics are effective in reducing the risk of peristomal infection. As methicillin-resistant Staphylococcus aureus (MRSA) or other resistant organisms are emerging as a major pathogen in peristomal infection, however, currently recommended antibiotic prophylaxis regimens might be inappropriate. Alternative regimens and other approaches to prevent contamination of the PEG tube during the procedure are required. [source]

    Extremely Rapid Formation of Mitral Valve Ring Abscess in Infective Endocarditis

    ECHOCARDIOGRAPHY, Issue 6 2004
    Balaram Shrestha M.D., Ph.D.
    A patient with infective endocarditis (IE) due to methicillin-resistant staphylococcus aureus (MRSA) was found to have conversion of the hypoechoic region of the posterior mitral valve ring apparatus into a clearly delineated echolucent space by repeating transthoracic echocardiography at an interval of 1 week. Color Doppler showed features of blood entry into this space. Abscess formation in IE due to MRSA may be quick and repeated echocardiography may help detect the complications of IE. Semiurgent mitral valve plasty was performed for the associated prolapse of the posterior mitral leaflet using a hand-made, rolled, twisted autologous pericardial ring. [source]

    Antimicrobial therapy for multidrug resistant pathogens

    J. S. Weese
    Summary Multidrug resistant bacteria are tremendous causes of morbidity and mortality in human medicine, and emerging pathogens in equine medicine. A variety of organisms, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus spp. (VRE) and multidrug resistant Acinetobacter spp., Pseudomonas spp. and Enterobacteriaceae are of concern in equine medicine. Veterinary practitioners need to be aware of key diagnostic, clinical, therapeutic, epidemiological and infection control aspects to limit the impact of these organisms on the equine, and perhaps human, population. [source]

    Human antibody response during sepsis against targets expressed by methicillin resistant Staphylococcus aureus

    Udo Lorenz
    Abstract The identification of target structures is a prerequisite for the development of new treatment options, like antibody based therapy, against methicillin resistant Staphylococcus aureus (MRSA). In this study we identified immunodominant structures which were expressed in vivo during sepsis caused by MRSA. Using human sera we compared the immune response of humans with MRSA sepsis with the immune response of normal individuals and asymptomatically colonized individuals. We identified and characterized four staphylococcal specific antigenic structures. One target is a staphylococcal protein of 29 kDa that exhibited 29% identity to secreted protein SceA precursor of Staphylococcus carnosus. The putative function of this protein, which was designated IsaA (immunodominant staphylococcal antigen), is unknown. The second target is an immunodominant protein of 17 kDa that showed no homology to any currently known protein. This immunodominant protein was designated IsaB. The third and fourth antigens are both immunodominant proteins of 10 kDa. One of these proteins showed 100% identity to major cold shock protein CspA of S. aureus and the other protein was identified as the phosphocarrier protein Hpr of S. aureus. The identified immunodominant proteins may serve as potential targets for the development of antibody based therapy against MRSA. [source]

    Current admission policies of long-term care facilities in Japan

    Yoshihisa Hirakawa
    Background: The rapidly aging society in Japan is putting demands on long-term care facilities for the elderly who require care. In Europe and the USA, there is ongoing reform of elderly care services, but the establishment of system based on social insurance is still being explored in Japan. Methods: Two studies were conducted, the first in 2000 and the second in 2001, involving 91 long-term care facilities located in or around the city of Nagoya. Questionnaires were sent to facility directors, chief administrators or head nurses to inquire about their admission policies for six major patient categories. Two educational lectures on methicillin-resistant Staphylococcus aureus (MRSA) and urinary incontinence were given between the distribution of the questionnaires. Results: For all six categories featured on the questionnaire, the acceptance rate in both studies was the highest in geriatric hospitals, and an improvement in acceptance rates was seen in the second study in all three types of care facilities. When the effect the lectures had on changes in admission policies at these facilities was examined, no correlation was found. Conclusions: Lectures should be given to facility management and personnel to raise their awareness of key issues and improve their efficiency. [source]

    Antimicrobial Gallium-Doped Phosphate-Based Glasses,

    Sabeel P. Valappil
    Abstract Novel quaternary gallium-doped phosphate-based glasses (1, 3, and 5 mol % Ga2O3) were synthesized using a conventional melt quenching technique. The bactericidal activities of the glasses were tested against both Gram-negative (Escherichia coli and Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and Clostridium difficile) bacteria. Results of the solubility and ion release studies showed that these glass systems are unique for controlled delivery of Ga3+. 71Ga NMR measurements showed that the gallium is mostly octahedrally coordinated by oxygen atoms, whilst FTIR spectroscopy provided evidence for the presence of a small proportion of tetrahedral gallium in the samples with the highest gallium content. FTIR and Raman spectra also afford an insight into the correlation between the structure and the observed dissolution behavior via an understanding of the atomic-scale network bonding characteristics. The results confirmed that the net bactericidal effect was due to Ga3+, and a concentration as low as 1 mol % Ga2O3 was sufficient to mount a potent antibacterial effect. The dearth of new antibiotics in development makes Ga3+ a potentially promising new therapeutic agent for pathogenic bacteria including MRSA and C. difficile. [source]

    Design of an Injectable ,-Hairpin Peptide Hydrogel That Kills Methicillin-Resistant Staphylococcus aureus

    ADVANCED MATERIALS, Issue 41 2009
    Daphne A. Salick
    A peptide-based, injectable hydrogel is designed that is inherently antibacterial and can kill methicillin- resistant Staphylococcus aureus (MRSA) on contact. Peptide gels can be used as coatings to inhibit MRSA infection or syringe-delivered to a contaminated surface where the gel kills MRSA on contact. [source]

    An audit of antibiotics usage and their effect on MRSA infection or colonisation following percutaneous endoscopic gastrostomy in a district general hospital

    O.A. Ogundipe
    Summary Percutaneous endoscopic gastrostomy (PEG) has become a widely practised procedure to maintain long-term nutrition in patients with a variety of medical conditions. Incidence of infection and the usage of prophylactic antibiotic continue to remain an area of debate. Guidelines in gastroenterology on antibiotic prophylaxis published by the British Society of Gastroenterology recommend the use of prophylactic antibiotic prior to placement of PEG tube (1). There has been an alarming rise in the incidence of MRSA, which has jumped from a reported 2% in 1992 to about 42% in 2001 in England & Wales. Use of antibiotic may lead to emergence of MRSA in debilitated patients requiring PEG feeding. This audit addresses some of the problems encountered in a small district general hospital. [source]

    Regional audit: Perioperative management of MRSA orthopaedic patients in the Oxford region

    N. Aslam
    Summary Aim:, Methicillin resistant staphylococcus aureus (MRSA) colonisation or infection is of particular importance in patients undergoing operations involving implanteable materials, such as in orthopaedic surgery. An audit of the perioperative management of orthopaedic patients in the Oxford region was carried out to assess the level of clinician awareness and the uniformity of current guidelines between hospitals. Methods:, A postal questionnaire was designed for asking information on various aspects of perioperative management of MRSA patients and was sent to each hospital. Results:, Responses were obtained from nine of 10 hospitals in the region. The average response rate for each hospital was 75%, and the overall individual response rate was 67.5% (27/40). Seventy-eight per cent of respondents knew that there was a pre-admission screening policy. Fifteen per cent were unaware of any MRSA policy. Forty-four per cent indicated that teicoplanin was used for prophylaxis in implant surgery whilst 44% used vancomycin. Eighteen per cent believed that cefuroxime was used for prophylaxis. Forty-eight per cent of hospitals had an MRSA-free zone for orthopaedic patients. Conclusion:, This study indicates a lack of uniformity in the perioperative management of MRSA-positive patients in the region and a lack of awareness of both MRSA guidelines and their implementation. Uniformity of MRSA guidelines is necessary to allow better clinician awareness and compliance, especially in surgical trainees who are travelling between different training hospitals in the region. Implementation of such a policy with re-audit of subsequent awareness and compliance is proposed. [source]

    MRSA pyomyositis complicating sickle cell anaemia

    C. Millar
    A patient being treated for sickle cell crisis developed swollen, painful, indurated, discoloured thighs after several days in hospital. Imaging revealed the presence of multiple small abscesses in the muscle and methicillin resistant Staphylococcus aureus (MRSA) was cultured from aspirated fluid. Pyomyositis usually occurs in association with damaged muscle and impaired host defences. Staphylococcus is the most frequent organism involved. It is not a common complication of sickle cell disease, although it may be under diagnosed. Availability of advanced imaging techniques facilitates early diagnosis of pyomyositis. [source]

    Silver dressings: their role in wound management

    David J Leaper
    Abstract Dressings have a part to play in the management of wounds; whether they are sutured or open, usually chronic wounds of many aetiologies which are healing by secondary intention. They traditionally provide a moist wound environment, but this property has been extended through simple to complex, active dressings which can handle excessive exudate, aid in debridement, and promote disorganised, stalled healing. The control of infection remains a major challenge. Inappropriate antibiotic use risks allergy, toxicity and most importantly resistance, which is much reduced by the use of topical antiseptics (such as povidone iodine and chlorhexidine). The definition of what is an antimicrobial and the recognition of infection has proven difficult. Although silver has been recognised for centuries to inhibit infection its use in wound care is relatively recent. Evidence of the efficacy of the growing number of silver dressings in clinical trials, judged by the criteria of the Cochrane Collaboration, is lacking, but there are good indications for the use of silver dressings, to remove or reduce an increasing bioburden in burns and open wounds healing by secondary intention, or to act as a barrier against cross contamination of resistant organisms such as MRSA. More laboratory, and clinical data in particular, are needed to prove the value of the many silver dressings which are now available. Some confusion persists over the measurement of toxicity and antibacterial activity but all dressings provide an antibacterial action, involving several methods of delivery. Nanocrystalline technology appears to give the highest, sustained release of silver to a wound without clear risk of toxicity. [source]

    MRSA in der Dermatologie , Prospektive epidemiologische Untersuchung bei Mitarbeitern und Patienten einer dermatologischen Universitätsklinik

    Stefanie Reich-Schupke
    First page of article [source]

    Effect of certain bioactive plant extracts on clinical isolates of ,-lactamase producing methicillin resistant Staphylococcus aureus

    Farrukh Aqil
    Ethanolic extracts and some fractions from 10 Indian medicinal plants, known for antibacterial activity, were investigated for their ability to inhibit clinical isolates of ,-lactamase producing methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA). Synergistic interaction of plant extracts with certain antibiotics was also evaluated. The MRSA test strains were found to be multi-drug resistant and also exhibited high level of resistance to common ,-lactam antibiotics. These strains produced ,-lactamases, which hydrolyze one or other ,-lactam antibiotics, tested. The extract of the plants from Camellia sinensis (leaves), Delonix regia (flowers), Holarrhena antidysenterica (bark), Lawsonia inermis (leaves), Punica granatum (rind), Terminalia chebula (fruits) and Terminalia belerica (fruits) showed a broad-spectrum of antibacterial activity with an inhibition zone size of 11 mm to 27 mm, against all the test bacteria. The extracts from the leaves of Ocimum sanctum showed better activity against the three MRSA strains. On the other hand, extracts from Allium sativum (bulb) and Citrus sinensis (rind) exhibited little or no activity, against MRSA strains. The antibacterial potency of crude extracts was determined in terms of minimum inhibitory concentration (MIC) by the tube dilution method. MIC values, of the plant extracts, ranged from 1.3 to 8.2 mg/ml, against the test bacteria. Further, the extracts from Punica granatum and Delonix regia were fractionated in benzene, acetone and methanol. Antibacterial activity was observed in acetone as well as in the methanol fractions. In vitro synergistic interaction of crude extracts from Camellia sinensis, Lawsonia inermis, Punica granatum, Terminalia chebula and Terminalia belerica was detected with tetracycline. Moreover, the extract from Camellia sinensis also showed synergism with ampicillin. TLC of the above extracts revealed the presence of major phytocompounds, like alkaloids, glycosides, flavonoids, phenols and saponins. TLC-bioautography indicated phenols and flavonoids as major active compounds. (© 2005 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    Effect of various estimates of renal function on prediction of vancomycin concentration by the population mean and Bayesian methods

    Y. Tsuji BSc
    Summary Objective:, Renal function was estimated in 129 elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) who were treated with vancomycin (VCM). The estimation was performed by substituting serum creatinine (SCR) measured enzymatically and a value converted using the Jaffe method into the Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations. The serum trough level was predicted from three estimates of renal function by the population mean (PM) and Bayesian methods and the predictability was assessed. Methods:, Two-compartment model-based Japanese population parameters for VCM were used, and the mean prediction error (ME) and root mean squared error (RMSE) were calculated as indices of bias and accuracy, respectively, for predictions by the PM and Bayesian methods. Results:, The PM method gave the highest correlation with the measured value using the estimate of renal function obtained by substituting the Jaffe-converted SCR into the Cockcroft-Gault equation. There was no positive or negative bias in the ME and the value was significantly smaller than for other predicted data (P < 0·05). RMSE was also the smallest, indicating that this method increases the predictability of the serum VCM trough level. While, ME showed a negative bias for all values predicted by the Bayesian method, both the ME and RMSE were very small. Conclusion:, In the application of the PM method for VCM treatment of elderly patients with MRSA, substitution of SCR based on the Jaffe method into the Cockcroft-Gault equation increases the predictability of the serum VCM trough level. The Bayesian method predicted the serum VCM trough level with high accuracy using any of the estimates of renal function. [source]

    Screening for Alternative Antibiotics: An Investigation into the Antimicrobial Activities of Medicinal Food Plants of Mauritius

    M.F. Mahomoodally
    ABSTRACT:, The present study was designed to evaluate the antimicrobial activities of 2 endemic medicinal plants; Faujasiopsis flexuosa,(Asteraceae) (FF) and Pittosporum senacia,(Pittosporaceae) (PS) and 2 exotic medicinal plants, Momordica charantia,(Cucurbitaceae) (MC) and Ocimum tenuiflorum,(Lamiaceae) (OT) that forms part of local pharmacopoeia of Mauritius and correlate any observed activity with its phytochemical profile. Aqueous and organic fractions of the leaves, fruits, and seeds of these plants were subjected to antimicrobial testing by the disc diffusion method against 8 clinical isolates of bacteria and 2 strains of fungus. It was found that MC, OT, and FF possessed antimicrobial properties against the test organisms. The MIC for MC ranged from 0.5 to 9 mg/mL and that of FF from 2 to 10 mg/mL and the lowest MIC value (0.5 mg/mL) was recorded for the unripe fruits of MC against E. coli. On the other hand, higher concentration of the unripe MC fruit extract of 9 mg/mL was needed to be effective against a resistant strain of Staphylococcus aureus,(MRSA). The antimicrobial effect against MRSA was lost upon ripening of the fruits. The methanolic extract of both MC and FF showed highest MIC values compared to the corresponding aqueous extract, which indicates the low efficacy and the need of higher doses of the plant extract. Phytochemical screening of the plants showed the presence of at least tannins, phenols, flavonoids, and alkaloids, which are known antimicrobial phyto-compounds. In conclusion, the observed antimicrobial properties would tend to further validate the medicinal properties of these commonly used endemic medicinal and food plants of Mauritius. [source]

    MRSA in a veterinary orthopaedic referral hospital

    Gerry Polton
    No abstract is available for this article. [source]

    Local and marginal control charts applied to methicillin resistant Staphylococcus aureus bacteraemia reports in UK acute National Health Service trusts

    O. A. Grigg
    Summary., We consider the general problem of simultaneously monitoring multiple series of counts, applied in this case to methicillin resistant Staphylococcus aureus (MRSA) reports in 173 UK National Health Service acute trusts. Both within-trust changes from baseline (,local monitors') and overall divergence from the bulk of trusts (,relative monitors') are considered. After standardizing for type of trust and overall trend, a transformation to approximate normality is adopted and empirical Bayes shrinkage methods are used for estimating an appropriate baseline for each trust. Shewhart, exponentially weighted moving average and cumulative sum charts are then set up for both local and relative monitors: the current state of each is summarized by a p -value, which is processed by a signalling procedure that controls the false discovery rate. The performance of these methods is illustrated by using 4.5 years of MRSA data, and the appropriate use of such methods in practice is discussed. [source]

    Prevalence of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus Carriage in Three Populations

    S. Kottler
    Background: A higher prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization is reported in healthcare workers compared with nonhealthcare workers. Hypothesis: The prevalence of MRSA colonization differed in people and pets in households with healthcare workers as compared with households without healthcare workers. Subjects: A person and 1 dog or cat from 586 households defined as either a nonhealthcare (n = 213), veterinary healthcare (n = 211), or human healthcare (n = 162) worker household. Methods: Prospective cross-sectional study. Samples from humans and pets were cultured in vitro. Staphylococcus aureus was identified as methicillin sensitive (MSSA) or MRSA with mecA polymerase chain reaction. Pulsed-field gel electrophoresis and spa -typing were used to characterize relatedness of S. aureus and MRSA and assign USA types. Results: The prevalence of MSSA and MRSA in humans was 21.5% (126/586) and 5.63% (33/586), respectively, and 7.85% (46/586) and 3.41% (20/586), respectively, in pets. There were no differences in prevalences of either MSSA or MRSA between household types. The proportion of MRSA among all S. aureus isolates in humans and pets was 20.8% (33/159) and 30.3% (20/66), respectively. In <1.0% (4/586) of households, the same strain of MRSA was found in both a person and a pet. Conclusions and Clinical Importance: There were no differences in the prevalences of MSSA or MRSA between healthcare worker and nonhealthcare worker households. Pets and people colonized with S. aureus were as likely to be colonized with MRSA. Colonization of a person and their pet with the same strain of MRSA was rare. [source]

    Methicillin-Resistant Staphylococcus aureus in Horses at a Veterinary Teaching Hospital: Frequency, Characterization, and Association with Clinical Disease

    J.S. Weese
    Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging equine pathogen. To attempt to control nosocomial and zoonotic transmission, an MRSA screening program was established for all horses admitted to the Ontario Veterinary College Veterinary Teaching Hospital, whereby nasal screening swabs were collected at admission, weekly during hospitalization, and at discharge. MRSA was isolated from 120 (5.3%) of 2,283 horses: 61 (50.8%) at the time of admission, 53 (44.2%) during hospitalization, and 6 from which the origin was unclear because an admission swab had not been collected. Clinical infections attributable to MRSA were present or developed in 14 (11.7%) of 120 horses. The overall rate of community-associated colonization was 27 per 1,000 admissions. Horses colonized at admission were more likely to develop clinical MRSA infection than those not colonized at admission (OR 38.9, 95% CI 9.49,160, P < 0.0001). The overall nosocomial MRSA colonization incidence rate was 23 per 1,000 admissions. The incidence rate of nosocomial MRSA infection was at the rate of 1.8 per 1,000 admissions, with an incidence density of 0.88 per 1,000 patient days. Administration of ceftiofur or aminoglycosides during hospitalization was the only risk factor associated with nosocomial MRSA colonization. MRSA screening of horses admitted to a veterinary hospital was useful for identification of community-associated and nosocomial colonization and infection, and for monitoring of infection control practices. [source]

    Bacterial contamination on touch surfaces in the public transport system and in public areas of a hospital in London

    J.A. Otter
    Abstract Aims:, To investigate bacterial contamination on hand-touch surfaces in the public transport system and in public areas of a hospital in central London. Methods and Results:, Dipslides were used to sample 118 hand-touch surfaces in buses, trains, stations, hotels and public areas of a hospital in central London. Total aerobic counts were determined, and Staphylococcus aureus isolates were identified and characterized. Bacteria were cultured from 112 (95%) of sites at a median concentration of 12 CFU cm,2. Methicillin-susceptible Staph. aureus (MSSA) was cultured from nine (8%) of sites; no sites grew methicillin-resistant Staph. aureus (MRSA). Conclusions:, Hand-touch sites in London are frequently contaminated with bacteria and can harbour MSSA, but none of the sites tested were contaminated with MRSA. Significance and Impact of the Study:, Hand-touch sites can become contaminated with staphylococci and may be fomites for the transmission of bacteria between humans. Such sites could provide a reservoir for community-associated MRSA (CA-MRSA) in high prevalence areas but were not present in London, a geographical area with a low incidence of CA-MRSA. [source]

    Comparison of methods for the detection of methicillin resistance in Staphylococcus aureus isolates from food products

    M. Corrente
    Abstract Aims:, To compare several methods for detection of methicillin resistance in Staphylococcus aureus isolates from food. Methods and Results:, Two hundred S. aureus isolates from food of animal origin were screened for methicillin resistance by a PCR assay specific for the mecA gene, an oxacillin agar screen test and a cefoxitin disk diffusion test. Six out of 200 strains (3%) were found to be methicillin-resistant Staphylococcus aureus (MRSA) by PCR. The oxacillin agar screen test detected only one of the MRSA isolates (sensitivity of 16·7%) and mischaracterized three additional strains as MRSA (specificity of 98·45%). None of the MRSA strains was detected by the cefoxitin test (sensitivity of 0%), while 15 methicillin-susceptible S. aureus (MSSA) strains were misclassified as resistant (specificity of 92·3%). Fifteen MSSA strains displayed a ,-lactamase hyperproducer-like phenotype. The six MRSA (mecA-positive) strains resembled the characteristics of heteroresistant strains. Conclusions:, As MRSA of animal origin may display atypical phenotypes, PCR appears to be more reliable for detection of methicillin resistance in animal strains. Significance and Impact of the Study:, The study stresses the need for implementing the methods of screening S. aureus from food of animal origin for methicillin resistance. [source]

    Different antibacterial actions of isoflavones isolated from Erythrina poeppigiana against methicillin-resistant Staphylococcus aureus

    M. Sato
    Abstract Aims:, To screen six isoflavones isolated from Erythrina poeppigiana (Leguminosae) for their antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA). Methods and Results:, Stem bark of E. poeppigiana was macerated with acetone and the methylene chloride-soluble fraction of the residue was applied to repeated silica gel column chromatography and eluted. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by a broth dilution method. Inactive compounds that failed inhibiting bacterial growth at 25 ,g ml,1 were further investigated for their combination effects with methicillin and oxacillin. Of the isolated isoflavones, 5,7,4,-trihydroxy-8,3,-di(,,, -dimethylallyl)isoflavone (isolupalbigenin) exhibited the highest anti-MRSA activity (MICs: 1·56,3·13 ,g ml,1; MBCs: 6·25,12·5 ,g ml,1), followed by 5,7,4,-trihydroxy-6- ,,, -dimethylallylisoflavone (erythrinin B). Inactive compounds were combined with methicillin or oxacillin, 5,4,-dihydroxy-(3,,,4,,-dihydro-3,,-hydroxy)-2,,,2,,-dimethylpyrano[5,,,6,,:6,7]isoflavone (M-Wi-2) intensifying the susceptibility of MRSA strains to these antibiotics. In all but one strain, the MIC values of methicillin were reduced from ,100 to 6·25,12·5 ,g ml,1 in the presence of M-Wi-2 (25 ,g ml,1). Conclusions:, Isoflavones from E. poeppigiana showed two different antibacterial activities against MRSA: direct growth inhibition and intensification of methicillin sensitivity. Significance and Impact of the Study:, Isolupalbigenin and M-Wi-2 could lead to the development of compounds for new approaches against MRSA infection. [source]

    Antimicrobial activities of eucalyptus leaf extracts and flavonoids from Eucalyptus maculata

    T. Takahashi
    Abstract Aims:, We investigated the antimicrobial activities of eucalyptus leaf extracts to find effective antibacterial agents. Methods and Results:, The antimicrobial activities of leaf extracts from 26 species of eucalyptus were measured. Extracts of Eucalyptus globulus, E. maculata and E. viminalis significantly inhibited the growth of six Gram-positive bacteria (Staphylococcus aureus, MRSA, Bacillus cereus, Enterococcus faecalis, Alicyclobacillus acidoterrestris, Propionibacterium acnes), and of a fungus (Trichophyton mentagrophytes), but they did not show strong antibacterial activity against Gram-negative bacteria (Escherichia coli, Pseudomonas putida). 2,,6,-dihydroxy-3,-methyl-4,-methoxy-dihydrochalcone, eucalyptin and 8-desmethyl-eucalyptin, isolated from E. maculata extracts, exhibited potent antimicrobial activities against seven micro-organisms with minimum inhibitory concentrations (MIC) ranging from 1·0 to 31 mg l,1. Conclusions:, The eucalyptus extracts and three compounds from E. maculata were found to be effective against micro-organisms that cause food poisoning, acne and athlete's foot. Significance and Impact of the Study:, This study shows potential uses of extracts from E. globulus, E. maculata and E. viminalis, and antimicrobial compounds isolated from E. maculata. [source]

    Involvement of endotoxin in the mortality of mice with gut-derived sepsis due to methicillin-resistant Staphylococcus aureus

    Masashi Uramatsu
    ABSTRACT MRSA causes a wide diversity of diseases, ranging from benign skin infections to life-threatening diseases, such as sepsis. However, there have been few reports of the pathophysiology and mechanisms of sepsis resulting from the gut-derived origin of MRSA. Therefore, we established a murine model of gut-derived sepsis with MRSA and factors of MRSA sepsis that cause deterioration. We separated mice into four groups according to antibiotic treatment as follows: (i) ABPC 40 mg/kg; (ii) CAZ 80 mg/kg; (iii) CAZ 80 mg/kg + endotoxin 10 ,g/mouse; and (iv) saline-treated control groups. Gut-derived sepsis was induced by i.p. injection of cyclophosphamide after colonization of MRSA strain 334 in the intestine. After the induction of sepsis, significantly more CAZ-treated mice survived compared with ABPC-treated and control groups. MRSA were detected in the blood and liver among all groups. Endotoxin levels were significantly lower in the CAZ-treated group compared to other groups. Inflammatory cytokine levels in the serum were lower in the CAZ-treated group compared to other groups. Fecal culture showed a lower level of colonization of E. coli in the CAZ-treated group compared to other groups. In conclusion, we found that CAZ-treatment ameliorates infection and suppresses endotoxin level by the elimination of E. coli from the intestinal tract of mice. However, giving endotoxin in the CAZ-treated group increased mortality to almost the same level as in the ABPC-treated group. These results suggest endotoxin released from resident E. coli in the intestine is involved in clinical deterioration resulting from gut-derived MRSA sepsis. [source]

    Anti-infectious activity of synbiotics in a novel mouse model of methicillin-resistant Staphylococcus aureus infection

    Enkhtuya Lkhagvadorj
    ABSTRACT The anti-infectious activity of synbiotics against methicillin-resistant Staphylococcus aureus (MRSA) infection was evaluated using a novel lethal mouse model. Groups of 12 mice treated with multiple antibiotics were infected orally with a clinical isolate of MRSA at an inoculum of 108 CFU on day 7 after starting the antibiotics. A dose of 400 mg/kg 5-fluorouracil (5-FU) was injected intraperitoneally on day 7 after the infection. A dose of 108 CFU Bifidobacterium breve strain Yakult and 10 mg of galactooligosaccharides (GOS) were given orally to mice daily with the antibiotic treatment until day 28. The intestinal population levels of MRSA in the mice on multiple antibiotics were maintained stably at 108 CFU/g of intestinal contents after oral MRSA infection and the subsequent 5-FU treatment killed all the mice in the group within 14 days. B. breve administration saved most of the mice, but the synbiotic treatment saved all of the mice from lethal MRSA infection. The synbiotic treatment was effective for the treatment of intestinal infection caused by four MRSA strains with different toxin productions. There was a large difference among the six Bifidobacteria strains that were naturally resistant to the antibacterial drugs used. B. breve in combination with GOS is demonstrated to have valuable preventive and curative effects against even fatal MRSA infections. [source]

    Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA)

    An Overview for Nurses
    First page of article [source]

    Bloodstream infections in hospitalized adults with sickle cell disease: A retrospective analysis

    Lalita Chulamokha
    Abstract Bloodstream infections (BSI) are a common cause of morbidity and mortality in people with sickle cell disease (SCD). In children with SCD, BSI are most often caused by encapsulated organisms. There is a surprising paucity of medical literature that is focused on evaluating SCD adults with BSI. We reviewed the charts of adults with SCD and BSI who were admitted to our hospital between April 1999 and August 2003. During this period a total of 1,692 hospital admissions for 193 adults with SCD were identified and 28% of these patients had at least 1 episode of positive blood cultures, with 69 episodes (17%) considered true BSI. Nosocomial BSI occurred in 34 episodes (49%). Among community BSI, in contrast to BSI in children with SCD, Streptococcus pneumoniae was rarely encountered. A high incidence of staphylococcal BSI in adults with SCD was noted. Twenty-eight percent of all BSI were caused by Staphylococcus aureus, and 15 of 22 isolates (68%) of these were methicillin-resistant. Gram-negative organisms, anaerobes, and yeast were found in 21 (27%), 3 (4%), and 4 isolates (5%) of BSI, respectively. Since over 80% of BSI were considered catheter-related, the higher incidence of gram-positive bacterial infections was likely due to the presence of indwelling central venous catheters. Empiric therapy for adults with SCD suspected of having BSI, especially in the presence of indwelling central venous catheters, should include antimicrobial therapy targeted at gram-positive bacteria (especially MRSA) and gram-negative bacteria. Also, if patients are critically ill, consideration should be made to include antifungal agents. Additional research into the adult SCD population appears necessary to further define this problem. Am. J. Hematol., 2006. © 2006 Wiley-Liss, Inc. [source]

    Ein neuer Stern am Antibiotikahimmel , Daptomycin

    Ulrike Holzgrabe
    In den letzten Jahren hat bei nosokomonialen Infektionen eine Verschiebung zu gram-positiven Bakterien stattgefunden. Außerdem wird im Krankenhaus zunehmend eine Resistenz gegen Penicilline, z. B. Methicillin- resistente Staphylococcus aureus (MRSA), festgestellt. [source]