Phage Treatment Trial to Eradicate LA-MRSA from Healthy Carrier Pigs

The increase of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) causes a threat to human health. LA-MRSA can be transmitted from animals to animal caretakers, which may further spread MRSA to communities and health care facilities. The objective of this work was to study the efficacy of phage treatment in the eradication of LA-MRSA from healthy carrier pigs. A total of 19 MRSA -positive weanling pigs were assigned to a test (n = 10) and a control group (n = 9). A phage cocktail containing three Staphylococcus phages, or a control buffer was administered to the nares and skin of the pigs three times every two days, after which the phage and MRSA levels in nasal and skin swab samples were monitored for a three-week period. The sensitivity of the strains isolated during the follow-up period to the phage cocktail and each phage individually was analyzed and the pig sera were tested for antibodies against the phages used in the cocktail. The phage treatment did not cause any side effects to the pigs. Phages were found in the skin and nasal samples on the days following the phage applications, but there was no reduction in the MRSA levels in the sampled animals. Phage-resistant strains or phage-specific antibodies were not detected during the experiment. The MRSA load in these healthy carrier animals was only 10–100 CFU/swab or nasal sample, which was likely below the replication threshold of phages. The effectiveness of phage treatment to eradicate MRSA from the pigs could thus not be (reliably) determined.

Evaluation of effectiveness and compliance with the mupirocin nasal ointment part of Staphylococcus aureus decolonization in real life using UPLC-MS/MS mupirocin quantification

Background Preoperative decolonization is recommended in Staphylococcus aureus nasal carriers scheduled for cardiac surgery. We aimed to evaluate the effectiveness of and compliance with mupirocin use in nasal S. aureus carriers in a real-life setting. Methods Prospective study including consecutive patients scheduled for cardiac surgery screened for S. aureus nasal carriage at preoperative consultation. Carriers were prescribed mupirocin nasal ointment, chlorhexidine shower and mouthwash. Effectiveness of decolonization was evaluated with a postoperative nasal sample. Compliance was evaluated objectively by determination of nasal mupirocin concentration using UPLC-MS/MS and self-reported by questionnaire. Results Over 10 months, 361 patients were included, 286 had preoperative screening, 75 (26.2%) were S. aureus nasal carriers and 19 of them (25.3%) failed to be effectively decolonized. No resistance to mupirocin was documented. Preoperative and postoperative strains were identical in all cases. Declared good compliance was associated with decolonization success (OR = 24; 95% CI 4–143, P < 0.0001). Mupirocin detection was significantly associated with the level of compliance. Mupirocin was detected in 52.2% (24/46) of patients effectively decolonized and in 12.5% (2/16) of patients with decolonization failure (P < 0.01). In 2/19 patients, failure of decolonization was not associated with a compliance issue. Postoperative carriage was associated with an increased risk of S. aureus infection (OR = 9.8; 95% CI 1.8–53, P < 0.01). Conclusions In real life, decolonization is not always effective, hence there is a persisting risk of S. aureus endogenous infection. Mupirocin concentration measurement may help to understand compliance issues and failures in decolonization.

Screening of erm Gene of Inducible Clindamycin Resistant Staphylococcus aureus

Antibiotic resistance exhibited by Staphylococcus aureus is a growing global concern. This work was undertaken to determine the prevalence rate of inducible clindamycin resistant S. aureus in nasal sample and detect ermB gene in the isolates with inducible clindamycin resistance. Nasal swabs were collected from the school children and cultured on Mannitol Salt Agar (MSA) and Blood Agar (BA) for observation of colony morphology. Gram staining and biochemical test (catalase, oxidase, O-F and coagulase) were performed for further identification of the bacteria. The Kirby-Bauer disc diffusion method using a cefoxitin disc (30 μg) was used to detect methicillin resistant S. aureus (MRSA). All, the MRSA isolates were tested for ermB gene by PCR amplification. Among 64 S. aureus isolates, 17 (26 %) were MRSA. The prevalence of Inducible clindamycin resistant S. aureus (iMLSB) isolates was 23.4 % in the S. aureus isolates. All the isolates of MRSA were resistant to penicillin, while 88.2 % were sensitive to gentamicin. The prevalence of ermB gene was 3.1 % in the total S. aureus isolates and 11.7 % MRSA showed the presence of this gene. Routinely performing a D-test in laboratory will guide the clinicians on the rationale use of clindamycin and improving hygienic practices can reduce the spread of inducible clindamycin resistance.

Complete Genome Sequence of Middle East Respiratory Syndrome Coronavirus Isolated from a Dromedary Camel in Egypt

We generated the near-full genome sequence of Middle East respiratory syndrome coronavirus (MERS-CoV) from a collected nasal sample of dromedary camel in Egypt. The newly characterized Egyptian strain has high similarity to the previously characterized Egyptian virus and both of viruses fell into a cluster distinct from other MERS-CoVs.

Effect of Pretreatment with Ketotifen on Pollinosis: Correlation with Eosinophil Cationic Protein

In this study, we examined the effect of pretreatment with ketotifen on pollinosis, and correlations with the concentration of ECP in nasal discharge and the existence of eosinophils in nasal smear. Ketotifen was prophylactically administered to 74 patients with pollen allergy, and the treatment continued to the end of pollen season. An additional 25 patients with the same allergy commenced ketotifen treatment during the pollen season. The results showed that pretreatment with ketotifen reduced symptom scores during the pollen season, but did not suppress the increase in ECP concentration and eosinophil influx into the nasal sample. We suggest that pretreatment with ketotifen is useful for the treatment of pollinosis, and its effects may not be the result of suppression of eosinophil activation.