scholarly journals Variation Between Community and Hospital Acquired Methicillin Resistant Coagulase-Positive Staphylococcus Isolates from The Nasal Carriage in The Central Region of Saudi Arabia

Author(s):  
Hazem Aqel ◽  
Sameera Al Johani ◽  
Norah Abu Khalid ◽  
Hajeer Al Shammari ◽  
Dema Al Koblan ◽  
...  

Abstract Background The coagulase-positive staphylococcus (CoPS) has become progressively prevailing in both community and hospital. The variation between community and hospital acquired methicillin resistant coagulase positive staphylococcus has been used to monitor decisions about realistic therapy. Methods Participants presenting with culture proven coagulase positive staphylococcus from the nose were enclosed during this study. Antibiotic susceptibility test was verified by exploiting the E-test and disk diffusion methods. Eleven toxin genes had been analyzed using a polymerase chain reaction. Results The oxacillin-resistant E-test showed extremely vital resistance in hospital-isolates (34.5%) than in community-isolates (19.2%) (p-value = 0.009). The most effective antibiotic against community acquired CoPS is a quinupristin followed by vancomycin and rifampin then clindamycin. Whereas, clindamycin, sulfamethoxazole/trimethoprim, rifampin, and quinupristin seem to be more effective against hospital acquired CoPS. The intermediate effects of both cefoxitin and vancomycin were highly significant in hospital acquired CoPS isolates compared with hospital acquired CoPS isolates (p-value = 0.009 and 0.005). The proven methicillin resistance coagulase positive staphylococcus (MRCoPS) was subjected for detection the following toxin embp (480 bp), aap (180 bp, 200 bp, 300 bp, 460 bp, and 480 bp), and aae (110 bp) genes that were present only in a community acquired MRCoPS. But the following coa (400 bp and 800 bp), spa (1100 bp and 1120 bp), aae (220 bp), and IcaD (100 bp) genes were present only in a hospital acquired MRCoPS. The PVL gene was absent in both community and hospital acquired MRCoPS isolates. Conclusion Hospital acquired coagulase positive staphylococci were highly significant resistant effects against oxacillin and intermediate effects against cefoxitin compared to community acquired coagulase positive staphylococci. All coagulase positive staphylococcus isolates were sensitive to sulfamethoxazole/trimethoprim and quinupristin, but they were resistant to penicillin only. Genotypically, all tested toxin genes showed variation between community and hospital depending on the gene size bands. This study stresses the vital would like for broad screening, precautionary, and educational methods to accomplish the cumulative MRSA prevalence rate.

Author(s):  
Gaël Grandmaison ◽  
Marine Baumberger ◽  
Charlotte Pellaud ◽  
Véronique Erard ◽  
Christian Chuard

Background: Various recommendations exist concerning the discontinuation of contact and droplet precautions (CDP) for patients hospitalised with coronavirus disease 2019 (COVID-19). Some are based on repeated negative real-time polymerase chain reaction (RT-PCR) results, whereas other are based on clinical criteria. The feasibility and safety of these recommendations are poorly documented. Method: We conducted a retrospective study to assess the feasibility and safety of a symptom-based strategy to discontinue CDP for patients hospitalised with COVID-19. We reviewed the clinical charts of all symptomatic patients hospitalised in our institution with RT-PCR-confirmed COVID-19 to assess the application of a symptom-based strategy for the implementation and discontinuation of CDP. The patients with discontinuation of CDP in accordance with the symptom-based strategy were cross-referenced with patients with potential hospital-acquired COVID-19 in order to assess the safety of this strategy. Results: Among the 147 patients included in our study, our symptom-based strategy was respected in 95 cases (64.6%). Discontinuation of CDP in accordance with the recommendations occurred in 39 patients (26.5%). After the discontinuation of CDP, patients remained hospitalised for a median time of 18 days, with exposure to a median number of three patients, resulting in a total number of 588 days ‘patient-day-exposition’. No hospital-acquired COVID-19 was detected in contact patients. Discussion: The use of a symptom-based strategy to discontinue CDP is applicable and safe. This symptom-based strategy was applicable regardless of patient’s age or COVID-19 severity.


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