scholarly journals Correlation between Vancomycin MIC Values and Those of Other Agents against Gram-Positive Bacteria among Patients with Bloodstream Infections Caused by Methicillin-Resistant Staphylococcus aureus

2009 ◽  
Vol 53 (12) ◽  
pp. 5141-5144 ◽  
Author(s):  
N. Patel ◽  
P. Lubanski ◽  
S. Ferro ◽  
M. Bonafede ◽  
S. Harrington ◽  
...  

ABSTRACT An increase in the distribution of vancomycin MIC values among methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) isolates has been noted. It is postulated that the shift in vancomycin MIC values may be associated with a concurrent rise in the MIC values of other anti-MRSA agents. Scant data are available on the correlation between vancomycin MIC values and the MIC values of other anti-MRSA agents. This study examined the correlation between vancomycin MIC values and the MIC values of daptomycin, linezolid, tigecycline, and teicoplanin among 120 patients with bloodstream infections caused by MRSA at a tertiary care hospital between January 2005 and May 2007. For each included patient, the MIC values of the antibiotics under study were determined by the Etest method and were separated into the following two categories: day 1 (index) and post-day 1 (subsequent). For subsequent isolates, the MIC values for each antibiotic from the post-day 1 terminal isolate were used. Among the index isolates, there was a significant correlation (P value, <0.01) between the MIC values for vancomycin and daptomycin and between the MIC values for vancomycin and teicoplanin. The MIC values for daptomycin were significantly correlated with linezolid, tigecycline, and teicoplanin MIC values. Among the 48 patients with subsequent isolates, vancomycin MIC values were significantly correlated with MIC values for daptomycin, linezolid, and teicoplanin (ρ value of ≥0.38 for all comparisons). This study documented an association between vancomycin MIC values and the MIC values of other anti-MRSA antibiotics among patients with bloodstream infections caused by MRSA primarily treated with vancomycin.

2021 ◽  
Author(s):  
Jadoon Khan ◽  
Israr Ahmad ◽  
Nosheen Basharat ◽  
Alam Khan ◽  
Asma Sadiq ◽  
...  

Abstract BackgroundNosocomial infections are a global health problem, affecting 1.4 million people in treatment centers, responsible for 80,000 estimated annual deaths. The current study aimed to assess the factor influencing nosocomial infections and to choose the best antibiotic for its treatment through culture analysis.MethodologyThe current study was conducted in a tertiary care hospital Rawalpindi. A total of 120 patients with at least one nosocomial episode were included. Blood, urine, and wound swab sample were collected for hematology, biochemistry, electrolyte, and microbial analysis. Multivariate regression analysis through SPSS (ver. 16.0) were done, p-value of ≤ 0.05 was considered statistically significant.ResultThe prevalence of culture-confirmed nosocomial infection was 25%, among which age groups (P = 0.00, 95% CI, − .382-.271) were significantly correlated. Hematological analysis shows that 73.3% have lymphopenia (P = 0.00, 95% CI .567-1.175), 73.3% have Neutrocytosis (P = 0.00, 95% CI .553-1.122) and anemia (26.7%) (P = 0.002, 95% CI .097-.404) were statistically significant. Raised level of ALT (60%), Bilirubin (26.7%) and ALP (13.3%) among liver functional tests (P = 0.68, 95% CI .686- .280) found insignificant however abnormal level of urea (33.3%) and creatinine (46.7%) (P = 0.00, 95% CI -1.227-.392) were significantly correlated with nosocomial infections. Electrolytes profile shows that Hypernatremia (26.7%) (P = 0.000, 95% CI-.491–.227) were strongly correlated. Culture analysis isolated six bacterial agents, comprising 83.3%:16.6% ratio of gram-negative and gram-positive isolates. Klebsiella pneumonia was frequently isolated gram-negative, while Methicillin-Resistant Staphylococcus aureus was the only gram-positive isolate collected. Urinary tract infection (UTI) (36.6%) was frequently found, followed by bloodstream infection (26.6%) (BSI). The majority of the gram-negative isolates were sensitive to Imipenem while resistant to Amoxicillin + Clavulanic acid, Trimethoprim/sulfamethoxazole, cefoxitin, Levofloxacin, Norfloxacin, and linezolid antibiotics. Methicillin-resistant staphylococcus aureus was found sensitive against Trimethoprim/sulfamethoxazole while resistant towards linezolid, Imipenem, and Cefotaxime.ConclusionThe current study revealed that nosocomial infection is still prevalent in our hospital environment and the leading cause of drug resistance and dysfunctions of various factors like WBCs, LFTs, RFTs, electrolytes, coagulation factors and anemia, which can lead to morbidity and mortality.


2020 ◽  
Vol 12 (03) ◽  
pp. 230-232
Author(s):  
Dhruv Mamtora ◽  
Sanjith Saseedharan ◽  
Ritika Rampal ◽  
Prashant Joshi ◽  
Pallavi Bhalekar ◽  
...  

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.


Author(s):  
Latha T ◽  
Anil K Bhat ◽  
Manjunatha Hande H ◽  
Chiranjay Mukhopadyay ◽  
Elsa Sanatombi Devi ◽  
...  

 Objective: The aim of this study was to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carrier status in anterior nares and hands of health-care professionals working in orthopedic wards of a tertiary care hospital and to decolonize them to reduce spread of MRSA to their patients.Methods: The study was conducted in a super specialty, tertiary care teaching hospital. The samples were collected from anterior nares, palm, web spaces, and fingertips of 140 health-care professionals (48 doctors, 74 nurses, and 18 technicians) working in orthopedic wards using sterile pre-moistened swabs. MRSA carrier status was identified by Kirby-Bauer disc diffusion method.Result: Most (76.4%) of the health-care professionals were <30 years of age and 51% were male. MRSA in anterior nares of doctors was 4.3%, nurses 1.4%, and technicians 0.7% and none had MRSA in their hands. Methicillin-sensitive Staphylococcus aureus (MSSA) growth was more among nurses (nurses - 5.7%, doctors - 2.1%, and technicians - 1.4%) in anterior nares. In addition, 1.4% nurses’ hands were colonized with MSSA. Both MRSA and MSSA carriers were decolonized effectively and repeat sampling showed no growth.Conclusion: Health-care professionals have a greater chance of transmitting MRSA to patients and orthopedic patients are more susceptible for infection. Although MRSA carrier status was not very high among orthopedic health-care professionals compared to previous studies, it cannot be ignored. Nasal mupirocin and bath with chlorhexidine soap were effective in decolonization. Periodic screening and treatment of colonizers would help in elimination of MRSA carriage.


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