MICROFLORA OF SURGICAL WOUNDS AND FISTULAS IN PATIENTS WITH CHRONIC OSTEOMYELITIS OF THE TIBIA BEFORE RECONSTRUCTIVE TREATMENT, IN CASE OF RECURRENCE OF INFECTION

2019 ◽  
Vol 64 (10) ◽  
pp. 627-631
Author(s):  
S. I. Burnashov ◽  
I. V. Shipitsyna ◽  
E. V. Osipova
Keyword(s):  
Chronic Osteomyelitis ◽  
Primary Cultures ◽  
Acquired Resistance ◽  
Rational Approach ◽  
Coagulase Negative Staphylococcus ◽  
Methicillin Resistant ◽  
Microbiological Study ◽  
Microbiological Monitoring ◽  
New Associations ◽  
Resistant Strains

Relevance of microbiological monitoring in chronic osteomyelitis of the tibia developed during treatment of fractures with a plate is associated with a noticeable increase of various kinds of the microflora. A microbiological study was conducted of pathological material taken from wounds, fistulas and from the focus of inflammation in 49 patients with chronic tibial osteomyelitis, developed during treatment of fractures with a plate. The patients underwent sequestrectomy of the tibia and subsequent application of bilocal consecutive compression-distraction osteosynthesis or monolocal compression osteosynthesis. Microbiological study of smears taken before the reconstructive treatment from fistulas and wounds of patients showed that in mono-culture there were 30 strains, the remaining 30 - as a part of 14 two - and three-component associations. The frequency of S. aureus strains was 55.3%, followed by coagulase-negative staphylococcus - 13.6% and representatives of the family Enterobacteriacae - 10.2%. There were methicillin-resistant strains of S. aureus in 11.8%, strains of coagulase-negative staphylococcus (MRCoNS) - 6.8%. Recurrence of the disease was observed in 7 patients. The microflora of the discharge from the fistula was represented by monocultures of S. aureus and associations of bacteria in which one of the components was methicillin-resistant strains of S. aureus. We observed differences in the contents of the microflora before reconstructive treatment of patients and in recurrence of infection. In case of recurrence of infection, the qualitative contents of the microflora changed: in 2 patients in the association of microorganisms and in 3 - in monocultures, S. aureus strains acquired resistance to ß-lactam antibiotics, new associations appeared, which were not present in primary cultures before reconstructive treatment. The study showed that the spectrum of micro-organisms in chronic osteomyelitis of the tibia, developed after osteosynthesis with a plate, varied and is subject to change and that dictates the need for microbiological monitoring to detect the etiological structure of pathogens, monitoring of antibiotic resistance of the isolated strains and rational approach to treatment of patients.

scholarly journals 1219. Increasing Methicillin Resistance of Staphylococcus lugdunensis in a Tertiary Care Community Hospital in Japan

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S370-S370
Author(s):  
Takahiro Ichikawa ◽  
Fumihiro Kodama
Keyword(s):  
Community Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Meca Gene ◽  
Coagulase Negative Staphylococcus ◽  
Staphylococcus Lugdunensis ◽  
Methicillin Resistant ◽  
Healthcare Facilities ◽  
Care Community ◽  
Resistant Strains

Abstract Background Staphylococcus lugdunensis, a coagulase-negative staphylococcus, has virulence and pathogenicity similar to that of Staphylococcus aureus. Methicillin resistance and presence of mecA gene are not common in S. lugdunensis in many parts of the world. Recently, higher prevalence of methicillin-resistant S. lugdunensis is reported from Taiwan and Japan. We describe the change in methicillin resistance of S. lugdunensis in a tertiary care community hospital in Sapporo, Japan. Methods We performed a retrospective study of S. lugdunensis, isolated from inpatients and outpatients at our hospital from 2008 to 2017. Rate of methicillin resistance of the first 5 years from 2008 to 2012, and that of the second 5 years from 2013 to 2017 were compared. Risk factors of methicillin resistance were also evaluated. Phenotypic detection of methicillin resistance was identified using broth microdilution by VITEK two system (bioMérieux). Results A total of 369 cases of S. lugdunensis were detected during the study period. Of all cases, 228 (61.8%) were men, and 177 (48.0%) were hospitalized. Twenty-one isolates (5.7%) were positive in blood culture, 216 (58.5%) were positive in cultures of skin and soft tissue. Methicillin-resistant strains were found in 43 (31.6%) of 136 isolates from 2008 to 2012, and in 108 (46.4%) of 233 from 2013 to 2017 (OR 1.87; 95% CI 1.20–2.91; P = 0.006). Of patients with methicillin-resistant S. lugdunensis, 105 cases (69.5%) were hospitalized (P < 0.001). Conclusion In our hospital, methicillin-resistant S. lugdunensis is increasing over the 10 years. Further research is needed to assess trend of methicillin resistance of S. lugdunensis in other healthcare facilities and countries. Disclosures All authors: No reported disclosures.

Multidrug resistant coagulase-negative Staphylococcus spp. isolated from cases of chronic rhinosinusitis in humans. Study from Poland

2021 ◽  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Pathogenic Bacteria ◽  
Medical Center ◽  
Multidrug Resistant ◽  
Coagulase Negative Staphylococcus ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Resistant Strains ◽  
Ethmoid Sinuses ◽  
Staphylococcus Spp

Abstract For many years, coagulase-negative staphylococci (CoNS) have been considered non-pathogenic bacteria. However, recently, CoNS are becoming more common bacteriological factors isolated from cases of chronic rhinosinusitis in humans. Moreover, most of them represent the multidrug-resistant or/and methicillin-resistant profile, which significantly increases the therapeutic difficulties. The aim of the study was to characterize profile of resistant coagulase-negative staphylococci isolated from cases of chronic rhinosinusitis in patients treated in a Medical Center in Warsaw in 2015–2016. The study material was derived from patients with diagnosed chronic rhinosinusitis treated at the MML Medical Center in Warsaw. The material was obtained intraoperatively from maxillary, frontal, and ethmoid sinuses. In total, 1,044 strains were isolated from the studied material. Coagulase-negative staphylococci were predominant, with the largest share of Staphylococcus epidermidis. Isolated CoNS were mainly resistant to macrolide, lincosamide, and tetracycline. Among the S. epidermidis strains, we also showed 35.6% of MDR and 34.7% of methicillin-resistant strains. The same values for other non-epidermidis species were 31.5% and 18.5%, respectively and the percentage of strains with MAR >0.2 was greater in S. epidermidis (32.6%) than S. non-epidermidis (23.9%). Although the percentage of strains resistant to tigecycline, glycopeptides, rifampicin and oxazolidinones was very small (2.3%, 1.9%, 1.4% and 0.7% respectively), single strains were reported in both groups. The study has shown a high proportion of MDR and methicillin-resistant CoNS strains, which indicates a large share of drug-resistant microorganisms in the process of persistence of chronic rhinosinusitis; therefore, isolation of this group of microorganisms from clinical cases using aseptic techniques should not be neglected.

scholarly journals Recurrent Challenges for Clinicians: Emergence of Methicillin-resistant Staphylococcus aureus, Vancomycin Resistance, and Current Treatment Options

2013 ◽  
Vol 5 (02) ◽  
pp. 071-078 ◽  
Author(s):  
Bansidhar Tarai ◽  
Poonam Das ◽  
Dilip Kumar
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Hospital Setting ◽  
Vancomycin Resistance ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Resistant Strains

ABSTRACTGram-positive pathogens mainly, Staphylococcus aureus, Enterococcus and coagulase-negative Staphylococcus, are developing increasing resistance to glycopeptides that pose a problem in treating infections caused by these pathogens. Vancomycin is the treatment of choice in treating methicillin-resistant S. aureus (MRSA). Community-acquired MRSA is associated with infections in patients without recent history of hospital admission and without the classical risk factors for MRSA carriage (including healthcare personnel). MRSA poses new threats and challenges beyond the hospital with the emergence of community-acquired MRSA. Indiscriminate use of vancomycin leads to the emergence and spread of vancomycin resistance in multidrug resistant strains is of growing concern in the recent years. Minimum Inhibitory concentration (MIC) remains an important determinant in choosing the right antibiotics. Infections caused by MRSA strains with vancomycin MIC > 4 μg/mL leads to the vancomycin treatment failure. The Clinical Laboratory Standards Institute had also lowered the cut-off susceptibility and resistance breakpoints for vancomycin. Despite the availability of newer antimicrobial agents (Linezolid, Daptomycin, Tigecycline) for drug-resistant Gram-positive pathogens, clinicians and patients still need options for treatment of MRSA infection. There is a need to reduce the global burden of infections caused by Gram-positive pathogens and its resistant strains (mainly MRSA). Continuous efforts should be made to prevent the spread and the emergence of glycopeptide resistance by early detection of the resistant strains and using the proper infection control measures in the hospital setting.

scholarly journals Antistaphylococcal Activity of Dihydrophthalazine Antifolates, a Family of Novel Antibacterial Drugs

2009 ◽  
Vol 53 (4) ◽  
pp. 1353-1361 ◽  
Author(s):  
Catherine Clark ◽  
Lois M. Ednie ◽  
Gengrong Lin ◽  
Kathy Smith ◽  
Klaudia Kosowska-Shick ◽  
...  
Keyword(s):  
Serial Passage ◽  
Single Step ◽  
Coagulase Negative Staphylococcus ◽  
Considerable Variability ◽  
Coagulase Negative Staphylococci ◽  
Resistance Development ◽  
Methicillin Resistant ◽  
Antistaphylococcal Activity ◽  
Resistant Strains ◽  
Vancomycin Resistant

ABSTRACT For a panel of 153 Staphylococcus aureus clinical isolates (including 13 vancomycin-intermediate or heterogeneous vancomycin-intermediate and 4 vancomycin-resistant strains), MIC50s and MIC90s of three novel dihydrophthalazine antifolates, BAL0030543, BAL0030544, and BAL0030545, were 0.03 and 0.25 μg/ml, respectively, for methicillin-susceptible strains and 0.03 and ≤0.25 μg/ml, respectively, for methicillin-resistant strains. For a panel of 160 coagulase-negative staphylococci (including 5 vancomycin-intermediate and heterogeneous vancomycin-intermediate strains and 7 linezolid-nonsusceptible strains), MIC50s and MIC90s were ≤0.03 and ≤0.06 μg/ml, respectively, for methicillin-susceptible strains and 0.06 and 0.5 μg/ml, respectively, for methicillin-resistant strains. Vancomycin was active against 93.0% of 313 staphylococci examined; linezolid was active against all S. aureus strains and 95.6% of coagulase-negative staphylococcus strains, whereas elevated MICs of clindamycin, minocycline, trimethoprim, and rifampin for some strains were observed. At 4× MIC, the dihydrophthalazines were bactericidal against 11 of 12 staphylococcal strains surveyed. The prolonged serial passage of some staphylococcal strains in the presence of subinhibitory concentrations of BAL0030543, BAL0030544, and BAL0030545 produced clones for which dihydrophthalazines showed high MICs (>128 μg/ml), although rates of endogenous resistance development were much lower for the dihydrophthalazines than for trimethoprim. Single-step platings of naïve staphylococci onto media containing dihydrophthalazine antifolates indicated considerable variability among strains with respect to preexistent subpopulations nonsusceptible to dihydrophthalazine antifolates.

scholarly journals Antibiotic Resistance Profile and Biofilm Production of Staphylococcus pseudintermedius Isolated from Dogs in Thailand

2021 ◽  
Vol 14 (6) ◽  
pp. 592
Author(s):  
Pavarish Jantorn ◽  
Hawaree Heemmamad ◽  
Tanawan Soimala ◽  
Saowakon Indoung ◽  
Jongkon Saising ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Meca Gene ◽  
Staphylococcus Pseudintermedius ◽  
Methicillin Resistant ◽  
Antibiotic Resistance Profile ◽  
Biofilm Production ◽  
Southern Thailand ◽  
Life Threatening ◽  
Suitable Treatment ◽  
Resistant Strains

Staphylococcus pseudintermedius is a zoonotic pathogen that can cause life-threatening infections in animals and humans. The study of methicillin-resistant S. pseudintermedius (MRSP) and its ability to produce biofilms is important to select the most suitable treatment. The prevalence and characteristics of S. pseudintermedius isolated from dogs admitted at the Veterinary Teaching Hospital, Prince of Songkla University, Thailand were assessed. Results showed that 28.30% (15/53) of the isolates were MRSP. Amplification of the mecA gene was observed in 93.33% (14/15) MRSP. Methicillin-resistant strains revealed co-resistant patterns against other antibiotics, including chloramphenicol, clindamycin, tetracycline, clarithromycin, ciprofloxacin, and trimethoprim. In this study, all bacterial isolates produced biofilms, while 90.55% of S. pseudintermedius isolates were strong or moderate biofilm producers. Most (45–60%) of the resistant strains were strong biofilm producers, while the correlation between biofilm production and antibiotic resistance was not statistically significant. This is the first study in southern Thailand to investigate the drug-resistant profile of S. pseudintermedius and its ability to form biofilm. The results will contribute to a better understanding of the emergence and prevalence of antimicrobial resistance in S. pseudintermedius.

scholarly journals Pefloxacin therapy for experimental endocarditis caused by methicillin-susceptible or methicillin-resistant strains of Staphylococcus aureus.

1985 ◽  
Vol 27 (5) ◽  
pp. 685-687 ◽  
Author(s):  
P M Sullam ◽  
M G Tauber ◽  
C J Hackbarth ◽  
H F Chambers ◽  
K G Scott ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Resistant Strains

scholarly journals Ceftaroline Activity against Bacterial Pathogens Frequently Isolated in U.S. Medical Centers: Results from Five Years of the AWARE Surveillance Program

2015 ◽  
Vol 59 (4) ◽  
pp. 2458-2461 ◽  
Author(s):  
Helio S. Sader ◽  
Robert K. Flamm ◽  
Jennifer M. Streit ◽  
David J. Farrell ◽  
Ronald N. Jones
Keyword(s):  
Staphylococcus Aureus ◽  
Streptococcus Pneumoniae ◽  
Bacterial Pathogens ◽  
Surveillance Program ◽  
Broth Microdilution ◽  
Methicillin Resistant ◽  
Content Type ◽  
Medical Centers ◽  
Resistant Strains

ABSTRACTA total of 84,704 isolates were collected from 191 medical centers in 2009 to 2013 and tested for susceptibility to ceftaroline and comparator agents by broth microdilution methods. Ceftaroline inhibited allStaphylococcus aureusisolates at ≤2 μg/ml and was very active against methicillin-resistant strains (MIC at which 90% of the isolates tested are inhibited [MIC90], 1 μg/ml; 97.6% susceptible). AmongStreptococcus pneumoniaeisolates, the highest ceftaroline MIC was 0.5 μg/ml, and ceftaroline activity against the most commonEnterobacteriaceaespecies (MIC50, 0.12 μg/ml; 78.9% susceptible) was similar to that of ceftriaxone (MIC50, ≤0.25 μg/ml; 86.8% susceptible).

scholarly journals Evidence of Another Anthropic Impact on Iguana delicatissima from the Lesser Antilles: The Presence of Antibiotic Resistant Enterobacteria

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 885
Author(s):  
Gustavo Di Lallo ◽  
Marco Maria D’Andrea ◽  
Samanta Sennati ◽  
Maria Cristina Thaller ◽  
Luciana Migliore ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Animal Species ◽  
Susceptibility Testing ◽  
Acquired Resistance ◽  
Climatic Conditions ◽  
Antibiotic Resistant ◽  
Associated Bacteria ◽  
Improper Use ◽  
Resistant Strains ◽  
Drug Resistant Strains

The improper use of antibiotics by humans may promote the dissemination of resistance in wildlife. The persistence and spread of acquired antibiotic resistance and human-associated bacteria in the environment, while representing a threat to wildlife, can also be exploited as a tool to monitor the extent of human impact, particularly on endangered animal species. Hence, we investigated both the associated enterobacterial species and the presence of acquired resistance traits in the cloacal microbiota of the critically endangered lesser Antillean iguana (Iguana delicatissima), by comparing two separate populations living in similar climatic conditions but exposed to different anthropic pressures. A combination of techniques, including direct plating, DNA sequencing and antimicrobial susceptibility testing allowed us to characterize the dominant enterobacterial populations, the antibiotic resistant strains and their profiles. A higher frequency of Escherichia coli was found in the samples from the more anthropized site, where multi-drug resistant strains were also isolated. These results confirm how human-associated bacteria as well as their antibiotic-resistance determinants may be transferred to wildlife, which, in turn, may act as a reservoir of antibiotic resistance.

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