scholarly journals Evaluation of effectiveness and compliance with the mupirocin nasal ointment part of Staphylococcus aureus decolonization in real life using UPLC-MS/MS mupirocin quantification

2020 ◽  
Vol 75 (6) ◽  
pp. 1623-1630 ◽  
Author(s):  
Roxane Nicolas ◽  
Anne Carricajo ◽  
Jérôme Morel ◽  
Josselin Rigaill ◽  
Florence Grattard ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cardiac Surgery ◽  
Real Life ◽  
Nasal Carriage ◽  
Nasal Sample ◽  
Real Life Setting ◽  
Increased Risk ◽  
Nasal Mupirocin ◽  
Compliance Issue

Abstract Background Preoperative decolonization is recommended in Staphylococcus aureus nasal carriers scheduled for cardiac surgery. We aimed to evaluate the effectiveness of and compliance with mupirocin use in nasal S. aureus carriers in a real-life setting. Methods Prospective study including consecutive patients scheduled for cardiac surgery screened for S. aureus nasal carriage at preoperative consultation. Carriers were prescribed mupirocin nasal ointment, chlorhexidine shower and mouthwash. Effectiveness of decolonization was evaluated with a postoperative nasal sample. Compliance was evaluated objectively by determination of nasal mupirocin concentration using UPLC-MS/MS and self-reported by questionnaire. Results Over 10 months, 361 patients were included, 286 had preoperative screening, 75 (26.2%) were S. aureus nasal carriers and 19 of them (25.3%) failed to be effectively decolonized. No resistance to mupirocin was documented. Preoperative and postoperative strains were identical in all cases. Declared good compliance was associated with decolonization success (OR = 24; 95% CI 4–143, P < 0.0001). Mupirocin detection was significantly associated with the level of compliance. Mupirocin was detected in 52.2% (24/46) of patients effectively decolonized and in 12.5% (2/16) of patients with decolonization failure (P < 0.01). In 2/19 patients, failure of decolonization was not associated with a compliance issue. Postoperative carriage was associated with an increased risk of S. aureus infection (OR = 9.8; 95% CI 1.8–53, P < 0.01). Conclusions In real life, decolonization is not always effective, hence there is a persisting risk of S. aureus endogenous infection. Mupirocin concentration measurement may help to understand compliance issues and failures in decolonization.

scholarly journals Clearance of Staphylococcus aureus Nasal Carriage Is T Cell Dependent and Mediated through Interleukin-17A Expression and Neutrophil Influx

2013 ◽  
Vol 81 (6) ◽  
pp. 2070-2075 ◽  
Author(s):  
Nathan K. Archer ◽  
Janette M. Harro ◽  
Mark E. Shirtliff
Keyword(s):  
Staphylococcus Aureus ◽  
Immune Response ◽  
T Cell ◽  
Immune Responses ◽  
Neutrophil Migration ◽  
Nasal Carriage ◽  
Causal Connection ◽  
Content Type ◽  
Neutrophil Influx ◽  
Increased Risk

ABSTRACTThe anterior nares of humans are the major reservoir forStaphylococcus aureuscolonization. Approximately 20% of the healthy human population is persistently and 80% is intermittently colonized withS. aureusin the nasal cavity. Previous studies have shown a strong causal connection betweenS. aureusnasal carriage and increased risk of nosocomial infection, as well as increased carriage due to immune dysfunction. However, the immune responses that permit persistence or mediate clearance ofS. aureuson the nasal mucosa are fundamentally undefined. In this study, we developed a carriage model in C57BL/6J mice and showed that clearance begins 14 days postinoculation. In contrast, SCID mice that have a deficient adaptive immune response are unable to eliminateS. aureuseven after 28 days postinoculation. Furthermore, decolonization was found to be T cell mediated but B cell independent by evaluating carriage clearance in T-cell receptor β/δ (TCR-β/δ) knockout (KO) and IgH-μ KO mice, respectively. Upregulation of the cytokines interleukin 1β (IL-1β), KC (also termed CXC ligand 1 [CXCL1]), and IL-17A occurred following inoculation with intranasalS. aureus. IL-17A production was crucial for clearance, since IL-17A-deficient mice were unable to effectively eliminateS. aureuscarriage. Subsequently, cell differential counts were evaluated from nasal lavage fluid obtained from wild-type and IL-17A-deficient colonized mice. These counts displayed IL-17A-dependent neutrophil migration. Antibody-mediated depletion of neutrophils in colonized mice caused reduced clearance compared to that in isotype-treated controls. Our data suggest that the Th17-associated immune response is required for nasal decolonization. This response is T cell dependent and mediated via IL-17A production and neutrophil influx. Th17-associated immune responses may be targeted for strategies to mitigate distal infections originating from persistentS. aureuscarriage in humans.

scholarly journals Nasal carriage of Staphylococcus aureus in farm animals and breeders in North of Morocco

2020 ◽  
Author(s):  
Nadira Mourabit ◽  
Abdelhay Arakrak ◽  
Mohammed Bakkali ◽  
Zeineb Zian ◽  
Joaira Bakkach ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Virulence Genes ◽  
Nasal Carriage ◽  
High Rate ◽  
Farm Animals ◽  
Carriage Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
Mrsa Strains

Abstract Background: The objectives of this study were to determine for the first time, in Morocco, the nasal carriage rate, antimicrobial susceptibility profiles and virulence genes of Staphylococcus. aureus isolated from animals and breeders in close contact.Methods: From 2015 to 2016, 421 nasal swab samples were collected from 26 different livestock areas in Tangier. Antimicrobial susceptibility phenotypes were determined by disk diffusion according to EUCAST 2015. The presence of nuc , mec A, mec C, lukS/F-PV, and tst genes were determined by Polymerase Chain Reaction (PCR) for all isolates.Results: The overall S. aureus nasal carriage rate was low in animals (9.97%) and high in breeders (60%) with a statistically significant difference, (OR= 13.536; 95% CI = 7.070- 25.912; p< 0.001). In general, S. aureus strains were susceptible to the majority of antibiotics and the highest resistance rates were found against tetracycline (16.7% in animals and 10% in breeders). No Methicillin-Resistant S. aureus (MRSA) was detected in animals and breeders. A high rate of tst and lukS/F-PV genes has been recovered only from animals (11.9% and 16.7%, respectively).Conclusion: Despite the lower rate of nasal carriage of S. aureus and the absence of MRSA strains in our study, S. aureus strains harbored a higher frequency of tst and lukS/F-PV virulence genes, which is associated to an increased risk of infection dissemination in humans. This highlights the need for further larger and multi-center studies to better define the transmission of the pathogenic S. aureus between livestock, environment, and humans.

scholarly journals Nasal carriage of Staphylococcus aureus in livestock in North of Morocco

2020 ◽  
Author(s):  
Nadira Mourabit ◽  
Abdelhay Arakrak ◽  
Mohammed Bakkali ◽  
Zeineb Zian ◽  
Joaira Bakkach ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Virulence Genes ◽  
Close Contact ◽  
Nasal Carriage ◽  
High Rate ◽  
Carriage Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
Mrsa Strains

Abstract Background : In Morocco, data of LA-MRSA nasal carriage are still limited. The objectives of this study were to determine for the first time the nasal carriage rate, antimicrobial susceptibility profiles and virulence genes of S aureus isolated from animals and breeders in close contact. Methods : From 2015 to 2016, 480 nasal swab samples were collected from 27 different Livestock areas in Tangier. The antimicrobial susceptibility phenotypes were determined by disk diffusion according to EUCAST 2016. The presence of nuc , mec A and his homologue mec C, lukS/F-PV, and tst genes were determined by PCR for all isolates. Results : The overall S. aureus nasal carriage rate was low in animals (9.97%) and high in breeders (60%) with a statistically significant difference, (OR = 14.321; 95% CI = 7.484- 27.405; p< 0.0001). In general, S. aureus strains were susceptible to the majority of antibiotics and the higher resistance rates were found against tetracycline (16.7% in animals and 10% in breeders). No MRSA was detected in animals and breeders. A high rate of tst and lukS/F-PV genes has been found only in animals (11.9% and 16.7%, respectively). Conclusion : Despite the lower colonization rate of S. aureus and the absence of MRSA strains in our study, S. aureus strains harbored a higher frequency of tst and lukS/F-PV of virulence genes, which is associated to an increased risk of infection dissemination in humans. This highlights the need for implementing adequate approaches for prevention. Further larger and multi-center studies are needed to validate and confirm our findings. Keywords: Staphylococcus aureus , nasal carriage, animals, breeders, MRSA, Morocco

scholarly journals Prevalence and population structure of Staphylococcus aureus nasal carriage in healthcare workers in a general population. The Tromsø Staph and Skin Study

2012 ◽  
Vol 141 (1) ◽  
pp. 143-152 ◽  
Author(s):  
K. OLSEN ◽  
M. SANGVIK ◽  
G. S. SIMONSEN ◽  
J. U. E. SOLLID ◽  
A. SUNDSFJORD ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Logistic Regression ◽  
Population Structure ◽  
Regression Models ◽  
Healthcare Workers ◽  
Nasal Carriage ◽  
Population Based ◽  
Family Status ◽  
Logistic Regression Models ◽  
Increased Risk

SUMMARYHealthcare workers (HCWs) may be a reservoir for Staphylococcus aureus transmission to patients. We examined whether HCW status is associated with S. aureus nasal carriage and population structure (spa types) in 1302 women (334 HCWs) and 977 men (71 HCWs) aged 30–69 years participating in the population-based Tromsø Study in 2007–2008. Multivariable logistic regression models were used. While no methicillin-resistant S. aureus (MRSA) was isolated, overall, 26·2% of HCWs and 26·0% of non-HCWs were S. aureus nasal carriers. For women overall and women residing with children, the odds ratios for nasal carriage were 1·54 [95% confidence interval (CI) 1·09–2·19] and 1·86 (95% CI 1·14–3·04), respectively, in HCWs compared to non-HCWs. Moreover, HCWs vs. non-HCWs had a 2·17 and 3·16 times higher risk of spa types t012 and t015, respectively. This supports the view that HCWs have an increased risk of S. aureus nasal carriage depending on gender, family status and spa type.

scholarly journals Impact of mass administration of azithromycin as a preventive treatment on the prevalence and resistance of nasopharyngeal carriage of Staphylococcus aureus

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257190
Author(s):  
Soumeya Hema-Ouangraoua ◽  
Juliette Tranchot-Diallo ◽  
Issaka Zongo ◽  
Nongodo Firmin Kabore ◽  
Frédéric Nikièma ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Infections ◽  
Methicillin Resistance ◽  
Pediatric Population ◽  
Preventive Treatment ◽  
Nasal Carriage ◽  
Post Intervention ◽  
Serious Illness ◽  
Increased Risk ◽  
The Impact

Staphylococcus aureus is a major cause of serious illness and death in children, indicating the need to monitor prevalent strains, particularly in the vulnerable pediatric population. Nasal carriage of S. aureus is important as carriers have an increased risk of serious illness due to systemic invasion by this pathogen and can transmit the infection. Recent studies have demonstrated the effectiveness of azithromycin in reducing the prevalence of nasopharyngeal carrying of pneumococci, which are often implicated in respiratory infections in children. However, very few studies of the impact of azithromycin on staphylococci have been undertaken. During a clinical trial under taken in 2016, nasal swabs were collected from 778 children aged 3 to 59 months including 385 children who were swabbed before administration of azithromycin or placebo and 393 after administration of azithromycin or placebo. Azithromycin was given in a dose of 100 mg for three days, together with the antimalarials sulfadoxine-pyrimethamine and amodiaquine, on four occasions at monthly intervals during the malaria transmission season. These samples were cultured for S. aureus as well as for the pneumococcus. The S. aureus isolates were tested for their susceptibility to azithromycin (15 g), penicillin (10 IU), and cefoxitine (30 g) (Oxoid Ltd). S. aureus was isolated from 13.77% (53/385) swabs before administration of azithromycin and from 20.10% (79/393) six months after administration (PR = 1.46 [1.06; 2.01], p = 0.020). Azithromycin resistance found in isolates of S. aureus did not differ significantly before and after intervention (26.42% [14/53] vs 16.46% [13/79], (PR = 0.62 [0.32; 1.23], p = 0.172). Penicillin resistance was very pronounced, 88.68% and 96.20% in pre-intervention and in post-intervention isolates respectively, but very little Methicillin Resistance (MRSA) was detected (2 cases before and 2 cases after intervention). Monitoring antibiotic resistance in S. aureus and other bacteria is especially important in Burkina Faso due to unregulated consumption of antibiotics putting children and others at risk.

scholarly journals Nasal carriage of Staphylococcus aureus in farm animals and breeders in North of Morocco

2020 ◽  
Author(s):  
Nadira Mourabit ◽  
Abdelhay Arakrak ◽  
Mohammed Bakkali ◽  
Zeineb Zian ◽  
Joaira Bakkach ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Virulence Genes ◽  
Close Contact ◽  
Nasal Carriage ◽  
High Rate ◽  
Farm Animals ◽  
Carriage Rate ◽  
Increased Risk ◽  
Significant Difference

Abstract Background: The objectives of this study were to determine for the first time, in Morocco, the nasal carriage rate, antimicrobial susceptibility profiles and virulence genes of Staphylococcus. aureus isolated from animals and breeders in close contact.Methods: From 2015 to 2016, 421 nasal swab samples were collected from 26 different livestock areas in Tangier. Antimicrobial susceptibility phenotypes were determined by disk diffusion according to EUCAST 2015. The presence of nuc, mecA, mecC, lukS/F-PV, and tst genes were determined by Polymerase Chain Reaction (PCR) for all isolates. Results: The overall S. aureus nasal carriage rate was low in animals (9.97%) and high in breeders (60%) with a statistically significant difference, (OR= 13.536; 95% CI = 7.070- 25.912; p< 0.001). In general, S. aureus strains were susceptible to the majority of antibiotics and the highest resistance rates were found against tetracycline (16.7% in animals and 10% in breeders). No Methicillin-Resistant S. aureus (MRSA) was detected in animals and breeders. A high rate of tst and lukS/F-PV genes has been recovered only from animals (11.9% and 16.7%, respectively).Conclusion: Despite the lower rate of nasal carriage of S. aureus and the absence of MRSA strains in our study, S. aureus strains harbored a higher frequency of tst and lukS/F-PV virulence genes, which is associated to an increased risk of infection dissemination in humans. This highlights the need for further larger and multi-center studies to better define the transmission of the pathogenic S. aureus between livestock, environment, and humans.

scholarly journals Nasal Carriage Of Staphylococcus aureus As A Major Risk Factor For Wound Infections After Cardiac Surgery

1995 ◽  
Vol 171 (1) ◽  
pp. 216-219 ◽  
Author(s):  
J. A. J. W. Kluytmans ◽  
J. W. Mouton ◽  
E. P. F. Ijzerman ◽  
C. M. J. E. Vandenbroucke-Grauls ◽  
A. W. P. M. Maat ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Nasal Carriage ◽  
Major Risk Factor ◽  
Wound Infections

scholarly journals NP108, an Antimicrobial Polymer with Activity against Methicillin- and Mupirocin-Resistant Staphylococcus aureus

2017 ◽  
Vol 61 (9) ◽  
Author(s):  
Derry K. Mercer ◽  
Laura K. Katvars ◽  
Fiona Hewitt ◽  
Daniel W. Smith ◽  
Jennifer Robertson ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infections ◽  
Standard Of Care ◽  
Nasal Carriage ◽  
Building Blocks ◽  
Water Soluble ◽  
Current Standard ◽  
Content Type ◽  
Increased Risk ◽  
Clinically Significant

ABSTRACT Staphylococcus aureus is a clinically significant human pathogen that causes infectious diseases ranging from skin and soft tissue infections (SSTI) and health care-associated infections (HAI) to potentially fatal bacteremia and endocarditis. Nasal carriage of S. aureus, especially for persistent carriage, is associated with an increased risk of subsequent infection, particularly nosocomial and surgical site infections (SSI), usually via autoinfection. NP108 is a cationic antimicrobial polymer composed of generally recognized as safe (GRAS) amino acid building blocks. NP108 is broad spectrum and rapidly bactericidal (3-log kill in ≤3 h), killing bacteria by membrane disruption and cell lysis. NP108, contrary to many antibiotics, shows equally effective antimicrobial activity against a variety of S. aureus (MIC100 = 8 to 500 mg/liter) and S. epidermidis (MIC100 = 4 to 8 mg/liter) isolates, whether exponentially growing or in stationary phase. NP108 is antimicrobially active under nutrient-limiting conditions similar to those found in the anterior nares (MIC100 = 8 mg/liter) and kills antibiotic-resilient small colony variants (MIC100 = 32 mg/liter) and S. aureus biofilms (prevention, MIC100 = 1 to 4 mg/liter; eradication, MIC100 ≥ 31.25 mg/liter). NP108 is active against isolates of S. aureus resistant to the current standard-of-care decolonization agent, mupirocin, with no significant increase in the MIC100. NP108 is water soluble and has been formulated into compatible aqueous gel vehicles for human use in which antimicrobial efficacy is retained (2.0% [wt/vol]). NP108 is a potential nonantibiotic antimicrobial alternative to antibiotics for the nasal decolonization of S. aureus, with clear advantages in its mechanism of action over the existing gold standard, mupirocin.

scholarly journals Safety of Endostar in combination with chemotherapy in patients with cancer

2020 ◽  
Author(s):  
dongxiao wang ◽  
man zhu ◽  
daihong guo ◽  
lei xia ◽  
xiaowu huang ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Real Life ◽  
Blood Cell Count ◽  
Bleeding Events ◽  
Real Life Setting ◽  
Increased Risk ◽  
Grade 3

Abstract Background: A number of studies indicated the benefits and safety of Endostar in combination with chemotherapy in cancer, but the exact real-life safety of Endostar is poorly known. This study aimed to assess the safety of Endostar in combination with chemotherapy in patients with cancer in a real-life setting in China. Methods: This was a retrospective study of patients treated with Endostarin combination with chemotherapy in the Chinese PLA General Hospital (Beijing, China) from 1 st January 2006to 31 st December 2017. All data were obtained from the Hospital Information System(HIS). Laboratory abnormalities were evaluated according to Common Terminology Criteria for Adverse Events(CTCAE) 4.0.Bleeding events and wound healing complications after surgery associated with Endostar were evaluated based on case records. Results: A total of 825 patients were included. There were no patients used Endostar alone in real-life settings. Overall, anemia occurred in 74.5% of the assessed patients, thrombocytopenia occurred in 29.0%, abnormal white blood cell count occurred in 54.5%, abnormal liver function occurred in 13.8%, and increased creatinine occurred in 1.2%. No definite bleeding events and wound healing complications after surgery associated with Endostar were found based on case records. Most laboratory AEs were of grade 1-2. Lung cancer, osteosarcoma and doxorubicin-based chemotherapy was associated with an increased risk of grade≥3 abnormal white blood cell count ( P <0.05). The total dose of Endostar was not associated with severe AEs(grade≥3)of thrombocytopenia and abnormal white blood cell count. Conclusion: The occurrence of AEs during treatment with Endostar in combination with chemotherapy differed across different tumor types and chemotherapy regimens. No new unexpected AEs relating to Endostar were observed from this study. The total dose of Endostar was not associated with increased risk of severe AEs (grade≥3)of thrombocytopenia and abnormal white blood cell count when used in combination with chemotherapy in the real-life setting.

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