scholarly journals Pathogenesis of infections related to intravascular catheterization.

1993 ◽  
Vol 6 (2) ◽  
pp. 176-192 ◽  
Author(s):  
D A Goldmann ◽  
G B Pier
Keyword(s):  
Staphylococcus Epidermidis ◽  
Antimicrobial Agents ◽  
Life Support ◽  
Normal Skin ◽  
Host Factors ◽  
Infusion Therapy ◽  
Coagulase Negative Staphylococci ◽  
The Past ◽  
Skin Flora ◽  
Technological Improvements

Over the past few decades, there have been major technological improvements in the manufacture of intravenous solutions and the manufacture and design of catheter materials. However, the risk of infection in patients receiving infusion therapy remains substantial, in part because of host factors (for example, increased use of immunosuppressive therapy, more aggressive surgery and life support, and improved survival at the extremes of life) and in part because of the availability of catheters that can be left in place for very long periods. Microbial components of normal skin flora, particularly coagulase-negative staphylococci, have emerged as the predominant pathogens in catheter-associated infections. Therefore, efforts to prevent skin microorganisms from entering the catheter wound (such as tunnelling of catheters and use of catheter cuffs and local antimicrobial agents) are logical and relatively effective. The specific properties of microorganisms that transform normally harmless commensals such as coagulase-negative staphylococci into formidable pathogens in the presence of a plastic foreign body are being explored. For example, Staphylococcus epidermidis elaborates a polysaccharide adhesin that also functions as a capsule and is a target for opsonic killing. However, the interactions between microorganism and catheter that lead to adherence, persistence, infection, and dissemination appear to be multifactorial.

scholarly journals Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

1992 ◽  
Vol 5 (1) ◽  
pp. 36-48 ◽  
Author(s):  
A von Graevenitz ◽  
D Amsterdam
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Antimicrobial Agents ◽  
Positive Culture ◽  
Bloodstream Infections ◽  
Peritoneal Macrophages ◽  
Gram Stain ◽  
Coagulase Negative Staphylococci ◽  
Safe Alternative ◽  
Skin Flora

The process of continuous ambulatory peritoneal dialysis has provided a useful, relatively inexpensive, and safe alternative for patients with end-stage renal disease. Infectious peritonitis, however, has limited a more widespread acceptance of this technique. The definition of peritonitis in this patient population is not universally accepted and does not always include the laboratory support of a positive culture (or Gram stain). In part, the omission of clinical microbiological findings stems from the lack of sensitivity of earlier microbiological efforts. Peritonitis results from decreased host phagocytic efficiency with depressed phagocytosis and bactericidal capacity of peritoneal macrophages. During episodes of peritonitis, fluid movement is reversed, away from the lymphatics and peritoneal membrane and toward the cavity. As a result, bloodstream infections are rare. Most peritonitis episodes are caused by bacteria. Coagulase-negative staphylococci are the most frequently isolated organisms, usually originating from the skin flora, but a wide array of microbial species have been documented as agents of peritonitis. Clinical microbiology laboratories need to be cognizant of the diverse agents so that appropriate primary media can be used. The quantity of dialysate fluid that is prepared for culture is critical and should constitute at least 10 ml. The sensitivity of the cultural approach depends on the volume of dialysate, its pretreatment (lysis or centrifugation), the media used, and the mode of incubation. The low concentration of microorganisms in dialysate fluids accounts for negative Gram stain results. Prevention of infection in continuous ambulatory peritoneal dialysis patients is associated with the socioeconomic status of the patient, advances in equipment (catheter) technology, and, probably least important, the application of prophylactic antimicrobial agents.

scholarly journals Lower activation of caspase-1 by Staphylococcus epidermidis isolated from prosthetic joint infections compared to commensals

2018 ◽  
Vol 3 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Emeli Månsson ◽  
Berolla Sahdo ◽  
Åsa Nilsdotter-Augustinsson ◽  
Eva Särndahl ◽  
Bo Söderquist
Keyword(s):  
Staphylococcus Epidermidis ◽  
Normal Skin ◽  
Human Neutrophils ◽  
Caspase 1 ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Skin Flora ◽  
Number Of Individuals ◽  
Active Caspase

Abstract. Nosocomial sequence types of Staphylococcus epidermidis dominate in prosthetic joint infections. We examined caspase-1 activation in human neutrophils after incubation with Staphylococcus epidermidis isolated from prosthetic joint infections and normal skin flora. Active caspase-1 was lower after incubation with isolates from prosthetic joint infections than after incubation with commensal isolates. Both host and isolate dependent differences in active caspase-1 were noted. Our results indicate that there might be a host-dependent incapacity to elicit a strong caspase-1 response towards certain strains of S. epidermidis. Further experiments with a larger number of individuals are warranted.

scholarly journals Prevalence of peritonitis-associated coagulase-negative staphylococci on the skin of continuous ambulatory peritoneal dialysis patients

1989 ◽  
Vol 102 (3) ◽  
pp. 365-378 ◽  
Author(s):  
M. A. Beard-Pegler ◽  
C. L. Gabelish ◽  
E. Stubbs ◽  
C. Harbour ◽  
J. Robson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Profile Analysis ◽  
Normal Skin ◽  
Plasmid Profile ◽  
Phage Typing ◽  
Body Site ◽  
Dialysis Fluid ◽  
Coagulase Negative Staphylococci ◽  
Skin Flora

SUMMARYThe predominance of coagulase-negative staphylococci as normal skin flora is thought to be a factor in their association with episodes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. We investigated the prevalence of peritonitis-associated strains on the skin of 28 patients undergoing peritoneal dialysis. Coagulase-negative staphylococci were the most frequently isolated organisms. comprising 47% of peritoncal dialysis fluid isolates and 59% of body site isolates. A total of 142 coagulase-negative staphylococci were speciated. tested for their antimicrobial sensitivity and slime production. and identified by phage typing and plasmid-profile analysis.Staphylococcus epidermidiswas the most commonly identified species from both peritoncal dialysis fluid (73%) and body sites (53%). Multiple antibiotic resistance was common, and the greater proportion of isolates were resistant to methicillin: 63·6% of peritoncal dialysis fluid isolates and 61·7% of body-site isolates.isolates.S. haemolyticusisolates were significantly more resistant to methicillin than other species. By phage typing and plasmid-profile analysis it was shown that peritonitis was rarely caused by skincolonizing strains. In only 3 of 14 patients were peritonitis-associated strains isolated as skin colonizers, and no patients developed peritonitis due to organisms previously isolated as skin colonizers.

scholarly journals Clonal Expansion of Staphylococcus epidermidis Strains Causing Hickman Catheter-Related Infections in a Hemato-Oncologic Department

1998 ◽  
Vol 36 (9) ◽  
pp. 2696-2702 ◽  
Author(s):  
Jan L. Nouwen ◽  
Alex van Belkum ◽  
Siem de Marie ◽  
Jacqueline Sluijs ◽  
Jenne J. Wielenga ◽  
...  
Keyword(s):  
Blood Culture ◽  
Staphylococcus Epidermidis ◽  
Removal Rate ◽  
Coagulase Negative Staphylococci ◽  
Pathogenic Potential ◽  
Air Samples ◽  
Hickman Catheter ◽  
Skin Flora ◽  
Oncologic Patients ◽  
Very High

The detailed analysis of 411 strains of coagulase-negative staphylococci (CoNS) obtained from 40 neutropenic hemato-oncologic patients (61 Hickman catheter episodes) on intensive chemotherapy is described. By random amplification of polymorphic DNA (RAPD) analysis, a total of 88 different genotypes were detected: 51 in air samples and 30 in skin cultures prior to insertion, 12 in blood cultures after insertion, and only 5 involved in catheter-related infections (CRI). Two RAPD genotypes of Staphylococcus epidermidis predominated, and their prevalence increased during patient hospitalization. At insertion, these clones constituted 11 of 86 (13%) CoNS isolated from air samples and 33 of 75 (44%) CoNS isolated from skin cultures. After insertion, their combined prevalence increased to 33 of 62 (53%) in catheters not associated with CRI and 139 of 188 (74%) in catheters associated with CRI (P= 0.0041). These two predominant S. epidermidis clones gave rise to a very high incidence of CRI (6.0 per 1,000 catheter days) and a very high catheter removal rate for CRI, 70%, despite prompt treatment with vancomycin. A likely source of S. epidermidis strains involved in CRI appeared to be the skin flora in 75% of cases. The validity of these observations was confirmed by pulsed-field gel electrophoresis (PFGE) of SmaI DNA macrorestriction fragments of blood culture CoNS isolates. Again, two predominant CoNS genotypes were found (combined prevalence, 60%). RAPD and PFGE yielded concordant results in 75% of cases. Retrospectively, the same two predominant CoNS clones were also found among blood culture CoNS isolates from the same hematology department in the period 1991 to 1993 (combined prevalence, 42%) but not in the period 1978 to 1982. These observations underscore the pathogenic potential of clonal CoNS types that have successfully and persistently colonized patients in this hemato-oncology department.

Surgical Scrub and Skin Disinfection

1984 ◽  
Vol 5 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Graham A.J. Ayliffe
Keyword(s):  
Normal Skin ◽  
Residual Effect ◽  
Repeated Application ◽  
Coagulase Negative Staphylococci ◽  
Skin Disinfection ◽  
Skin Flora ◽  
Plastic Bag ◽  
Repeated Applications ◽  
The Uk

AbstractThe role of pre-operative disinfection of the surgeon's hands and the skin of the operative site in the prevention of wound infection remains uncertain. The normal resident skin flora, consisting mainly of coagulase-negative staphylococci and aerobic and anaerobic diphtheroids, is an uncommon cause of infection except in prosthetic operations. Staphylococcus aureus is rarely a resident on normal skin other than the perineum, and is mostly present on the hands as a transient acquired from the nose. Nevertheless, it seems rational to kill or remove all transients on the hands of the surgeon and reduce residents to low levels.Surgical skin disinfection is usually assessed by measuring the reduction in organisms on the hands immediately after disinfection, after repeated applications of the disinfectant and after wearing gloves for two to three hours. The hands are commonly sampled in a bowl or plastic bag containing Ringer's or a similar solution and relevant neutralizers, or by the use of glove washings. A standardized technique is necessary to provide a statistical comparison between agents. Antiseptic detergents, chlorhexidine or povidone iodine show immediate reductions in bacterial counts of 70% to 80%, increasing to 99% after repeated application. Hexachloraphene and triclosan detergents show a lower immediate reduction but a good residual effect. Seventy percent ethyl or 60% propyl alcohol, with or without an antiseptic, show an immediate reduction of over 95%, and in excess of 99% on repeated application. Residual levels of organisms tend to be lower after repeated alcohol treatment than following the use of antiseptic detergents. A two to three-minute application of the antiseptic to the hands, without a scrubbing brush, is commonly recommended in the UK, but possibly in routine surgery an application time of 30 seconds is sufficient, killing or removing transients and superficial residents.

Plasmid Profile and Slime Analysis of Coagulase-Negative Staphylococci from Capd Patients with Peritonitis

1986 ◽  
Vol 6 (4) ◽  
pp. 195-198 ◽  
Author(s):  
Gregory B. Horsman ◽  
Leslie MacMillan Yuri ◽  
Amatnieks Oretta RifKin ◽  
Stephen I. Vas
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Normal Skin ◽  
Recurrent Infection ◽  
Plasmid Profile ◽  
Coagulase Negative Staphylococci ◽  
Plasmid Profiles ◽  
Skin Flora ◽  
Initial Episode ◽  
Multiple Episodes

Little is known about the epidemiology of infections causing peritonitis in continuous ambulatory peritoneal dialysis (CAPD). The commonest cause, coagulase-negative staphylococci (C-NS), are normal skin flora. The main source is thought to be organisms from the patient's own skin or environment. Using plasmid profiles as an epidemiological marker, the authors identified cases in which surveillance skin cultures taken just before an episode of peritonitis were identical to those isolated from the effluent. On comparing the plasmid profiles from the effluent of patients who had multiple episodes over eight weeks, they identified two patterns. One group had different plasmid profiles between episodes of infection. The second group (the majority of the cases) had identical plasmid profiles between the initial episode and the second which occurred between 10 days and four weeks after stopping antibiotics. This suggests that, in most cases of recurrent infection studied, the second episode represented a reinfection or recurrence with the same organism (as the initial episode). Slime production did not discriminate those patients who would develop recurring peritonitis.

scholarly journals Need for appropriate specimen for microbiology diagnosis of chronic osteomyelitis

2018 ◽  
Vol 10 (01) ◽  
pp. 021-025 ◽  
Author(s):  
Lakshmi Vemu ◽  
Sukanya Sudhaharan ◽  
Neeraja Mamidi ◽  
Padmasri Chavali
Keyword(s):  
Chronic Osteomyelitis ◽  
Bone Biopsy ◽  
Normal Skin ◽  
Tissue Specimen ◽  
Coagulase Negative Staphylococci ◽  
Culture Methods ◽  
Isolation And Identification ◽  
Culture Positivity ◽  
Skin Flora ◽  
Culture Positive

Abstract INTRODUCTION: Chronic osteomyelitis (COM) is a common infection, especially in developing countries. An adequate bone biopsy specimen processed with appropriate microbiology culture methods for isolation and identification of the causative organisms is considered as the gold standard for the diagnosis of osteomyelitis. MATERIALS AND METHODS: The present study is a retrospective microbiology analysis of the specimen from 219 clinically diagnosed cases of COM between January 2013 and April 2016. RESULTS: The overall culture positivity was 111/219 (50. 6%), colonization was seen in 22/219 (10.5%), while the rest 86/219 (39.3%) were culture-negative specimen; culture positivity was highest from tissue specimen (71/113, 62.8%). Among the swabs, 40/106 (37.7%) were culture positive. About 28/40 (70%) culture-positive swabs showed significant growth of Gram-positive organisms. Colonization with skin flora such as diphtheroids and Coagulase-negative Staphylococci was seen in 22/106 (20.7%) of the swabs. Sterile cultures (44/106, 41.6%) were high among the swab specimen. Gram-positives were most common (75/111, 67.56%). Staphylococcus aureus was the predominant organism isolated in 70/111 (63%) cases. Gram-negative bacilli showed a high level of antibiotic resistance. CONCLUSION: As per our data, the culture yield from wound swabs was low or contaminated with normal skin flora, as compared to the biopsy or tissue specimen. Hence, an appropriate sampling of the infected bone using recommended protocols is highly essential for improving microbiological yield and the outcome of COM.

scholarly journals Microbial Biofilms and Breast Tissue Expanders

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Melissa J. Karau ◽  
Kerryl E. Greenwood-Quaintance ◽  
Suzannah M. Schmidt ◽  
Nho V. Tran ◽  
Phyllis A. Convery ◽  
...  
Keyword(s):  
Breast Tissue ◽  
Clinical Evidence ◽  
Normal Skin ◽  
Coagulase Negative Staphylococci ◽  
Tissue Expanders ◽  
Microbial Biofilms ◽  
Prosthetic Joints ◽  
Skin Flora ◽  
Biofilm Bacteria ◽  
Sonication Technique

We previously developed and validated a vortexing-sonication technique for detection of biofilm bacteria on the surface of explanted prosthetic joints. Herein, we evaluated this technique for diagnosis of infected breast tissue expanders and used it to assess colonization of breast tissue expanders. From April 2008 to December 2011, we studied 328 breast tissue expanders at Mayo Clinic, Rochester, MN, USA. Of seven clinically infected breast tissue expanders, six (85.7%) had positive cultures, one of which grewPropionibacteriumspecies. Fifty-two of 321 breast tissue expanders (16.2%, 95% CI, 12.3–20.7%) without clinical evidence of infection also had positive cultures, 45 growingPropionibacteriumspecies and ten coagulase-negative staphylococci. While vortexing-sonication can detect clinically infected breast tissue expanders, 16 percent of breast tissue expanders appear to be asymptomatically colonized with normal skin flora, most commonly,Propionibacteriumspecies.

scholarly journals Identification and medical importance of coagulase-negative staphylococci species

1999 ◽  
Vol 117 (4) ◽  
pp. 175-178 ◽  
Author(s):  
Elaine Cristina Manini Minto ◽  
Cristiane Barelli ◽  
Roberto Martinez ◽  
Ana Lúcia da Costa Darini
Keyword(s):  
Staphylococcus Epidermidis ◽  
Antimicrobial Agents ◽  
University Hospital ◽  
Intravenous Catheter ◽  
Catheter Colonization ◽  
Coagulase Negative Staphylococci ◽  
Blood Samples ◽  
Medical Importance ◽  
The University ◽  
Intravenous Catheters

A total of 126 coagulase-negative staphylococci strains (CNS) were isolated from blood samples and from the intravenous catheters and cerebrospinal fluid of 103 patients admitted to the University Hospital of Ribeirão Preto. Staphylococcus epidermidis (68.2%), S. haemolyticus (11.1%) and S. hominis (3.2%) were the most frequent species. The last two CNS showed greater resistance to antimicrobial agents than S. epidermidis. CNS were the agents of infection in 10.7% of the patients and the agents of intravenous catheter colonization in 18.4% of the cases.

scholarly journals Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review

2021 ◽  
Vol 70 (1) ◽  
Author(s):  
KLAUDIA LISOWSKA-ŁYSIAK ◽  
RYSZARD LAUTERBACH ◽  
JACEK MIĘDZOBRODZKI ◽  
MAJA KOSECKA-STROJEK
Keyword(s):  
Staphylococcus Epidermidis ◽  
Bloodstream Infections ◽  
Species Level ◽  
Diagnostic Methods ◽  
Host Factors ◽  
Coagulase Negative Staphylococci ◽  
Similar Frequency ◽  
North American Data ◽  
High Level ◽  
Prevalent Species

Staphylococci are among the most frequent human microbiota components associated with the high level of bloodstream infection (BSI) episodes. In predisposed patients, there is a high risk of transformation of BSI episodes to sepsis. Both bacterial and host factors are crucial for the outcomes of BSI and sepsis. The highest rates of BSI episodes were reported in Africa, where these infections were up to twice as high as the European rates. However, there remains a great need to analyze African data for comprehensive quantification of staphylococcal BSI prevalence. The lowest rates of BSI exist in Australia. Asian, European, and North American data showed similar frequency values. Worldwide analysis indicated that both Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequent BSI agents. In the second group, the most prevalent species was Staphylococcus epidermidis, although CoNS were not identified at the species level in many studies. The lack of a significant worldwide decrease in BSI episodes indicates a great need to implement standardized diagnostic methods and research etiological factors using advanced genetic methods.

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