Methicillin-resistant Staphylococcus aureus (MRSA) is among the most alarming pathogens affecting both humans and the global bovine industry. The current control measures in hospitals and on farms for MRSA have proven...Methicillin-resistant Staphylococcus aureus (MRSA) is among the most alarming pathogens affecting both humans and the global bovine industry. The current control measures in hospitals and on farms for MRSA have proven to be inadequate leaving a need for new rapid control methods to curb MRSA infections in situ. New control measures for bacterial infection are widely sought, with particular interest in the applications for bacteriophages (phages) as a biocontrol or therapeutic agent. The current study uses a wild highly lytic phage isolated from cow’s milk taken from three farms in Baghdad, Iraq. The resulting phage was able to rescue 100% of the mice from a median lethal dose (LD50) or (1 × 108 CFU mL-1 per mouse) for MRSA wild isolates achieved when the phage: bacteria ratio was 100:1. Even when treatment was delayed for 6 h post lethal infection, to the point where all mice were moribund, 80% of them were rescued by a single injection of this phage preparation. Based on the current results, a comprehensive study is needed to guide further research on the MRSA phage as a biocontrol for MRSA mastitis in dairy cows to replace or reduce the use of antibiotics in animal husbandry.展开更多
We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denu...We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denudations and enterotoxigenic methicillin-resistant Staphylococcus aureus (MRSA) was detected in mucosal biopsies. After treatment with linezolide and steroids, a significant amelioration of colitis was detected and testing for MRSA became negative. In face of the case presented here, we suggest that in patients with refractory inflammatory bowel disease (IBD), microbiological assessment should be performed to detect a possible Staphylococcus aureus infection in order to initiate an antimicrobial treatment in addition to IBDspecific treatment.展开更多
Re-screening following methicillin-resistant Staphylococcus aureus(MRSA) decolonization will be helpful to minimize the development of prosthetic joint infection among MRSA colonizers.
Purpose: To capture the sensitivity and resistance trends of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a heterogenous demographic. Methods: Between 1/1/2004-12/31/2011, ophthalmic MRSA infection...Purpose: To capture the sensitivity and resistance trends of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a heterogenous demographic. Methods: Between 1/1/2004-12/31/2011, ophthalmic MRSA infections were searched in the electronic medical record system ofCommunityRegionalMedicalCenterinFresno,California. We reviewed whether the infection was community-acquired or hospital-acquired, culture site, and sensitivity/resistance profiles. Results: The ophthalmic MRSA isolates tested for vancomycin, sulfamethoxazole-trimethoprim, and gentamycin were 100% sensitive to these to these antibiotics. Tetracycline and rifampin had the next highest sensitivity to resistance ratio, followed by clindamycin. More cases were community-acquired than hospital acquired. Almost half of the hospital-acquired cases were in newborns. Most hospital acquired infections were post-ophthalmic surgery. Conclusion: There is an increasing trend of community- acquired ophthalmic MRSA infection with eyelid involvement being the most common manifestation. Hospital-acquired cases are common in newborns and post-ophthalmic surgery. Have a high index of suspicion for MRSA infection with suspected “insect bites”. Vancomycin, sulfamethoxazole-trimethoprim, gentamycin, tetracycline, and rifampin are good choices to treat ophthalmic MRSA infection. There may be emerging resistance to clindamycin, at least in theCentral Californiaregion. If MRSA infection is suspected, erythromycin and fluoroquinolones should be avoided.展开更多
Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insig...Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.展开更多
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most problematic human pathogens. Antibiotic treatment of MRSA often associated with resistance to multiple classes of antibiotics is extrem...Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most problematic human pathogens. Antibiotic treatment of MRSA often associated with resistance to multiple classes of antibiotics is extremely challenging and urgently demands action to treat MRSA. Glutathione (GSH) is a biogenic thiol-compound that maintains an optimal intracellular redox-potential required for various normal cellular processes. Antibacterial activity of exogenous GSH has been reported in some bacterial pathogens but is largely unknown in MRSA. Aim: This study aimed to understand antibacterial activity of GSH, its role in antibiotic susceptibility, and a potential antibacterial mechanism in clinical isolates of S. aureus. Materials and Methods: Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), checkerboard, time-killing, and bacterial killing assays were performed for 14 clinical isolates of S. aureus including 10 MRSA and two type strains (ATCC 700699 and 35556). Results: MIC and MBC levels for the clinical and type strains were 15 - 20 mM and 25 - 40 mM of GSH, respectively. Subinhibitory concentrations of GSH synergistically enhanced susceptibility of all tested-antibiotics, resulting in sensitizing all-tested S. aureus. Bacterial-killing produced by GSH-mediated acidity was significantly higher than that by hydrochloric acid-mediated acidity. Conclusion: Overall results concluded that GSH exhibited antibacterial activity on S. aureus regardless of antibiotic susceptibility and synergistically enhanced antibiotic susceptibility. Additionally, GSH-mediated acidity was one of the antibacterial mechanisms. These findings suggest that GSH may be a potential antimicrobial agent or adjuvant for the conventional anti-MRSA regimens.展开更多
Background: β lactamase is a plasmid-encoded enzyme that hydrolyzes β lactam ring of β lactam antibiotics rendering them ineffective. These enzymes, produced by Staphylococcus aureus along with many other organisms...Background: β lactamase is a plasmid-encoded enzyme that hydrolyzes β lactam ring of β lactam antibiotics rendering them ineffective. These enzymes, produced by Staphylococcus aureus along with many other organisms, have hindered the use of many useful and once life-saving β lactam antibiotics from clinical practice. Methods: This study was aimed to compare three test methods-chromogenic, acidimetric and iodometric-for the detection of β lactamase enzyme produced by 404 nosocomial induced S. aureus isolated from two Nepali hospitals, Kathmandu based hospital (KBH) and Lalitpur based Hospital (LBH). The study was carried out following standard methodology during November 2007 to June 2009 in the Department of Microbiology, Institute of Medicine, Kathmandu, Nepal. Sensitivity, specificity, efficiency, positive predictive value, and negative predictive values of the tests were calculated taking penicillin resistance and sensitivity as the standard. Results: Chromogenic method was found to be the most sensitive (98.93%) and efficient (98.51%) test and had a high positive predictive value (99.46%). Sensitivity (98.4%) and efficiency (98.27%) of iodometric method was found to be comparable to chromogenic test;its specificity (96.55 %) and positive predictive value (99.73%) were the highest among the 3 tests. Acidimetric test was the least sensitive (97.33%) and efficient (96.78%). Of note, the sensitivity and specificity of these test methods have been compromised due to the negativity of few penicillin resistant isolates and positivity of some penicillin sensitive isolates, respectively. Conclusion: Chromogenic method was found comparatively to be the best test method for the detection of β lactamase production. However, in contrast to the other two test methods whose reagents can be locally and economically prepared, chromogenic test’s use has been impeded by its cost and unavailability in the local Nepali market.展开更多
Epidemiological surveillance for microbes is currently based on either agar culture followed by identification, or genetic amplification. Both techniques are highly skilled-labor intensive, costly, and must be done in...Epidemiological surveillance for microbes is currently based on either agar culture followed by identification, or genetic amplification. Both techniques are highly skilled-labor intensive, costly, and must be done in central laboratories. The Defined Substrate Utilization®(DSU®) format provides an epidemiological series of specific screening formulations that obviate these limitations. All reagents are present in optimized stable powder form in a test tube—add water, inoculate, and incubate. A specific color change provides a sensitive and specific detection of the target microbe. Two DSU®methods for Staphylococcus aureus (S. aureus) are presented: aureusAlert®for all S. aureus and EPI-M®for methicillin-resistant S. aureus (MRSA). Both aureusAlert®and EPI-M®had a detection level of 20 colony forming units (CFU) in 18 hours. aureusAlert®and conventional methods agreed 93.6% and EPI-M®and conventional methods agreed 94.1%. DSU®and conventional methods showed the same specificity.展开更多
Staphylococcus aureus typing using gene encoding protein A (spa typing) seems to have a high potential discriminatory power for typing this bacterium. This study was designed based on spa typing method to compare the ...Staphylococcus aureus typing using gene encoding protein A (spa typing) seems to have a high potential discriminatory power for typing this bacterium. This study was designed based on spa typing method to compare the S. aureus types among healthy carrier vs patients, and MRSA vs MSSA isolates. Method: This study was carried out on 182 spa typeable S. aureus isolates, including 52 MRSA. DNA was extracted by phenol chloroform-isoamyl alcohol method and it was amplified by specific primer of polymorphic X region of spa. Spa types were determined by Ridom Staph Type software. The spa types distribution among MRSA vs MSSA and healthy carrier vs patients, isolates were statistically compared by X2 method and P < 0.05 was considered as significant. Result: The most common types of spa in our region were t037 (18.3%) and t937 (13.9%) from 50 spa types which were identified in this study. spa types in this study were isolated from various age groups but t660 spa types were only isolated from children. Distribution of all spa types among MRSA and MSSA isolates was 16 and 38 types, respectively which is significant. In this study we found seven new spa types (belong to twelve isolates) which are reported for the first time. In 5 out of the above 7 new types the 24 bp repeated sequences in spa gene X region were already recognized but their 24 bp arrangement is introduced in our present investigation. In the remaining 2 new types we found new 24 bp nucleotide sequences which are also introduced for the first time in our present study. Conclusion: The distribution of spa types in MSSA strains was significantly higher than MRSA isolates, but there are not any specific spa types for discrimination between MRSA and MSSA. The novelty of our study is the introducing 7 new spa types including 2 new 24 bp repeated sequences in the X region of spa gene.展开更多
Background: Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S...Background: Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S. aureus pneumonia in DM is limited, we sought to make a relatively comprehensive exploration of clinical characteristics, antimicrobial resistance, and risk factors for mortality of S. aureus pneumonia in DM and non-diabetics mellitus (non-DM). Methods: A retrospective study was conducted in Ruijin Hospital from 2014 to 2017. The characteristics of DM and non-DM patients were assessed, including demographics, comorbidities, using of invasive mechanical ventilation, Hemoglobin A1c (HbA1C), confusion, urea, respiratory rate, blood pressure, age ≥65 years (CURB-65) score, length of hospital stay, clinical outcomes, antimicrobial susceptibility. Independent risk factors for mortality were identified by univariate and multivariate logistic regression analysis. Results: A total of 365 patients with S. aureus pneumonia were included in our study, including 144 with DM and 221 non-DM. DM patients were more susceptible to MRSA infection (65.3% vs. 56.1%, P > 0.05), suffered from much severer pneumonia with a higher CURB-65 score, invasive mechanical ventilation rate (46.5% vs. 28.1%, P < 0.01) and mortality rates (30.6% vs. 23.1%, P > 0.05);almost all DM patients had higher antimicrobial resistance than non-DM patients, the DM group had a higher coinfection rate (47.2% vs. 45.7%, P > 0.05), and Acinetobacter baumannii was the most common bacterium in DM, while Klebsiella pneumoniae ranked first in patients with non-DM. Independent risk factors for pneumonia-related mortality were MRSA and CURB-65. Higher HbA1c levels were linked to a higher MRSA infection and co-infection rate and more severe pneumonia, leading to an increase in mortality. Conclusions: DM patients with poor glucose control are more susceptible to MRSA infection. They suffer from higher antimicrobial resistance, a higher co-infection rate, and much severer pneumonia than non-DM. MRSA itself is an independent risk factor for mortality in all patients.展开更多
To the Editor: The incidence of community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection and reports of CA-MRSA infection have been increasing yearly. But community-acquired intraspinal methi...To the Editor: The incidence of community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection and reports of CA-MRSA infection have been increasing yearly. But community-acquired intraspinal methicillin-resistant Staphylococcus aureus (MRSA) infection has never been reported. We describe a case of intraspinal abscess due to CA-MRSA infection.展开更多
Importance:Regional clonal replacements of methicillin-resistant Staphylococcus aureus (MRSA) are common.It is necessary to understand the clonal and drug resistance changes in specific areas.Objective:To evaluate the...Importance:Regional clonal replacements of methicillin-resistant Staphylococcus aureus (MRSA) are common.It is necessary to understand the clonal and drug resistance changes in specific areas.Objective:To evaluate the clonal and drug resistance dynamics of MRSA in Chinese children from 2010 to 2017.Methods:MRSA was isolated from patients in Beijing Children's Hospital from 2010 to 2013 and from 2016 to 2017.The molecular characteristics and antibiotic resistance were determined,Results:In total,211 MRSA isolates were collected,and 104 isolates were classified as community-associated MRSA (CA-MRSA).ST59-SCCmec Ⅳ was the most prevalent type in both CA-MRSA (65.4%) and healthcare-associated-MRSA (HA-MRSA) (46.7%).ST239-SCCmec Ⅲ accounted for 21.5% of all HA-MRSA,which were not detected in 2016,and only three isolates were detected in 2017.The pvl gene carrying rate of CA-MRSA was significantly higher than that of HA-MRSA (42.3% vs.29.0%,P =0.0456).Among CA-MRSA,resistance rate to all tested antibiotics excluding chloramphenicol remained stable over the periods of 2010-2013 and 2016-2017.HA-MRSA displayed an overall trend of decreased resistance to oxacillin,gentamicin,tetracycline,ciprofloxacin,and rifampin,and increased resistance to chloramphenicol,consistent with the difference of antibiotic resistance patterns between ST59-SCCmec Ⅳ and ST239-SCCmec Ⅲ isolates.Vancomycin minimal inhibitory concentration (MIC) creep was found in the study period in all MRSA and ST59-SCCmec Ⅳ isolates.Interpretation:ST59-SCCmec Ⅳ has spread to hospitals and replaced the traditional ST239-SCCmec Ⅲ clone,accompanied by changes in drug resistance.Furthermore,vancomycin MIC creep indicated that the rational use of antibiotics should be seriously considered.展开更多
From a further purification study,two new congeners designated cyslabdans B(1)and C(2)were isolated along with previously reported cyslabdan(cyslabdan A(3)in this study)from the culture broth of Streptomyces sp.K04-01...From a further purification study,two new congeners designated cyslabdans B(1)and C(2)were isolated along with previously reported cyslabdan(cyslabdan A(3)in this study)from the culture broth of Streptomyces sp.K04-0144.The structure was elucidated by various spectroscopy including NMR,revealing that 1 and 2 was 18-hydroxy and 10-methoxy cyslabdan,respectively.Compounds 1 and 2 were found to potentiate imipenem activity against methicillinresistant Staphylococcus aureus by 123 fold and 533 fold,respectively.Comparison with the activity of compound 3 indicated that the introduction of a hydrophilic group at the dimethyl moiety of the decalin ring was unfavorable for its activity.展开更多
Silica nanorattles(SNs) with zinc oxide(ZnO) combination nanoparticles are reported to inhibit methicillin-resistant Staphylococcus aureus(MRSA) for the first time. SNs loaded with ZnO nanoparticles,which can produce ...Silica nanorattles(SNs) with zinc oxide(ZnO) combination nanoparticles are reported to inhibit methicillin-resistant Staphylococcus aureus(MRSA) for the first time. SNs loaded with ZnO nanoparticles,which can produce free radicals, can cause severe damage to bacteria. ZnO nanoparticles not only provide free radicals in the combined nanostructures, which can inhibit the growth of bacteria, but also form nanorough surfaces with an irregular distribution of spikes on the SNs, which can enhance their adhesion to bacteria. Nanorough silica shell surfaces maintain the high activity and stability of small-sized ZnO nanoparticles and gather ZnO nanoparticles together to enhance production, which improves the efficiency of free radicals against the cytomembranes of bacterial cells. The enhanced adhesion of ZnO@SN nanoparticles to MRSA cells shortens the effective touching distance between free radicals and MRSA, which also improves antibacterial activity. As we expected, the ZnO@SN nanoparticles exhibit a better antibacterial effect than free ZnO nanoparticles against MRSA in vitro and in vivo. We also demonstrate that SNs loaded with ZnO nanoparticles can accelerate wound healing in MRSA skin inflammation models. This method of multilevel functionalization will be potentially applicable to the antibacterial field.展开更多
Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be...Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be changing.The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Study design:Retrospective review of an institutional microbiologic database.Methods:A retrospective analysis was performedon serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April 2016.The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration(MIC)testing.Medical records were reviewed to document patient characteristics,chronicity of infection,symptomatology,and previous treatments.Results:Over the study period,173 patients were diagnosed with AOE and underwent otologic cultures of the ear.Fifty-three(30.6%)of cultures grew S.aureus(SA).Of SA infections,15(28.3%)were identified as MRSA.MRSA patients were typically older than patients with methicillin-sensitive SA(MSSA)(mean age 46.717.9 vs 2919.4,PZ0.003)and had more medical comorbidities(4 vs 1.7,PZ0.001).Compared to patients with MSSA,patients with MRSAwere significantly more likely to have had prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature.Clinicians should consider ear cultures to identify MRSA AOE.Level of Evidence:IV.展开更多
The practice of phage therapy, which uses bacterial viruses(phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed ...The practice of phage therapy, which uses bacterial viruses(phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed interest in revisiting this practice. Conventionally, phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Biotechnological advances have further expanded the repertoire of potential phage therapeutics to include novel strategies using bioengineered phages and purified phage lytic proteins. Current research on the use of phages and their lytic proteins against multidrug-resistant bacterial infections, suggests phage therapy has the potential to be used as either an alternative or a supplement to antibiotic treatments. Antibacterial therapies, whether phage-or antibiotic-based, each have relative advantages and disadvantages; accordingly, many considerations must be taken into account when designing novel therapeutic approaches for preventing and treating bacterial infection. Although much about phages and human health is still being discovered, the time to take phage therapy serious again seems to be rapidly approaching.展开更多
Photodynamic inactivation of microorganisms known as antibacterial photodynamic therapy(APDT)is one of the most promising and innovative approaches for the destruction of pathogenic microorganisms.Among the photosensi...Photodynamic inactivation of microorganisms known as antibacterial photodynamic therapy(APDT)is one of the most promising and innovative approaches for the destruction of pathogenic microorganisms.Among the photosensitizers(PSs),compounds based on cationic porphyrins/metalloporphyrins are most successfully used to inactivate microorganisms.Series of meso-substituted cationic pyridylporphyrins and metalloporphyrins with various peripheral groups in the third and fourth positions of the pyrrole ring have been synthesized in Armenia.The aim of this work was to determine and test the most e®ective cationic porphyrins and metalloporphyrins with high photoactivity against Gram negative and Gram positive microorganisms.It was shown that the synthesized cationic pyridylporphyrins/metalloporphyrins exhibit a high degree of phototoxicity towards both types of bacteria,including the methicillinresistant S.aureus strain.Zinc complexes of porphyrins are more phototoxic than metal-free porphyrin analogs.The e®ectiveness of these Zn–metalloporphyrins on bacteria is consistent with the level of singlet oxygen generation.It was found that the high antibacterial activity of the studied cationic porphyrins/metalloporphyrins depends on four factors:the presence in the porphyrin macrocycle of a positive charge(+4),a central metal atom(Zn2þÞand hydrophobic peripheral functional groups as well as high values of quantum yields of singlet oxygen.The results indicate that meso-substituted cationic pyridylporphyrins/metalloporphyrins cannd wider application in photoinactivation of bacteria than anionic or neutral PSs usually used in APDT.展开更多
In the first article of this series, we presented some evidence of hyperforin as an antibiotic, antiprotozoal, antiviral, anticancer, and immunomodulatory substance. In the present article, evidence of the permeabilit...In the first article of this series, we presented some evidence of hyperforin as an antibiotic, antiprotozoal, antiviral, anticancer, and immunomodulatory substance. In the present article, evidence of the permeability of the blood-testis barrier (BTB) and blood-brain barrier (BBB) to hyperforin and its distribution in other organs of the domestic pig (Sus scrofa domesticus) are revealed. Seven-month-old male boars with a body mass of 100 kg were fed a diet containing hyperforin. Organs were surgically removed under anesthesia. Organs were suitable prepared and extracted, and then analyzed using gas chromatography-mass spectrometry with supersonic molecular beams (GC-MS with SMB). The presence of hyperforin was recorded in all organs and body fluids. Special attention was paid to the evaluation of the presence of hyperforin in the brain and testes of experimental animals. The presence of hyperforin in the brain and testes of experimental animals was established by GC-MS with SMB. The results are of interest because penicillin and numerous other antibiotics cannot pass through the BTB or BBB if healthy or non-inflamed, which limits their use in patients with meningitis and gonorrhea. The findings are also of interest in cases of penicillin- and multi-antibiotic-resistant bacterial infections.展开更多
文摘Methicillin-resistant Staphylococcus aureus (MRSA) is among the most alarming pathogens affecting both humans and the global bovine industry. The current control measures in hospitals and on farms for MRSA have proven to be inadequate leaving a need for new rapid control methods to curb MRSA infections in situ. New control measures for bacterial infection are widely sought, with particular interest in the applications for bacteriophages (phages) as a biocontrol or therapeutic agent. The current study uses a wild highly lytic phage isolated from cow’s milk taken from three farms in Baghdad, Iraq. The resulting phage was able to rescue 100% of the mice from a median lethal dose (LD50) or (1 × 108 CFU mL-1 per mouse) for MRSA wild isolates achieved when the phage: bacteria ratio was 100:1. Even when treatment was delayed for 6 h post lethal infection, to the point where all mice were moribund, 80% of them were rescued by a single injection of this phage preparation. Based on the current results, a comprehensive study is needed to guide further research on the MRSA phage as a biocontrol for MRSA mastitis in dairy cows to replace or reduce the use of antibiotics in animal husbandry.
基金supported by a research fellowship from the Faculty of Medicine, Westflische Wilhelms-Universitt Münster
文摘We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denudations and enterotoxigenic methicillin-resistant Staphylococcus aureus (MRSA) was detected in mucosal biopsies. After treatment with linezolide and steroids, a significant amelioration of colitis was detected and testing for MRSA became negative. In face of the case presented here, we suggest that in patients with refractory inflammatory bowel disease (IBD), microbiological assessment should be performed to detect a possible Staphylococcus aureus infection in order to initiate an antimicrobial treatment in addition to IBDspecific treatment.
文摘Re-screening following methicillin-resistant Staphylococcus aureus(MRSA) decolonization will be helpful to minimize the development of prosthetic joint infection among MRSA colonizers.
文摘Purpose: To capture the sensitivity and resistance trends of ophthalmic Methicillin-resistant Staphylococcus aureus (MRSA) in a heterogenous demographic. Methods: Between 1/1/2004-12/31/2011, ophthalmic MRSA infections were searched in the electronic medical record system ofCommunityRegionalMedicalCenterinFresno,California. We reviewed whether the infection was community-acquired or hospital-acquired, culture site, and sensitivity/resistance profiles. Results: The ophthalmic MRSA isolates tested for vancomycin, sulfamethoxazole-trimethoprim, and gentamycin were 100% sensitive to these to these antibiotics. Tetracycline and rifampin had the next highest sensitivity to resistance ratio, followed by clindamycin. More cases were community-acquired than hospital acquired. Almost half of the hospital-acquired cases were in newborns. Most hospital acquired infections were post-ophthalmic surgery. Conclusion: There is an increasing trend of community- acquired ophthalmic MRSA infection with eyelid involvement being the most common manifestation. Hospital-acquired cases are common in newborns and post-ophthalmic surgery. Have a high index of suspicion for MRSA infection with suspected “insect bites”. Vancomycin, sulfamethoxazole-trimethoprim, gentamycin, tetracycline, and rifampin are good choices to treat ophthalmic MRSA infection. There may be emerging resistance to clindamycin, at least in theCentral Californiaregion. If MRSA infection is suspected, erythromycin and fluoroquinolones should be avoided.
文摘Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.
文摘Background: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most problematic human pathogens. Antibiotic treatment of MRSA often associated with resistance to multiple classes of antibiotics is extremely challenging and urgently demands action to treat MRSA. Glutathione (GSH) is a biogenic thiol-compound that maintains an optimal intracellular redox-potential required for various normal cellular processes. Antibacterial activity of exogenous GSH has been reported in some bacterial pathogens but is largely unknown in MRSA. Aim: This study aimed to understand antibacterial activity of GSH, its role in antibiotic susceptibility, and a potential antibacterial mechanism in clinical isolates of S. aureus. Materials and Methods: Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), checkerboard, time-killing, and bacterial killing assays were performed for 14 clinical isolates of S. aureus including 10 MRSA and two type strains (ATCC 700699 and 35556). Results: MIC and MBC levels for the clinical and type strains were 15 - 20 mM and 25 - 40 mM of GSH, respectively. Subinhibitory concentrations of GSH synergistically enhanced susceptibility of all tested-antibiotics, resulting in sensitizing all-tested S. aureus. Bacterial-killing produced by GSH-mediated acidity was significantly higher than that by hydrochloric acid-mediated acidity. Conclusion: Overall results concluded that GSH exhibited antibacterial activity on S. aureus regardless of antibiotic susceptibility and synergistically enhanced antibiotic susceptibility. Additionally, GSH-mediated acidity was one of the antibacterial mechanisms. These findings suggest that GSH may be a potential antimicrobial agent or adjuvant for the conventional anti-MRSA regimens.
文摘Background: β lactamase is a plasmid-encoded enzyme that hydrolyzes β lactam ring of β lactam antibiotics rendering them ineffective. These enzymes, produced by Staphylococcus aureus along with many other organisms, have hindered the use of many useful and once life-saving β lactam antibiotics from clinical practice. Methods: This study was aimed to compare three test methods-chromogenic, acidimetric and iodometric-for the detection of β lactamase enzyme produced by 404 nosocomial induced S. aureus isolated from two Nepali hospitals, Kathmandu based hospital (KBH) and Lalitpur based Hospital (LBH). The study was carried out following standard methodology during November 2007 to June 2009 in the Department of Microbiology, Institute of Medicine, Kathmandu, Nepal. Sensitivity, specificity, efficiency, positive predictive value, and negative predictive values of the tests were calculated taking penicillin resistance and sensitivity as the standard. Results: Chromogenic method was found to be the most sensitive (98.93%) and efficient (98.51%) test and had a high positive predictive value (99.46%). Sensitivity (98.4%) and efficiency (98.27%) of iodometric method was found to be comparable to chromogenic test;its specificity (96.55 %) and positive predictive value (99.73%) were the highest among the 3 tests. Acidimetric test was the least sensitive (97.33%) and efficient (96.78%). Of note, the sensitivity and specificity of these test methods have been compromised due to the negativity of few penicillin resistant isolates and positivity of some penicillin sensitive isolates, respectively. Conclusion: Chromogenic method was found comparatively to be the best test method for the detection of β lactamase production. However, in contrast to the other two test methods whose reagents can be locally and economically prepared, chromogenic test’s use has been impeded by its cost and unavailability in the local Nepali market.
文摘Epidemiological surveillance for microbes is currently based on either agar culture followed by identification, or genetic amplification. Both techniques are highly skilled-labor intensive, costly, and must be done in central laboratories. The Defined Substrate Utilization®(DSU®) format provides an epidemiological series of specific screening formulations that obviate these limitations. All reagents are present in optimized stable powder form in a test tube—add water, inoculate, and incubate. A specific color change provides a sensitive and specific detection of the target microbe. Two DSU®methods for Staphylococcus aureus (S. aureus) are presented: aureusAlert®for all S. aureus and EPI-M®for methicillin-resistant S. aureus (MRSA). Both aureusAlert®and EPI-M®had a detection level of 20 colony forming units (CFU) in 18 hours. aureusAlert®and conventional methods agreed 93.6% and EPI-M®and conventional methods agreed 94.1%. DSU®and conventional methods showed the same specificity.
文摘Staphylococcus aureus typing using gene encoding protein A (spa typing) seems to have a high potential discriminatory power for typing this bacterium. This study was designed based on spa typing method to compare the S. aureus types among healthy carrier vs patients, and MRSA vs MSSA isolates. Method: This study was carried out on 182 spa typeable S. aureus isolates, including 52 MRSA. DNA was extracted by phenol chloroform-isoamyl alcohol method and it was amplified by specific primer of polymorphic X region of spa. Spa types were determined by Ridom Staph Type software. The spa types distribution among MRSA vs MSSA and healthy carrier vs patients, isolates were statistically compared by X2 method and P < 0.05 was considered as significant. Result: The most common types of spa in our region were t037 (18.3%) and t937 (13.9%) from 50 spa types which were identified in this study. spa types in this study were isolated from various age groups but t660 spa types were only isolated from children. Distribution of all spa types among MRSA and MSSA isolates was 16 and 38 types, respectively which is significant. In this study we found seven new spa types (belong to twelve isolates) which are reported for the first time. In 5 out of the above 7 new types the 24 bp repeated sequences in spa gene X region were already recognized but their 24 bp arrangement is introduced in our present investigation. In the remaining 2 new types we found new 24 bp nucleotide sequences which are also introduced for the first time in our present study. Conclusion: The distribution of spa types in MSSA strains was significantly higher than MRSA isolates, but there are not any specific spa types for discrimination between MRSA and MSSA. The novelty of our study is the introducing 7 new spa types including 2 new 24 bp repeated sequences in the X region of spa gene.
基金the National Key R&D Program of China (No. 2017YFC1309701 and No. 2017YFC1309700)National Natural Science Foundation of China (No. 81570029)Shanghai Key Discipline for Respiratory Diseases (No. 2017ZZ02014).
文摘Background: Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an important issue with significant morbidity and mortality in clinical practice, especially in diabetes mellitus (DM). Studies focusing on S. aureus pneumonia in DM is limited, we sought to make a relatively comprehensive exploration of clinical characteristics, antimicrobial resistance, and risk factors for mortality of S. aureus pneumonia in DM and non-diabetics mellitus (non-DM). Methods: A retrospective study was conducted in Ruijin Hospital from 2014 to 2017. The characteristics of DM and non-DM patients were assessed, including demographics, comorbidities, using of invasive mechanical ventilation, Hemoglobin A1c (HbA1C), confusion, urea, respiratory rate, blood pressure, age ≥65 years (CURB-65) score, length of hospital stay, clinical outcomes, antimicrobial susceptibility. Independent risk factors for mortality were identified by univariate and multivariate logistic regression analysis. Results: A total of 365 patients with S. aureus pneumonia were included in our study, including 144 with DM and 221 non-DM. DM patients were more susceptible to MRSA infection (65.3% vs. 56.1%, P > 0.05), suffered from much severer pneumonia with a higher CURB-65 score, invasive mechanical ventilation rate (46.5% vs. 28.1%, P < 0.01) and mortality rates (30.6% vs. 23.1%, P > 0.05);almost all DM patients had higher antimicrobial resistance than non-DM patients, the DM group had a higher coinfection rate (47.2% vs. 45.7%, P > 0.05), and Acinetobacter baumannii was the most common bacterium in DM, while Klebsiella pneumoniae ranked first in patients with non-DM. Independent risk factors for pneumonia-related mortality were MRSA and CURB-65. Higher HbA1c levels were linked to a higher MRSA infection and co-infection rate and more severe pneumonia, leading to an increase in mortality. Conclusions: DM patients with poor glucose control are more susceptible to MRSA infection. They suffer from higher antimicrobial resistance, a higher co-infection rate, and much severer pneumonia than non-DM. MRSA itself is an independent risk factor for mortality in all patients.
文摘To the Editor: The incidence of community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection and reports of CA-MRSA infection have been increasing yearly. But community-acquired intraspinal methicillin-resistant Staphylococcus aureus (MRSA) infection has never been reported. We describe a case of intraspinal abscess due to CA-MRSA infection.
基金This study was funded by National Natural Science Foundation of China(81571948)the Beijing Natural Science Foundation(7172075).
文摘Importance:Regional clonal replacements of methicillin-resistant Staphylococcus aureus (MRSA) are common.It is necessary to understand the clonal and drug resistance changes in specific areas.Objective:To evaluate the clonal and drug resistance dynamics of MRSA in Chinese children from 2010 to 2017.Methods:MRSA was isolated from patients in Beijing Children's Hospital from 2010 to 2013 and from 2016 to 2017.The molecular characteristics and antibiotic resistance were determined,Results:In total,211 MRSA isolates were collected,and 104 isolates were classified as community-associated MRSA (CA-MRSA).ST59-SCCmec Ⅳ was the most prevalent type in both CA-MRSA (65.4%) and healthcare-associated-MRSA (HA-MRSA) (46.7%).ST239-SCCmec Ⅲ accounted for 21.5% of all HA-MRSA,which were not detected in 2016,and only three isolates were detected in 2017.The pvl gene carrying rate of CA-MRSA was significantly higher than that of HA-MRSA (42.3% vs.29.0%,P =0.0456).Among CA-MRSA,resistance rate to all tested antibiotics excluding chloramphenicol remained stable over the periods of 2010-2013 and 2016-2017.HA-MRSA displayed an overall trend of decreased resistance to oxacillin,gentamicin,tetracycline,ciprofloxacin,and rifampin,and increased resistance to chloramphenicol,consistent with the difference of antibiotic resistance patterns between ST59-SCCmec Ⅳ and ST239-SCCmec Ⅲ isolates.Vancomycin minimal inhibitory concentration (MIC) creep was found in the study period in all MRSA and ST59-SCCmec Ⅳ isolates.Interpretation:ST59-SCCmec Ⅳ has spread to hospitals and replaced the traditional ST239-SCCmec Ⅲ clone,accompanied by changes in drug resistance.Furthermore,vancomycin MIC creep indicated that the rational use of antibiotics should be seriously considered.
基金supported in part by Grants from Kakenhis 21310146(to H.T.)23790020(to N.K.)from the Ministry of Education,Culture,Sports,Science,and Technology of Japan+1 种基金the Uehara Memorial Foundation(to H.T.)a Kitasato University Research Grant for Young Researchers(to N.K.).
文摘From a further purification study,two new congeners designated cyslabdans B(1)and C(2)were isolated along with previously reported cyslabdan(cyslabdan A(3)in this study)from the culture broth of Streptomyces sp.K04-0144.The structure was elucidated by various spectroscopy including NMR,revealing that 1 and 2 was 18-hydroxy and 10-methoxy cyslabdan,respectively.Compounds 1 and 2 were found to potentiate imipenem activity against methicillinresistant Staphylococcus aureus by 123 fold and 533 fold,respectively.Comparison with the activity of compound 3 indicated that the introduction of a hydrophilic group at the dimethyl moiety of the decalin ring was unfavorable for its activity.
基金supported by the National Natural Science Foundation of China(61671435,81630053)Beijing Natural Science Foundation(4161003)CAS-DOE Program
文摘Silica nanorattles(SNs) with zinc oxide(ZnO) combination nanoparticles are reported to inhibit methicillin-resistant Staphylococcus aureus(MRSA) for the first time. SNs loaded with ZnO nanoparticles,which can produce free radicals, can cause severe damage to bacteria. ZnO nanoparticles not only provide free radicals in the combined nanostructures, which can inhibit the growth of bacteria, but also form nanorough surfaces with an irregular distribution of spikes on the SNs, which can enhance their adhesion to bacteria. Nanorough silica shell surfaces maintain the high activity and stability of small-sized ZnO nanoparticles and gather ZnO nanoparticles together to enhance production, which improves the efficiency of free radicals against the cytomembranes of bacterial cells. The enhanced adhesion of ZnO@SN nanoparticles to MRSA cells shortens the effective touching distance between free radicals and MRSA, which also improves antibacterial activity. As we expected, the ZnO@SN nanoparticles exhibit a better antibacterial effect than free ZnO nanoparticles against MRSA in vitro and in vivo. We also demonstrate that SNs loaded with ZnO nanoparticles can accelerate wound healing in MRSA skin inflammation models. This method of multilevel functionalization will be potentially applicable to the antibacterial field.
文摘Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be changing.The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Study design:Retrospective review of an institutional microbiologic database.Methods:A retrospective analysis was performedon serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April 2016.The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration(MIC)testing.Medical records were reviewed to document patient characteristics,chronicity of infection,symptomatology,and previous treatments.Results:Over the study period,173 patients were diagnosed with AOE and underwent otologic cultures of the ear.Fifty-three(30.6%)of cultures grew S.aureus(SA).Of SA infections,15(28.3%)were identified as MRSA.MRSA patients were typically older than patients with methicillin-sensitive SA(MSSA)(mean age 46.717.9 vs 2919.4,PZ0.003)and had more medical comorbidities(4 vs 1.7,PZ0.001).Compared to patients with MSSA,patients with MRSAwere significantly more likely to have had prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature.Clinicians should consider ear cultures to identify MRSA AOE.Level of Evidence:IV.
基金Supported by Winkler Bacterial Overgrowth Research Fund(in part)
文摘The practice of phage therapy, which uses bacterial viruses(phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed interest in revisiting this practice. Conventionally, phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Biotechnological advances have further expanded the repertoire of potential phage therapeutics to include novel strategies using bioengineered phages and purified phage lytic proteins. Current research on the use of phages and their lytic proteins against multidrug-resistant bacterial infections, suggests phage therapy has the potential to be used as either an alternative or a supplement to antibiotic treatments. Antibacterial therapies, whether phage-or antibiotic-based, each have relative advantages and disadvantages; accordingly, many considerations must be taken into account when designing novel therapeutic approaches for preventing and treating bacterial infection. Although much about phages and human health is still being discovered, the time to take phage therapy serious again seems to be rapidly approaching.
基金the Decree of the Government of the Russian Federation No.220 of April 9,2010(Agreement No.075-15-2021-615 of June 4,2021).
文摘Photodynamic inactivation of microorganisms known as antibacterial photodynamic therapy(APDT)is one of the most promising and innovative approaches for the destruction of pathogenic microorganisms.Among the photosensitizers(PSs),compounds based on cationic porphyrins/metalloporphyrins are most successfully used to inactivate microorganisms.Series of meso-substituted cationic pyridylporphyrins and metalloporphyrins with various peripheral groups in the third and fourth positions of the pyrrole ring have been synthesized in Armenia.The aim of this work was to determine and test the most e®ective cationic porphyrins and metalloporphyrins with high photoactivity against Gram negative and Gram positive microorganisms.It was shown that the synthesized cationic pyridylporphyrins/metalloporphyrins exhibit a high degree of phototoxicity towards both types of bacteria,including the methicillinresistant S.aureus strain.Zinc complexes of porphyrins are more phototoxic than metal-free porphyrin analogs.The e®ectiveness of these Zn–metalloporphyrins on bacteria is consistent with the level of singlet oxygen generation.It was found that the high antibacterial activity of the studied cationic porphyrins/metalloporphyrins depends on four factors:the presence in the porphyrin macrocycle of a positive charge(+4),a central metal atom(Zn2þÞand hydrophobic peripheral functional groups as well as high values of quantum yields of singlet oxygen.The results indicate that meso-substituted cationic pyridylporphyrins/metalloporphyrins cannd wider application in photoinactivation of bacteria than anionic or neutral PSs usually used in APDT.
文摘In the first article of this series, we presented some evidence of hyperforin as an antibiotic, antiprotozoal, antiviral, anticancer, and immunomodulatory substance. In the present article, evidence of the permeability of the blood-testis barrier (BTB) and blood-brain barrier (BBB) to hyperforin and its distribution in other organs of the domestic pig (Sus scrofa domesticus) are revealed. Seven-month-old male boars with a body mass of 100 kg were fed a diet containing hyperforin. Organs were surgically removed under anesthesia. Organs were suitable prepared and extracted, and then analyzed using gas chromatography-mass spectrometry with supersonic molecular beams (GC-MS with SMB). The presence of hyperforin was recorded in all organs and body fluids. Special attention was paid to the evaluation of the presence of hyperforin in the brain and testes of experimental animals. The presence of hyperforin in the brain and testes of experimental animals was established by GC-MS with SMB. The results are of interest because penicillin and numerous other antibiotics cannot pass through the BTB or BBB if healthy or non-inflamed, which limits their use in patients with meningitis and gonorrhea. The findings are also of interest in cases of penicillin- and multi-antibiotic-resistant bacterial infections.