Variation of Coagulase-Negative Staphylococci in the Skin Flora of Healthy Individuals during One Year

ABSTRACT Staphylococcus lugdunensis is a member of the coagulase-negative staphylococci and commonly found as part of the human skin flora. It is a significant cause of catheter-related bacteremia and also causes serious infections like native valve endocarditis in previously healthy individuals. We report the complete genome sequence of this medically important bacterium.

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251. Poor Outcomes in the Treatment of Coagulase-Negative Staphylococci Periprosthetic Joint Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.453 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S233-S233

Author(s):

Ayden Case ◽

Lefko T Charalambous ◽

Jessica Seidelman ◽

Edward Hendershot ◽

William Jiranek ◽

...

Keyword(s):

Board Member ◽

Treatment Success ◽

Research Support ◽

Coagulase Negative Staphylococci ◽

Educational Support ◽

Material Support ◽

Joint Infections ◽

Skin Flora ◽

One Year

Abstract Background Coagulase-negative staphylococci (CoNS) are a common skin flora often considered lab contaminants, but these pathogens can also be the cause of periprosthetic joint infections (PJIs). The role of these organisms in PJIs is not well characterized, with little data relating to treatment outcomes. We sought to evaluate success at one year for patients undergoing treatment for a CoNS PJI. Methods This is a retrospective cohort study of adults at a tertiary academic center from 2009 to 2020 with CoNS PJI. An institutional database was queried to identify potential patients and manually reviewed by two infectious disease specialists to confirm inclusion. Variables included sex, follow-up time, procedure type, age, race, Elixhauser score, success at one year, failure organism, and revisions. Both univariate and descriptive statistics were used to assess findings. Results We identified 61 patients with a CoNS PJI. The cohort was 50.8% male, with 49 patients identifying as Caucasian (80.3%), and 10 as African American (16.4%). The median age was 65.0 years old, the median Elixhauser score was 3.0, and the average follow-up time was 24.4 months. Of the 61 patients in the cohort, 24 underwent successful treatment (39.3%) at one year, and 37 failed treatment (60.7%). Within the failure group, 19 experienced persistence of the same organism (51.4%), 11 were infected by another organism (29.7%), and 28 underwent a revision surgery secondary to failure (76.9%). When stratified by treatment procedure after initial PJI, 26 (41.7%) received debridement, antibiotics, and implant retention (DAIR) whereas 35 (58.3%) underwent resection. Treatment success was not significantly different between the two procedures (p=0.964). Summary of Treatment Success for CoNS PJI Conclusion These results indicate that the success rate of treatment for CoNS PJI is less than for other organisms, such as coagulase-positive staphylocci. These results provide a focus for future research and clinical management of PJIs resulting from CoNS. Disclosures William Jiranek, MD, Depuy Synthes (Other Financial or Material Support, Royalty/Licensing) Michael Bolognesi, MD, Heron Therapeutics, Inc. (Consultant)Total Joint Orthopedics, Inc. (Other Financial or Material Support, Royalty/Licensing)Zimmer Biomet Holdings, Inc. (Other Financial or Material Support, Royalty/Licensing) Thorsten Seyler, MD/PhD, Depuy Synthes (Other Financial or Material Support, Resident Educational Support)Extrel Therapeutics (Board Member, Shareholder)Heraeus Medical (Consultant)MiCare Path (Board Member, Shareholder)OREF (Grant/Research Support)Pattern health (Board Member)Restor3D (Other Financial or Material Support, Royalties)Smith+Nephew, Inc. (Grant/Research Support, Speaker’s Bureau)Stryker (Other Financial or Material Support, Resident Educational Support)Total Joint Orthopedics, Inc. (Consultant)Wolters Kluwer Health (Other Financial or Material Support, Royalties)Zimmer Biomet (Grant/Research Support)

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The prevalence of resistance to macrolides and lincosamides among community- and hospital- acquired staphylococci and streptococci isolates in southeast Serbia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh170407197m ◽

2018 ◽

Vol 146 (7-8) ◽

pp. 384-390

Author(s):

Milena Misic ◽

Aleksandra Arsovic ◽

Jelena Cukic ◽

Milenko Rosic ◽

Jelena Tosic-Pajic ◽

...

Keyword(s):

Empirical Therapy ◽

Local Area ◽

Diffusion Method ◽

Streptococcal Infections ◽

Coagulase Negative Staphylococci ◽

Disk Diffusion Method ◽

Inducible Clindamycin Resistance ◽

Drug Of Choice ◽

One Year ◽

Hospital Acquired

Introduction/Objective. The increasing resistance to macrolides and lincosamides among staphylococci and streptococci is becoming a global problem. The aim of this study was to investigate the prevalence of macrolide-lincosamide-streptogramin (MLS) resistance phenotypes in staphylococcal and streptococcal isolates in southeast Serbia. Methods. The MLS phenotypes were determined by the double-disk diffusion method in 2,121 inpatient and outpatient staphylococcal and streptococcal isolates collected during a one-year period at the Center for Microbiology. Results. The methicillin-resistant staphylococci isolates were significantly more resistant to penicillin, erythromycin, clindamycin, gentamicin, and ciprofloxacin (100%, 100%, 29.2%, 65.6%, and 53.1%, respectively) than the methicillin-sensitive ones (93.6%, 64.9%, 12%, 28.9%, and 11.7%, respectively). The inducible clindamycin resistance phenotype was dominant in S. aureus and coagulase-negative staphylococci isolates. S. pneumoniae, S. pyogenes, and S. agalactiae isolates showed very high resistance to erythromycin (77.8%, 46.2%, and 32.4%, respectively). All staphylococci and streptococci isolates were sensitive to vancomycin and linezolid, and all beta-hemolytic streptococci isolates to penicillin and ceftriaxone. Conclusion. The phenotypic triage of staphylococci is necessary in order to separate inducible resistant and truly clindamycin-sensitive isolates. Macrolides should not be recommended for empirical therapy of streptococcal infections. Penicillins remain the drug of choice for treatment of streptococcal infections in our local area.

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Phenotypic and Genomic Variation among Staphylococcus epidermidis Strains Infecting Joint Prostheses

Journal of Clinical Microbiology ◽

10.1128/jcm.37.5.1306-1312.1999 ◽

1999 ◽

Vol 37 (5) ◽

pp. 1306-1312 ◽

Cited By ~ 43

Author(s):

Jacques-Olivier Galdbart ◽

Anne Morvan ◽

Nicole Desplaces ◽

Nevine el Solh

Keyword(s):

Drug Resistance ◽

Staphylococcus Epidermidis ◽

Genomic Variation ◽

Infected Tissue ◽

Healthy Individuals ◽

Skin Flora ◽

Resistance Patterns ◽

Tissue Specimens ◽

Multiple Strains ◽

Joint Prostheses

We studied the SmaI and SstII macrorestriction patterns of 54 Staphylococcus epidermidisstrains isolated from 14 patients infected following the implantation of joint prostheses. Multiple strains from pus and infected tissue specimens of each patient were selected on the basis of different colony morphologies and drug resistance patterns. The same criteria were used to select 23 S. epidermidis strains from hand swabs of eight healthy individuals. For 10 of the 14 patients, all the intrapatient strains appeared to be closely or possibly related, whereas related strains were detected in the skin flora of only one of the eight healthy individuals. This observation suggests that, in most cases, the patients were infected by a single S. epidermidis clone which subsequently underwent rearrangements that yielded derivatives with divergent phenotypes and, occasionally, divergent macrorestriction patterns. The four patients whose specimens contained unrelated S. epidermidisstrains were probably infected with several polyclonal strains.

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Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1040 ◽

2020 ◽

Author(s):

Audrey Le Bot ◽

Raphaël Lecomte ◽

Pierre Gazeau ◽

François Benezit ◽

Cédric Arvieux ◽

...

Keyword(s):

Prosthetic Valve ◽

Outcome Measurement ◽

Prosthetic Valve Endocarditis ◽

Hospital Length Of Stay ◽

Coagulase Negative Staphylococci ◽

Valvular Surgery ◽

Duke Criteria ◽

One Year ◽

The Impact ◽

Relapse Rates

Abstract Background International guidelines recommend rifampin-based combinations for staphylococcal prosthetic valve endocarditis (PVE). However, no robust clinical data support this recommendation, and rifampin tolerability is an issue. We aimed to evaluate the impact of rifampin for the treatment of staphylococcal PVE. Methods An observational retrospective cohort study of all adults with staphylococcal PVE (modified Duke criteria) was conducted in 3 referral centers for endocarditis, during years 2000–2018. Primary outcome measurement was 1-year mortality. Results We enrolled 180 patients with PVE due to Staphylococcus aureus (n = 114, 63.3%), or coagulase-negative staphylococci (n = 66, 36.7%), on bioprosthesis (n = 111, 61.7%), mechanical valve (n = 67, 37.2%), or both (n = 2). There were 132 males (73.3%), and mean age was 70.4 ± 12.4 years. Valvular surgery was performed in 51/180 (28.3%) cases. Despite all isolates were susceptible to rifampin, only 101 (56.1%) were treated with rifampin, for a median duration of 33.0 days, whereas 79 (43.9%) received no rifampin. Baseline characteristics were similar in both groups. One-year mortality was, respectively, 37.6% (38/101), and 31.6% (25/79), in patients treated with, or without, rifampin (P = .62). Relapse rates were 5.9% (6/101), and 8.9% (7/79), P = .65. Patients treated with rifampin had longer hospital length-of-stay: 42.3 ± 18.6 vs 31.3 ± 14.0 days (P < .0001). On multivariate analysis, only cerebral emboli (odds ratio [OR] 2.95, 95% confidence interval [CI], 1.30–6.70, P = .009), definite endocarditis (OR 7.15, 95% CI, 1.47–34.77, P = .018), and methicillin-resistant S. aureus (OR 6.04, 95% CI, 1.34–27.26, P = .019), were associated with 1-year mortality. Conclusions A large proportion (43.9%) of staphylococcal PVE received no rifampin. One-year survival and relapse rates were similar in patients treated with or without rifampin.

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Bacterial Colonization of the Skin Following Aseptic Preoperative Preparation and Impact of the Use of Plastic Adhesive Drapes

Biological Research For Nursing ◽

10.1177/1099800411430381 ◽

2012 ◽

Vol 15 (2) ◽

pp. 242-248 ◽

Cited By ~ 21

Author(s):

Karin Falk-Brynhildsen ◽

Örjan Friberg ◽

Bo Söderquist ◽

Ulrica G. Nilsson

Keyword(s):

Sampling Method ◽

Bacterial Colonization ◽

Surgical Team ◽

Preoperative Preparation ◽

Coagulase Negative Staphylococci ◽

Established Method ◽

Wound Contamination ◽

Skin Flora ◽

The Impact ◽

Chlorhexidine Solution

Surgical site contamination, for example, with coagulase-negative staphylococci, probably derives from both the patient’s own skin flora and those of the surgical team. Despite preoperative antiseptic preparation with chlorhexidine solution, complete sterilization of the skin is not possible and gradual recolonization will occur. Plastic adhesive drape is an established method used to prevent direct wound contamination from adjacent skin. In this study, the time to skin recolonization after antiseptic preparation was measured and the impact of using plastic adhesive drape on this recolonization was evaluated. Repeated bacterial sampling using three different methods over 6 hr was conducted after antiseptic preparation in 10 volunteers. Recolonization of skin was observed after 30 min with plastic drape and after 60 min without plastic drape; there were significantly more positive cultures with the plastic drape than without (31% vs. 7.5%, respectively, p < .001). Sampling with a rayon swab was the most sensitive sampling method. In conclusion, covering the skin with a plastic adhesive drape seems to hasten recolonization of the skin after antiseptic preparation. However, clinical trials to confirm this finding are warranted.

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Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

Clinical Microbiology Reviews ◽

10.1128/cmr.5.1.36 ◽

1992 ◽

Vol 5 (1) ◽

pp. 36-48 ◽

Cited By ~ 78

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.

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Staphylococcus aureus: Prevalence among normal healthy individuals

Nepal Journal of Medical Sciences ◽

10.3126/njms.v2i2.8968 ◽

2013 ◽

Vol 2 (2) ◽

pp. 160-164

Author(s):

D Finney ◽

R Ranganathan ◽

AKS Khan ◽

J Shanmugam

Keyword(s):

Staphylococcus Aureus ◽

Nasal Swab ◽

Throat Swab ◽

Research Centre ◽

Carrier Status ◽

Healthy Individuals ◽

Coagulase Negative Staphylococci ◽

College Hospital ◽

Mannitol Salt Agar ◽

Hospital Infection Control

Background: To determine the prevalence of Staphylococcus aureus among normal healthy individuals in relation to age, gender and site of isolation. Methods: A cross sectional study was conducted among healthy students and staff volunteers between the age group 15-65 years from Gulf Medical University (GMU) and Gulf Medical College Hospital and Research Centre (GMCH&RC), Ajman. Aseptically collected nasal and throat swabs were processed for direct Gram stain Microscopy and cultured on appropriate media. Based on the growth on Mannitol Salt Agar and tube coagulase test Staphylococcus aureus and Coagulase negative Staphylococci (CoNS) were grouped. Results: Of the 127 voulnteers screened 67 were from GMU and 60 from GMCH&RC. From 49/127 (38.5%) volunteers 124 Staphylococci isolates were isolated. Of which 62 (50%) were Staphylococcus aureus and 62 (50%) were CoNS. Among the 62 Staphylococcus aureus 35 (56.45%) were from nasal swab and 27 (43.54%) were from throat swab. Of the 62 CoNS 44 (70.96%) were from nasal swab, 4 (6%) from throat swab and 14 (22.58%) were from both nasal and throat swabs. Conclusion: The study revealed the asymptomatic inhabitation of Staphyloccus aureus in the nose and throat of healthy individuals. This should be seriously looked into since this in future may lead to carrier status. This alarms the hospital infection control committee to screen students and staff on regular basis to minimize the carrier status to protect the community. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 160-164 DOI: http://dx.doi.org/10.3126/njms.v2i2.8968

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Contamination and Decontamination of Doppler Probes

Annals of The Royal College of Surgeons of England ◽

10.1308/003588406x114866 ◽

2006 ◽

Vol 88 (5) ◽

pp. 479-481 ◽

Cited By ~ 11

Author(s):

Emma J Whitehead ◽

John F Thompson ◽

David R Lewis

Keyword(s):

Nosocomial Infection ◽

Vascular Surgery ◽

Revision Surgery ◽

Medical Staff ◽

Staff Education ◽

Bacterial Colonisation ◽

Coagulase Negative Staphylococci ◽

Bacteriological Culture ◽

Surgical Ward ◽

Skin Flora

INTRODUCTION Nosocomial infection occurs in 2–9% of patients undergoing vascular surgery and can lead to death, amputation or require complex revision surgery. Neck ties, pagers, stethoscopes and Doppler probes have been shown to carry pathogens. We measured bacterial colonisation of Doppler probes on a vascular unit and audited the effect of staff education at reducing this contamination. MATERIALS AND METHODS Bacteriological culture swabs were taken from hand-held Doppler probes on the vascular surgical ward and clinic. There was no protocol for cleaning the Doppler probes, so manufacturers were contacted for their recommendations. The results of cultures were presented to nursing and medical staff, who were then asked to clean the probes with alcohol wipes after each use. After an interval of 1 week, bacteriological cultures from the same Doppler probes was repeated. RESULTS Fifty bacteriological cultures were performed from 10 Doppler probes over a 4-week period. Thirteen (26%) cultures were positive for diphtheroids, coliforms, coagulase-negative staphylococci and skin flora. After staff education, 42 further swabs were taken from the same probes; two positive cultures were obtained with scanty growth of skin flora (χ2 P < 0.05). CONCLUSIONS Staff education and simple cleaning significantly reduces the contamination of hand-held Doppler probes and may help prevent nosocomial infection.

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