Heterogeneously Vancomycin-Resistant Staphylococcus epidermidis Strain Causing Recurrent Peritonitis in a Dialysis Patient during Vancomycin Therapy

1999 ◽  
Vol 37 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Krzysztof Sieradzki ◽  
Richard B. Roberts ◽  
David Serur ◽  
Judie Hargrave ◽  
Alexander Tomasz
Keyword(s):  
Staphylococcus Epidermidis ◽  
Exit Site ◽  
Vancomycin Therapy ◽  
Single Strain ◽  
Microbiological Methods ◽  
Vancomycin Mics ◽  
Vancomycin Resistant ◽  
Prophylactic Use ◽  
Similar Enrichment

Methicillin-resistant Staphylococcus epidermidis (MRSE) was recovered over a 2-month period from the dialysis fluid of a peritoneal dialysis (PD) patient who experienced recurrent episodes of peritonitis during therapeutic and prophylactic use of vancomycin. Characterization of five consecutive MRSE isolates by molecular and microbiological methods showed that they were representatives of a single strain, had reduced susceptibility to vancomycin, did not react with DNA probes specific for the enterococcal vanA orvanB gene, and showed characteristics reminiscent of the properties of a recently described vancomycin-resistant laboratory mutant of Staphylococcus aureus. Cultures of these MRSE isolates were heterogeneous: they contained—with a frequency of 10−4 to 10−5—bacteria for which vancomycin MICs were high (25 to 50 μg/ml) which could easily be selected to “take over” the cultures by using vancomycin selection in the laboratory. In contrast, the five consecutive MRSE isolates recovered from the PD patient during virtually continuous vancomycin therapy showed no indication for a similar enrichment of more resistant subpopulations, suggesting the existence of an “occult” infection site in the patient (presumably at the catheter exit site) which was not accessible to the antibiotic.

scholarly journals Characterization of Passage-Selected Vancomycin-Resistant Staphylococcus aureus Strains of Diverse Parental Backgrounds

2000 ◽  
Vol 44 (2) ◽  
pp. 294-303 ◽  
Author(s):  
Richard F. Pfeltz ◽  
Vineet K. Singh ◽  
Jennifer L. Schmidt ◽  
Michael A. Batten ◽  
Christopher S. Baranyk ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cell Walls ◽  
Methicillin Resistance ◽  
Surface Hydrophobicity ◽  
Whole Cell ◽  
Transmission Electron ◽  
Vancomycin Mics ◽  
Vancomycin Resistant ◽  
Doubling Times

ABSTRACT A series of 12 Staphylococcus aureus strains of various genetic backgrounds, methicillin resistance levels, and autolytic activities were subjected to selection for the glycopeptide-intermediate S. aureus (GISA) susceptibility phenotype on increasing concentrations of vancomycin. Six strains acquired the phenotype rapidly, two did so slowly, and four failed to do so. The vancomycin MICs for the GISA strains ranged from 4 to 16 μg/ml, were stable to 20 nonselective passages, and expressed resistance homogeneously. Neither ease of acquisition of the GISA phenotype nor the MIC attained correlated with methicillin resistance hetero- versus homogeneity or autolytic deficiency or sufficiency. Oxacillin MICs were generally unchanged between parent and GISA strains, although the mec members of both isogenic methicillin-susceptible and methicillin-resistant pairs acquired the GISA phenotype more rapidly and to higher MICs than did their susceptible counterparts. Transmission electron microscopy revealed that the GISA strains appeared normal in the absence of vancomycin but had thickened and diffuse cell walls when grown with vancomycin at one-half the MIC. Common features among GISAs were reduced doubling times, decreased lysostaphin susceptibilities, and reduced whole-cell and zymographic autolytic activities in the absence of vancomycin. This, with surface hydrophobicity differences, indicated that even in the absence of vancomycin the GISA cell walls differed from those of the parents. Autolytic activities were further reduced by the inclusion of vancomycin in whole-cell and zymographic studies. The six least vancomycin-susceptible GISA strains exhibited an increased capacity to remove vancomycin from the medium versus their parent lines. This study suggests that while some elements of the GISA phenotype are strain specific, many are common to the phenotype although their expression is influenced by genetic background. GISA strains with similar glycopeptide MICs may express individual components of the phenotype to different extents.

Impact of a Vancomycin Restriction Policy on Use and Cost of Vancomycin and Incidence of Vancomycin-Resistant Enterococcus

1997 ◽  
Vol 31 (9) ◽  
pp. 970-973 ◽  
Author(s):  
Amy S Morgan ◽  
Patrick J Brennan ◽  
Neil O Fishman
Keyword(s):  
Policy Implementation ◽  
University Teaching ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Therapy ◽  
Billing Data ◽  
Restriction Policy ◽  
Number Of Patients ◽  
Before And After ◽  
Vancomycin Resistant ◽  
Prophylactic Use

Objective To review the appropriateness of vancomycin therapy, changes in vancomycin use, and the incidence of vancomycin-resistant Enterococcus (VRE) after implementation of a limited restriction policy requiring approval from the Infectious Diseases Approval service to continue vancomycin therapy beyond 72 hours. Design A prospective chart review was conducted in April 1995. Pharmacy billing data and infection control data were compared before and after policy implementation. Setting A 725-bed university teaching institution. Patients All patients receiving vancomycin during April 1995. Main outcome Measures Appropriateness of use was based on the Centers for Disease Control and Prevention (CDC) recommendations for prudent vancomycin use. Results A total of 333 courses of vancomycin therapy were reviewed. Vancomycin use was appropriate in 219 (66%) courses. Of the 114 courses that did not meet the CDC guidelines, 76 (67%) were for empiric use, 35 (31%) were for prophylactic use, and 3 (3%) were for therapeutic use. Overall, the total number of grams used decreased 9%, grams per 1000 patient-days decreased by 10, and the total number of patients exposed to vancomycin decreased 0.5%. Several services had large decreases in vancomycin use. Vancomycin expenditures decreased by $15 788 for the 7-month time period. The incidence of VRE remained unchanged, at 30% of all enterococcal isolates 2 years after policy implementation. Conclusions The limited restriction policy was effective in decreasing the total grams of vancomycin used. However, one-third of vancomycin therapy was inappropriate and the incidence of VRE was unchanged. A more stringent restriction policy could potentially increase appropriate use, further decrease the amount of vancomycin used, and decrease the incidence of VRE.

scholarly journals Treatment of intracranial infection caused by methicillin-resistant Staphylococcus epidermidis with linezolid following poor outcome of vancomycin therapy: A case report and literature review

2020 ◽  
Author(s):  
Zhiqiang Lin ◽  
Sumei Chen ◽  
Limian Hong ◽  
Shuifa Wu ◽  
Xueping Yu
Keyword(s):  
Staphylococcus Epidermidis ◽  
Drug Susceptibility ◽  
Therapeutic Effects ◽  
Optimal Management ◽  
Vancomycin Therapy ◽  
Case Presentation ◽  
Methicillin Resistant ◽  
Intracranial Infection ◽  
Poor Outcome ◽  
Vancomycin Mics

Abstract Background: To investigate the efficacy of linezolid in the treatment of intracranial infection caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant coagulase-negative Staphylococcus (MRCoNS).Case presentation: The patient at our hospital was diagnosed with methicillin-resistant Staphylococcus epidermidis (MRSE) intracranial infection, which was resistant to oxacillin and sensitive to vancomycin (MIC = 2 µg/mL) and linezolid (MIC = 4 µg/mL). Vancomycin was replaced with linezolid after 36 days of treatment due to poor outcome, and the patient was eventually cured. Further, a total of 23 cases of intracranial MRSA/MRCoNS infections were reported, of which 1 case with MRSA had a vancomycin MIC = 1 µg/mL, while the remaining 22 cases had vancomycin MICs greater than 1 µg/mL, with MIC = 1.5 µg/mL in 1 case, MIC = 2 µg/mL in 19 cases and MIC = 4 µg/mL in 2 cases. The linezolid-containing regimen was used after drug susceptibility results or if the initial treatment failed, leading to recovery in 19 patients, microbial clearance in 3 patients (of which 2 patients died of comorbidities and 1 patient died of Pseudomonas aeruginosa infection), and treatment failure in 1 case.Conclusion: The PK/PD parameter for evaluating the efficacy of vancomycin is AUC/MIC ≥ 400 (assuming a vancomycin MICBMD of 1 µg/mL), and trough concentration should not be used as a substitute for AUC/MIC. For optimal management, vancomycin dosing should be based on AUC-guided dosing and monitoring. When the vancomycin MIC of MRSA/MRCoNS is > 1 µg/mL, the target AUC/MIC cannot be achieved. In such cases, linezolid can be used with good therapeutic effects.

Application of commercial test-systems to identify gram-negative facultatively anaerobic bacteria

2016 ◽  
Vol 3 (1) ◽  
pp. 43-48 ◽  
Author(s):  
V. Patyka ◽  
L. Butsenko ◽  
L. Pasichnyk
Keyword(s):  
Erwinia Amylovora ◽  
Anaerobic Bacteria ◽  
Biochemical Properties ◽  
Test System ◽  
Phytopathogenic Bacteria ◽  
Gram Negative ◽  
Test Systems ◽  
Facultatively Anaerobic ◽  
Microbiological Methods

Aim. To validate the suitability of commercial API 20E test-system (bioMerieux) for the identifi cation and characterization of facultative gram-negative phytopathogenic bacterial isolates. Methods. Conventional mi- crobiological methods, API 20E test-system (bioMerieux) according to the manufacturer’s instructions. Re- sults. The identifi cation results for Erwinia amylovora, Pectobacterium carotovorum and Pantoea agglome- rans isolates were derived from the conventional and API 20E test systems, which, were in line with the literature data for these species. The API 20E test-system showed high suitability for P. agglomerans isolates identifi cation. Although not all the species of facultatively anaerobic phytopathogenic bacteria may be identi- fi ed using API 20E test-system, its application will surely allow obtaining reliable data about their physiologi- cal and biochemical properties, valuable for identifi cation of bacteria, in the course of 24 h. Conclusions. The results of tests, obtained for investigated species while using API 20E test-system, and those of conventional microbiological methods coincided. The application of API 20E test-system (bioMerieux) ensures fast obtain- ing of important data, which may be used to identify phytopathogenic bacteria of Erwinia, Pectobacterium, Pantoea genera.

scholarly journals Genetic Characterization of Methicillin Resistant and Sensitive, Vancomycin Intermediate Staphylococcus aureus Strains Isolated from Different Iranian Hospitals

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Seyed Asghar Havaei ◽  
Amir Azimian ◽  
Hosein Fazeli ◽  
Mahmood Naderi ◽  
Kiarash Ghazvini ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Genetic Analysis ◽  
Clinical Samples ◽  
Different Types ◽  
Health Care Policies ◽  
Global Health Care ◽  
Vancomycin Resistant ◽  
Epidemiological Evaluation ◽  
Mrsa Strains

Background. Global concerns have been raised due to upward trend of Vancomycin Intermediate Staphylococcus aureus (VISA) and Vancomycin Resistant Staphylococcus aureus (VRSA) reports which mean casting doubt on the absolute effectiveness of the last line of antibiotic treatment for S. aureus, vancomycin. Hence, epidemiological evaluation can improve global health care policies. Methodology. 171 Isolates of Staphylococcus aureus were collected from different types of clinical samples in selected hospitals in Isfahan, Mashhad, and Tehran, Iran. Then, they were evaluated by agar screening, disk diffusion, and MIC method to determine their resistance to vancomycin and methicillin. The isolated VISA strains were then confirmed with genetic analysis by the evaluation of mecA and vanA genes, SCCmec, agr, and spa type, and also toxin profiles. MLST was also performed. Results and Conclusion. Our data indicated that 67% of isolated S. aureus strains were resistant to methicillin. Furthermore, five isolates (2.9%) had intermediate resistance to vancomycin (VISA). In contrast to usual association of VISA with MRSA strains, we found two isolates of MSSA-VISA. Therefore, our data suggests a probable parallel growing trend of VISA towards MSSA, along with MRSA strains. However, more samples are required to confirm these primarily data. Moreover, genetic analysis of the isolated VISA strains revealed that these strains are endemic Asian clones.

scholarly journals Antimicrobial Activities of Mefloquine and a Series of Related Compounds

2000 ◽  
Vol 44 (4) ◽  
pp. 848-852 ◽  
Author(s):  
C. M. Kunin ◽  
W. Y. Ellis
Keyword(s):  
Staphylococcus Epidermidis ◽  
Antimicrobial Activities ◽  
Walter Reed Army Institute ◽  
Gram Negative Bacteria ◽  
Antimicrobial Drugs ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Resistant Strains ◽  
Vancomycin Resistant ◽  
Related Compounds

ABSTRACT Mefloquine was found to have bactericidal activity against methicillin- and fluoroquinolone-susceptible and -resistant strains ofStaphylococcus aureus and Staphylococcus epidermidis and gentamicin- and vancomycin-resistant strains ofEnterococcus faecalis and Enterococcus faecium. The MICs were 16 μg/ml, and the minimal bactericidal concentrations (MBCs) were 16 to 32 μg/ml. These concentrations cannot be achieved in serum. Mefloquine was active at a more achievable concentration against penicillin-susceptible and -resistant Streptococcus pneumoniae, with MICs of 0.2 to 1.5 μg/ml. Mefloquine was not active against gram-negative bacteria and yeasts. In an attempt to find more active derivatives, 400 mefloquine-related compounds were selected from the chemical inventory of The Walter Reed Army Institute of Research. We identified a series of compounds containing a piperidine methanol group attached to pyridine, quinoline, and benzylquinoline ring systems. These had activities similar to that of mefloquine against S. pneumoniae but were far more active against other gram-positive bacteria (MICs for staphylococci, 0.8 to 6.3 μg/ml). They had activities similar to that of amphotericin B againstCandida spp. and Cryptococcus neoformans. Combinations of the compounds with gentamicin and vancomycin were additive against staphylococci and pneumococci. The MIC and MBC of gentamicin were decreased by four- to eightfold when this drug was combined with limiting dilutions of the compounds. There was no antagonism with other antimicrobial drugs. The compounds were rapidly bactericidal. They appear to act by disrupting cell membranes. Combinations of the compounds with aminoglycoside antibiotics may have potential for therapeutic use.

Prevalence and characterization of vancomycin-resistant enterococci in chicken intestines and humans of korea

2004 ◽  
Vol 27 (2) ◽  
pp. 246-253 ◽  
Author(s):  
Chi Nam Seong ◽  
Eun Sook Shim ◽  
Shin Moo Kim ◽  
Jin Cheol Yoo
Keyword(s):  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

Phytochemical characterization of Caraway (Carum carvi) seed extract and its use as a potent medicinal agent

2021 ◽  
Vol 16 (10) ◽  
pp. 102-110
Author(s):  
Vivek Chauhan ◽  
Sunita Devi ◽  
Sonaxi Sharma ◽  
Shamsher S. Kanwar
Keyword(s):  
Staphylococcus Epidermidis ◽  
Arable Land ◽  
Seed Extract ◽  
Phytochemical Analysis ◽  
Phytochemical Screening ◽  
Food Industries ◽  
Carum Carvi ◽  
Medicinal Properties ◽  
The Village

Carum carvi (Caraway) is a member of Apiaceae family which originated in Asia. Due to its economic importance, it is widely cultivated. Caraway is the only annual species, commonly present in arable land, moist meadows and on low lands to mountains. Caraway has different applications in pharmaceutical and food industries. Phytochemical screening of different medicinal plants is helpful in identifying new sources of industrially and therapeutically important compounds. In this study, Caraway obtained from forest surrounding the village Goherman, Lahaul and Spiti, Himachal Pradesh (India) was used. Seed extract of caraway extracted in methanol (MSE) and distilled water (WSE) was used for phytochemical analysis to determine the constituents of caraway seeds. Further, caraway seeds extract was checked for antibacterial activity [Staphylococcus aureus (ATCC 6538), Salmonella typhimurium (NCTC 74), Escherichia coli (ATCC 25922) and Staphylococcus epidermidis (ATCC 12228)], antioxidant activity and acid neutralizing activity. After analysing the results, it can be said that caraway seeds possess many medicinal properties and it can be used in enhancing human health.

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