Is nasal steroid spray bottle contamination a potential issue in chronic rhinosinusitis?

2013 ◽  
Vol 128 (S1) ◽  
pp. S28-S33 ◽  
Author(s):  
N C-W Tan ◽  
A J Drilling ◽  
C Jardeleza ◽  
P-J Wormald
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Rhinosinusitis ◽  
Cold Water ◽  
Contamination Rate ◽  
Microbiological Analysis ◽  
Coagulase Negative Staphylococci ◽  
Intranasal Steroids ◽  
Metered Dose ◽  
Nasal Steroid

AbstractBackground:Intranasal steroids are the first line of treatment for chronic rhinosinusitis. Although contamination of adjunctive devices (e.g. irrigation bottles) has been much investigated, little is known about nasal contamination of the metered-dose spray bottles used to deliver intranasal steroids, and the potential influence on disease chronicity.Methods:Twenty-five prospectively recruited patients with stable chronic rhinosinusitis underwent microbiological analysis of their nasal vestibule and middle meatus and also of their steroid bottle tip and contents. Additionally, bottle tips were inoculated in vitro with Staphylococcus aureus and various sterilisation techniques tested.Results:For 18 of the 25 (72 per cent) patients, both nasal and bottle tip swabs grew either Staphylococcus aureus or coagulase-negative staphylococci. Staphylococcus aureus was cultured from 7 of the 25 (28 per cent) patients, and 5 of these 7 had concomitant bacterial growth from both nose and steroid bottle. Thus, the cross-contamination rate was 71 per cent for Staphylococcus aureus infected patients and 20 per cent overall. Sterilisation was effective with boiling water, ethanol wipes and microwaving, but not with cold water or dishwashing liquid.Conclusion:Nasal steroid spray bottle tips can become contaminated with sinonasal cavity bacteria. Simple sterilisation methods can eliminate this contamination. Patient education on this matter should be emphasised.

Bacterial Colonization of Nasal Steroid Inhalers in Chronic Rhinosinusitis

2002 ◽  
Vol 16 (6) ◽  
pp. 319-321 ◽  
Author(s):  
Neil Bhattacharyya ◽  
Lynn Kepnes
Keyword(s):  
Chronic Rhinosinusitis ◽  
Pathogenic Bacteria ◽  
Bacterial Colonization ◽  
Bacillus Species ◽  
Microbiological Analysis ◽  
Coagulase Negative Staphylococci ◽  
Chi Square ◽  
Oral Flora ◽  
Nasal Steroid ◽  
And Control

Background The aim of this study was to determine if nasal steroid inhalers harbor bacteria. Methods Nasal steroid inhalers were randomly selected from an adult patient population with chronic rhinosinusitis. Swab cultures of the tip of the nasal inhaler were obtained and submitted for microbiological analysis. Contemporaneous control cultures were obtained from freshly opened nasal steroid inhalers. Comparisons were conducted between bacterial recovery rates and types of organisms recovered from the patient and control groups. Results Among 31 nasal inhalers in use, 14 inhalers (45%) were found to harbor bacteria. The most common organisms were coagulase negative Staphylococci (11 inhalers) followed by oral flora (2 inhalers) and bacillus species (1 inhaler). None of the 10 control cultures were found to harbor bacteria. Nasal steroid inhalers in use were more likely to have bacterial colonization than new inhalers (p = 0.008, chi-square). Conclusions Nasal steroid inhalers may harbor pathogenic bacteria. Therefore, they may serve as a vehicle for subsequent reinfection.

scholarly journals In Vitro activity of a Novel Benzoquinolizine Antibiotic, Levonadifloxacin (WCK 771) against Blood Stream Gram-Positive Isolates from a Tertiary Care Hospital

2020 ◽  
Vol 12 (03) ◽  
pp. 230-232
Author(s):  
Dhruv Mamtora ◽  
Sanjith Saseedharan ◽  
Ritika Rampal ◽  
Prashant Joshi ◽  
Pallavi Bhalekar ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tolerability Profile ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Methicillin Resistant

Abstract Background Blood stream infections (BSIs) due to Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality ranging from 10 to 60%. The current anti-MRSA agents have limitations with regards to safety and tolerability profile which limits their prolonged usage. Levonadifloxacin and its oral prodrug alalevonadifloxacin, a novel benzoquinolizine antibiotic, have recently been approved for acute bacterial skin and skin structure infections including diabetic foot infections and concurrent bacteremia in India. Methods The present study assessed the potency of levonadifloxacin, a novel benzoquinolizine antibiotic, against Gram-positive blood stream clinical isolates (n = 31) collected from January to June 2019 at a tertiary care hospital in Mumbai, India. The susceptibility of isolates to antibacterial agents was defined following the Clinical and Laboratory Standard Institute interpretive criteria (M100 E29). Results High prevalence of MRSA (62.5%), quinolone-resistant Staphylococcus aureus (QRSA) (87.5%), and methicillin-resistant coagulase-negative staphylococci (MR-CoNS) (82.35%) were observed among bacteremic isolates. Levonadifloxacin demonstrated potent activity against MRSA, QRSA, and MR-CoNS strains with significantly lower minimum inhibitory concentration MIC50/90 values of 0.5/1 mg/L as compared with levofloxacin (8/32 mg/L) and moxifloxacin (2/8 mg/L). Conclusion Potent bactericidal activity coupled with low MICs support usage of levonadifloxacin for the management of BSIs caused by multidrug resistant Gram-positive bacteria.

scholarly journals Evaluation of a Bioengineered Honey and Its Synthetic Equivalent as Novel Staphylococcus aureus Biofilm-Targeted Topical Therapies in Chronic Rhinosinusitis

2019 ◽  
Vol 34 (1) ◽  
pp. 80-86 ◽  
Author(s):  
Dionyssia Papadopoulou ◽  
Alicja Dabrowska ◽  
Philip G. Harries ◽  
Jeremy S. Webb ◽  
Raymond N. Allan ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Activity ◽  
Chronic Rhinosinusitis ◽  
In Vitro Study ◽  
Sinus Surgery ◽  
Bacterial Strains ◽  
Methicillin Resistant ◽  
Log Reduction ◽  
Lower Minimum Inhibitory Concentration

Background Chronic rhinosinusitis (CRS) is a common condition which affects the quality of life of millions of patients worldwide and has a significant impact on health-care resources. While Staphylococcus aureus bacterial biofilms play an important role in this disease, antimicrobial therapy is rarely effective and may promote antibiotic resistance. Thus, development of novel biofilm-targeting and antibiotic-sparing therapies is highly desirable and urgently required. Objective This in vitro study evaluated the antimicrobial activity of a novel synthetic honey-equivalent product which was designed to have the same reactive oxygen release profile as the engineered honey SurgihoneyRO™. Methods Treatment efficacy was investigated by assessment of planktonic growth, biofilm viability, thickness, and biomass using 12 CRS-related S. aureus mucosal bacterial strains. Results Both SurgihoneyRO™ and the synthetic honey-equivalent product inhibited growth of planktonic methicillin-resistant and methicillin-sensitive S. aureus strains, with the synthetic honey-equivalent product exhibiting a lower minimum inhibitory concentration. Treatment of established S. aureus biofilms reduced biofilm viability with 24-hour treatment resulting in a 2-log reduction in viability of biofilms formed by methicillin-resistant strains and a 1-log reduction in biofilms formed by methicillin-sensitive strains. Conclusions This preliminary study shows that the synthetic honey-equivalent product provides marked antimicrobial activity against S. aureus biofilms, with the potential for development in the clinical setting as an adjunctive biofilm-targeted therapy in CRS. The ultimate aim of such a product would be to reduce the need for antibiotics, steroids, and invasive surgical procedures in CRS patients as well as improving clinical outcomes following endoscopic sinus surgery.

scholarly journals In Vitro Activities of Tigecycline (GAR-936) against Recently Isolated Clinical Bacteria in Spain

2002 ◽  
Vol 46 (3) ◽  
pp. 892-895 ◽  
Author(s):  
Carmen Betriu ◽  
Iciar Rodríguez-Avial ◽  
Blas Ali Sánchez ◽  
María Gómez ◽  
Juan Álvarez ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Streptococcus Pneumoniae ◽  
Stenotrophomonas Maltophilia ◽  
Wide Spectrum ◽  
Anaerobic Bacteria ◽  
Antimicrobial Activities ◽  
Coagulase Negative Staphylococci ◽  
Medical Centers ◽  
Aerobic And Anaerobic

ABSTRACT The antimicrobial activities of tigecycline (GAR-936) were compared with those of other agents against 1,087 strains recently isolated in 12 Spanish medical centers. Tigecycline showed activity against a wide spectrum of aerobic and anaerobic bacteria, including strains such as methicillin-resistant Staphylococcus aureus, coagulase-negative staphylococci, penicillin-resistant Streptococcus pneumoniae, Enterococcus faecium, Acinetobacter baumannii, and Stenotrophomonas maltophilia.

scholarly journals Comparative In Vitro Activities and Postantibiotic Effects of the Oxazolidinone Compounds Eperezolid (PNU-100592) and Linezolid (PNU-100766) versus Vancomycin against Staphylococcus aureus, Coagulase-Negative Staphylococci, Enterococcus faecalis, and Enterococcus faecium

1998 ◽  
Vol 42 (3) ◽  
pp. 721-724 ◽  
Author(s):  
Michael J. Rybak ◽  
Diane M. Cappelletty ◽  
Tabitha Moldovan ◽  
Jeffrey R. Aeschlimann ◽  
Glenn W. Kaatz
Keyword(s):  
Staphylococcus Aureus ◽  
Enterococcus Faecalis ◽  
Inhibitory Activity ◽  
Enterococcus Faecium ◽  
Antibacterial Agents ◽  
Clinical Isolates ◽  
Postantibiotic Effect ◽  
Coagulase Negative Staphylococci ◽  
Time Kill

ABSTRACT The activities of the oxazolidinone antibacterial agents eperezolid (PNU-100592) and linezolid (PNU-100766) were compared with that of vancomycin against clinical isolates of methicillin-susceptible and -resistant Staphylococcus aureus (n = 200), coagulase-negative staphylococci (n = 100), and vancomycin-susceptible and -resistant Enterococcus faecalisand Enterococcus faecium (n = 50). Eperezolid and linezolid demonstrated good in vitro inhibitory activity, regardless of methicillin susceptibility for staphylococci (MIC at which 90% of the isolates are inhibited [MIC90] range, 1 to 4 μg/ml) or vancomycin susceptibility for enterococci (MIC90 range, 1 to 4 μg/ml). In time-kill studies, eperezolid and linezolid were bacteriostatic in action. A postantibiotic effect of 0.8 ± 0.5 h was demonstrated for both eperezolid and linezolid against S. aureus, S. epidermidis, E. faecalis, and E. faecium.

scholarly journals In Vitro Activities of Noveltrans-3,5-Disubstituted Pyrrolidinylthio-1β-Methylcarbapenems with Potent Activities against Methicillin-Resistant Staphylococcus aureus andPseudomonas aeruginosa

2000 ◽  
Vol 44 (3) ◽  
pp. 489-495 ◽  
Author(s):  
Rie Nagano ◽  
Kaneyoshi Shibata ◽  
Yuka Adachi ◽  
Hideaki Imamura ◽  
Terutaka Hashizume ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Side Chain ◽  
The Novel ◽  
Good Activity ◽  
Penicillin Binding Protein ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
The Family

ABSTRACT The in vitro activities of the novel 1β-methylcarbapenems J-111,225, J-114,870, and J-114,871, which have a structurally unique side chain that consists of a trans-3,5-disubstituted 5-arylpyrrolidin-3-ylthio moiety at the C-2 position, were compared with those of reference antibiotics. Among isolates of both methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCoNS), 90% were inhibited by J-111,347 (prototype), J-111,225, J-114,870, and J-114,871 at concentrations of 2, 4, 4, and 4 μg/ml (MICs at which 90% of isolates are inhibited [MIC90s]), respectively, indicating that these agents were 32- to 64-fold more potent than imipenem, which has an MIC90 of 128 μg/ml. Although these drugs were less active in vitro than vancomycin, which had MIC90s of 1 and 2 μg/ml for MRSA and MRCoNS, respectively, the new carbapenems displayed better killing kinetics than vancomycin. The potent anti-MRSA activity was ascribed to the excellent affinities of the new carbapenems for penicillin-binding protein 2a of MRSA. Since the new carbapenems also exhibited good activity against gram-positive and -negative bacteria including clinically important pathogens such as penicillin-resistantStreptococcus pneumoniae, Haemophilus influenzae, members of the family Enterobacteriaceae,Pseudomonas aeruginosa, and Clostridium difficile, as well as MRSA, the novel carbapenems are worthy of further evaluation.

Bacteriology of chronic purulent secretions in chronic rhinosinusitis

1998 ◽  
Vol 112 (12) ◽  
pp. 1162-1166 ◽  
Author(s):  
Jean-Michel Klossek ◽  
Luc Dubreuil ◽  
Hervé Richet ◽  
Béatrice Richet ◽  
Patrice Beutter
Keyword(s):  
Chronic Rhinosinusitis ◽  
Bacterial Flora ◽  
Nasal Discharge ◽  
Oral Antibiotic ◽  
Pathogenic Species ◽  
Coagulase Negative Staphylococci ◽  
Sinus Cavity ◽  
Endoscopic Guidance ◽  
Sinus Ostium

AbstractThe aim of this work was to study the bacterial flora of purulent secretions during chronic rhinosinusitis. We studied a total of 533 patients divided into two groups. The control population consisted of 139 adults (> 16 years) of both sexes seen in the community or hospitalized for less than 72 hours for non-rhinological conditions. The rhinosinusitis group consisted of 394 patients referred to the ENT clinic with chronic rhinosinusitis. All the patients with rhinosinusitis had had a post-nasal discharge for at least three months, associated with purulent or mucopurulent secretions originating from the involved sinus cavity. All samples were obtained endonasally under endoscopic guidance from the sinus ostium or from the sinus cavity during surgery. Cultures were positive in 81.3 per cent of the control subjects and 83.1 per cent of the patients with rhinosinusitis.Corynebacteria, coagulase-negative staphylococci, propionibacteria and peptostreptococci were the main commensal organisms, whileHaemophilus influenzae, streptococci,Streptococcus pneumoniae, Prevotellaspp andFusobacteriumspp were probable causative pathogens. Anaerobes were isolated from approximately 25 per cent of the patients in the rhinosinusitis group. Betalactamase producers represented 27.5 per cent ofH. influenzaeand 28 per cent ofPrevotellaspp isolates. Diminished susceptibility to penicillin was found in 13 per cent ofS. pneumoniaeisolates. The amoxycillin-clavulanate combination was the most active oral antibiotic tested against the pathogenic species in vitro.

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