scholarly journals Methicillin Susceptible Staphylococcus aureus is the predominant Organism in Septic Bursitis with the Majority Involving the Olecranon Bursa: A Study of 65 Cases

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Don Walter Kannangara ◽  
Dhyanesh Pandya

Bursae are fluid filled structures between mobile parts of the musculoskeletal system to reduce friction by lubrication. Repeated trauma to bursae results in bursitis which are usually aseptic initially, which may be followed by infection. Many cases are related to occupational or recreational activities. We present an analysis of cases of Staphylococcus aureus septic bursitis admitted to 10 hospitals over a 3-year period. The olecranon bursa was the most common site involved 42/65 (64.6%) followed by prepatellar bursa 17/65 (26.1%). The mean age was 61.2 years. Fifty five out of Sixty-five (84.6%) were male. The majority were caused by methicillin susceptible Staphylococcus aureus 52/65 (80%). The occupational history was missing for most patients. The occupations reported in few of the patient charts were floor worker, construction worker and roofer. Sixty one out of sixty-five (92.4%) of cases involved the elbow and knee. Avoidance of activities that result in repeated friction or trauma to elbows and knees would prevent majority of cases of septic bursitis.

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S779-S779
Author(s):  
Don Kannangara ◽  
Dhyanesh Pandya

Abstract Background Bursae are fluid filled structures between mobile parts of the musculoskeletal system to reduce friction between surfaces by lubrication. The most frequently infected are the olecranon and prepatellar bursae. In reported studies there is male preponderance, a relationship to occupational or recreational activities, a mean age of about 50 years and the most frequent organism being Staphylococcus aureus. The frequency of methicillin resistance is not well documented. Methods We analyzed approximately 7000 Staphylococcus aureus isolates reported by the laboratory over a 3-year period in 10 of our network hospitals, 9 in Eastern Pennsylvania and one in adjacent Warren County, New Jersey and found 61 cases of S. aureus septic bursitis. Results Only 13/61 (21.3%) were caused by methicillin resistant S. aureus (MRSA), 8 olecranon (61.5%), 4 prepatellar (30.8%) and one subacromial (7.7%). Only one in MRSA group (olecranon bursitis) was female. The mean age of MRSA cases was 58.5. Methicillin susceptible S. aureus (MSSA) predominated with 34/48 (70.8%) olecranon bursitis (28M/6F), 11/48 (22.9%) prepatellar bursitis (10M/1F) and 3/48 (6.3%) sub acromial bursitis (1M/2F) with a mean age of 61.9. Overall (MRSA +MSSA), 51/61 (83.6%) were male and 10/61 (16.4%) were female. The olecranon bursa was involved in 42/61 (68.9%), prepatellar bursa 15/54 (24.6%) and subacromial bursa 4/54 (6.6%). The mean age for the entire group was 61.2 with the youngest 23 and the oldest 93. The occupational history was recorded only in a few patients e.g. roofer, floor worker, construction worker. Three in the MSSA group had bacteremia (2 subacromial bursitis and 1 olecranon bursitis). There was 1 death from gram negative sepsis which was unrelated. The majority were successfully treated with a combination of drainage and antibiotics. Conclusion In summary, our study shows a predominance of olecranon bursitis, with a higher incidence in males and majority caused by MSSA. The mean age around 61 was higher than the mean age in prior reports around 50 years. Elbows and knees accounted for 57/61 (93%) cases of septic bursitis. Avoidance of activities involving friction or repeated trauma to elbows and knees should help prevention of septic bursitis. As far as we are aware, this is the largest series of septic bursitis reported. Disclosures All Authors: No reported disclosures


1983 ◽  
Vol 46 (11) ◽  
pp. 978-981 ◽  
Author(s):  
B. A. WENTZ ◽  
A. P. DURAN ◽  
A. SWARTZENTRUBER ◽  
A. H. SCHWAB ◽  
R. B. READ

The microbiological quality of fresh blue crabmeat, soft- and hardshell clams and shucked Eastern oysters was determined at the retail (crabmeat, oysters) and wholesale (clams) levels. Geometric means of aerobic plate counts incubated at 35°C were: blue crabmeat 140,000 colony-forming units (CFU)/g, hardshell clams, 950 CFU/g, softshell clams 680 CFU/g and shucked Eastern oysters 390,000 CFU/g. Coliform geometric means ranged from 3,6/100 g for hardshell clams to 21/g for blue crabmeat. Means for fecal coliforms or Escherichia coli ranged from <3/100 g for clams to 27/100 g for oysters, The mean Staphylococcus aureus count in blue crabmeat was 10/g.


1979 ◽  
Vol 42 (11) ◽  
pp. 872-876 ◽  
Author(s):  
J. RITTER ◽  
J. O'LEARY ◽  
B. E. LANGLOIS

Staphylococcus aureus, Clostridium perfringens. Salmonella choleraesuis, and Salmonella typhimurium were inoculated (108 cells or spores) into two slow cookers containing green bean casserole, baked navy beans, chicken cacciatore, barbecued ribs or pork pot roast, and their fate determined after cooking. Heating patterns also were determined at three positions inside the two cookers. None of the foods cooked in either of the slow cookers contained detectable levels of S. aureus or salmonellae. The similarity between C. perfringens vegetative and spore counts indicate that only spores were present in the cooked foods. Except for the green bean casserole cooked using a low temperature setting, cooking resulted in a 0.44–1.67 and 0.36–1.54 log count reduction, respectively, of vegetative cells and spores of C. perfringens. Counts of vegetative cells and spores after cooking the green bean casserole were approximately .18 and .30 log counts higher than the uncooked counts. The mean times for the coldest areas in Cooker A to reach 50 C were 2.57 and 0.97 h, respectively, for the low (80 watts) and high (160 watts) temperature settings. The mean times for the coldest areas in Cooker B (removable liner) to reach 50 C were 2.35 and 0.52 h for the low (130 watts) and high (260 watts) temperature settings, respectively. Results suggest that when the recommended quantities of ingredients are used and the proper cooking procedure followed, foods prepared in the slow cookers studied do not present a health hazard.


2020 ◽  
Vol 33 (02) ◽  
pp. 099-103
Author(s):  
Pritam Goswami ◽  
Sayak Ghosh ◽  
Sk Swaif Ali ◽  
Anamika Basu ◽  
Joydeep Khanra ◽  
...  

Abstract Background Panton-Valentine toxin (PVT) is an important pathological marker of staphylococcal infection mediated by functional as well as morphological damage of the phagocytic cells. Human body being an ecological niche for the bacteria shows higher affinity toward staphylococcal infection. A steady escalation in mortality and morbidity associated with antibiotic resistance in gram-positive infections is an emerging threat all over the globe; thus, it is important to find out an alternative strategy that can diminish the virulence and pathogenicity of the bacteria. Staphylococcin is a colicin-type chemical secreted by Staphylococcus aureus helps to prevent growth of organisms other than its progenitor. In this study, we evaluated the efficacy of homoeopathic medicine Staphylococcinum against staphylococcal PVT at different potencies (6CH, 12CH, 30CH and 200CH). Materials and Methods Different potencies of Staphylococcinum were administered in a leucocyte buffy coat preparation infected with staphylococcal suspension (0.5 McFarland's standard) along with control with alcohol. They were kept in incubator for 2 hours and then centrifuged at 1200 rpm for 5 minutes. Smears prepared on slides with centrifuged deposits stained by Preston and Morrell's modified Gram's method of staining and evaluated under the microscope. Results It was observed that there was extensive destruction of leukocytes in control and 6CH potency, while the degree of destruction decreased markedly from 12CH to 200CH. At 200CH potency, leukocytes were almost normal, which clearly indicate the preventive action of Staphylococcinum against PVT. The mean percentages of intact leucocytes were 0.73, 0.93, 10.00, 27.67 and 65.00 in control, 6CH, 12CH, 30CH and 200CH potencies, respectively. Conclusion The finding may help in the use of this medicine in moribund patients in cases of disseminated S. aureus infection as there is no known side effect of the medicine. However, in vivo study is necessary before such use in those cases.


2018 ◽  
Vol 44 (1) ◽  
pp. 7 ◽  
Author(s):  
Suzana Evelyn Bahr Solomon ◽  
Marconi Rodrigues de Farias ◽  
Claudia Turra Pimpão

Background: Recurrent staphylococcal infections are frequent in dogs with atopic dermatitis (AD). Many factors seem to contribute to making bacterial pyoderma refractory to treatment. Short-term systemic antibiotic therapy is effective for the treatment of acute symptoms, and may, along with pulsatile therapy, contribute to the long-term control of the disease. However, microbial resistance has become a growing and alarming problem. The aim of this study was to evaluate whether the use of Staphylococcus aureus Phage Lysate Staphage Lysate (SPL)®, can minimize the symptoms of recurrent pyoderma and increase the interval between acute atopic manifestations in dogs.Materials, Methods & Results: Thirteen dogs with a history of Canine Atopic Dematitis (CAD) and recurrent bacterial pyoderma received SPL at increasing intervals for 23 weeks. The contents of an intact pustule of each dog was collected and submitted to microbiological analysis. Systemic antibiotic therapy was established for the first 4-6 weeks of SPL protocol, based on the antibiotic sensitivity tests. The animals included in the study underwent a therapeutic protocol receiving shots of 0.5 mL of SPL subcutaneously (SC) twice a week for the first 12 weeks; 1.0 mL of SPL (SC) once a week for four weeks; 1.0 mL of SPL (SC) once every 15 days; 1.0 mL of SPL (SC) after a three-week interval from the last dose on week 20, until final observation at week 26, with no application. The animals underwent clinical examination every week and the evaluation of pruritus was used according Rybnicek et al. During the therapeutic protocol with SPL, a significant decline in the pruritus was observed in the treated dogs (P < 0.05). In week 1, the mean pruritus index was 7.33 on the Rybnicek scale; in weeks 12 and 23, the mean indices were 2.41 and 1.91. An effectiveness of 83.33% for the control of pruritus along with regression of the lesions was observed.Discussion: Before treatment, the selected animals presented worsening of the pruritus during the pyoderma eczema episodes (pruritic), resulting in the emergence of a vicious cycle where the pruritus induced the appearance of new lesions, requiring the use of antibiotics for a long period. During the therapeutic protocol with SPL, a significant decline in the pruritus was observed in the treated dogs. The control of pruritus associated with pyoderma eczema of the dogs in this study before the vaccination protocol with SPL was satisfactory when they were subjected to antibiotic therapy; however, after suspending therapy, the bacterial infections recurred, on average, after 2-4 weeks. On the other hand, with the use of SPL, the animals were recurrence-free until the end of the experimental protocol. This was attributed to the antibiotic therapy administered at the beginning of the protocol, as this led to a regression of the bacterial pyoderma and involution of the lesions. However, after suspending antibiotics, it was observed that, by the end of the study, 83.33% of the dogs still had a low level of pruritus, few or no lesions, which were considered acceptable to most owners. At this moment none of these patients needed to be subjected to antibiotic treatment. The sums of the scores for the dogs on weeks 1, 12, and 23 were 53.33, 4.41, and 3.5, respectively, indicating significant improvements of the lesions, showing that the proposed protocol with SPL was able to prevent new episodes of pyoderma.


2021 ◽  
Vol 16 (2) ◽  
pp. 132-143
Author(s):  
Selvia Tharukliling ◽  
Lilik Eka Radiati ◽  
Imam Thohari ◽  
Agus Susilo

This study aims to determine the antimicrobial activity of red fruit paste against Staphylococcus aureus FNCC-0047 and Eschericia coli FNCC-0091 by using ethanol and n-hexane as well as the total plate count value of the patty with red fruit paste added on different observations day. The concentration of paste extract for antimicrobial activity test was 6.25%, 12.5%, 25%, 50%. The calculation of the total value of the burger patty plate is calculated on the 3rd, 7th and 14th d with the red fruit paste content in the formula as much as 0%, 5%, 10%, 15%. The results showed that the fatty acids of red fruit paste were dominated by oleic acid and linoleic acid, which are unsaturated fatty acids and palmitic acid, which are saturated fatty acids. The yield of red fruit paste in n-hexane solvent was higher than ethanol solvent. There was a significant difference (P <0.05) from the use of different solvents to the mean clear zone of the two bacteria tested. The antibacterial activity shown by the ethanol extract and n-hexane extract of red fruit paste was in the inactive category at the 6.12% level, the moderate category at the 12.5% to 25% level and the strong category at the 50% level. There was a significant difference (P <0.05) from the total microbial value in each treatment where the higher the red fruit paste content in the patty, the lower the total microbial value found on each d of observation. The use of red fruit paste at a level of 10% to 15% can withstand the rate of microbial growth


Author(s):  
Pooja Bains ◽  
Simplepreet Kaur

<p class="abstract"><strong>Background:</strong> To describe the clinico epidemiologic profile and dermoscopic findings in children with alopecia areata (AA) and correlate the dermoscopic findings with stage and severity.</p><p class="abstract"><strong>Methods:</strong> The present study was performed over a period of six months, from July 2020 to December 2020 in a tertiary care hospital where 50 clinically diagnosed children ≤15 years with AA were enrolled. A thorough clinical examination followed by dermoscopy was performed. The results were tabulated and then analyzed statistically.</p><p class="abstract"><strong>Results: </strong>The mean age of presentation was 9.74 years. The most common site involved was scalp and the most common dermoscopic findings were yellow dots (25/50, 50%), short vellus hair (22/50, 44%), black dots (21/50, 42%), exclamation mark hair (15/50, 30%) and broken hair (11/50, 22%).</p><p class="abstract"><strong>Conclusions:</strong> No significant associations was found between dermoscopic findings and severity or stage of childhood alopecia areata. There was a significant correlation of alopecia areata severity with nail findings in children with alopecia areata.</p>


2018 ◽  
Vol 146 (16) ◽  
pp. 2122-2130 ◽  
Author(s):  
H. G. Ternavasio-de la Vega ◽  
F. Castaño-Romero ◽  
S. Ragozzino ◽  
R. Sánchez González ◽  
M. P. Vaquero-Herrero ◽  
...  

AbstractThe objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S229-S229
Author(s):  
Jae Hong Choi ◽  
Hyunju Lee ◽  
Eun Hwa Choi

Abstract Background Staphylococcal scalded skin syndrome (SSSS) is a blistering and desquamative skin disease caused by the exfoliative toxins of Staphylococcus aureus. SSSS mainly affects children younger than 5 years of age. Although many countries show a predominance of methicillin-susceptible S. aureus (MSSA), recently an increase in cases due to methicillin-resistant S. aureus (MRSA) has been reported. We investigated the molecular characteristics of S. aureus isolated from the children with SSSS in Korea. Methods From January 2010 to December 2017, children clinically diagnosed as SSSS under the age of 5 years were enrolled. Cases from 3 different university hospitals in Korea were included. S. aureus isolated from nasal, axillary, or inguinal area of the children were analyzed for multilocus sequence type and exfoliative toxins (eta, etb). Medical records were retrospectively reviewed for clinical characteristics and antimicrobial susceptibility patterns of S. aureus. Results A total of 26 cases were enrolled. The mean age was 2.3 years (range, 0–4.8 years). Twenty-two (84.6%) patients were hospitalized. Skin manifestations were classified as follows; generalized (n = 10, 38.5%), intermediate (n = 11, 42.3%), and abortive (n = 5, 19.2%). Twenty-five isolates (96.2%) were resistant to methicillin and macrolide-resistance was found in 92.3% (n = 24). ST89 (n = 21, 80.8%) was the most prevalent clone, with single clones of ST1, ST5, ST72, ST121, and ST1507. The eta gene was detected in 1 (3.8%) MSSA isolate. The etb gene was detected in 14 (53.8%) isolates all of which were ST89. All patients were treated with antibiotics, and the mean duration was 8.3 days regardless of the administration route. Nafcillin or first cephalosporin was most commonly prescribed (n = 20, 76.9%), clindamycin was administered in combination in 9 patients (34.6%) and vancomycin in 4 patients (15.4%). Among the 25 MRSA cases, only 6 (24.0%) were treated with susceptible antibiotics. However, there was no difference in treatment duration according to antimicrobial susceptibility (8.43:8.22 days, P > 0.05). Conclusion The molecular epidemiology of S. aureus isolated from the Korean children with SSSS demonstrated the high prevalence of methicillin-resistant ST89 clone that harbors the etb gene. Disclosures All authors: No reported disclosures.


Chemotherapy ◽  
2019 ◽  
Vol 64 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Vesa Cheng ◽  
Matthew Rawlins ◽  
Tim Chang ◽  
Emma Fox ◽  
John Dyer ◽  
...  

Prolonged intermittent renal replacement therapy (PIRRT) is an increasingly adopted method of renal replacement in critically ill patients. Like continuous renal replacement therapy, PIRRT can alter the pharmacokinetics (PK) of many drugs. In this setting, dosing data for antibiotics like benzylpenicillin are lacking. In order to enable clinicians to prescribe benzylpenicillin safely and effectively, knowledge of the effects of PIRRT on the plasma PK of benzylpenicillin is required. Herein, we describe the PK of benzylpenicillin in 2 critically ill patients on PIRRT for the treatment of penicillin-susceptible Staphylococcus aureus bacteremia complicated by infective endocarditis. Blood samples were taken for each patient taken over dosing periods during PIRRT and off PIRRT. Two-compartment PK models described significant differences in the mean clearance of benzylpenicillin with and without PIRRT (6.61 vs. 3.04 L/h respectively). We would suggest a benzylpenicillin dose of 1,800 mg (3 million units) every 6-h during PIRRT therapy as sufficient to attain PK/pharmacodynamic target.


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