The potential of the antiplatelet agent ticagrelor as a new antibacterial agent

The number of deaths caused by drug-resistant bacteria is expected to increase in the future, and there is a need to develop new antimicrobial agents. Recently, the antiplatelet drug ticagrelor has been reported to have promising antibacterial properties. The purpose of this review is to analyze articles and case reports that describe the antimicrobial action of ticagrelor. Ticagrelor was found to have antibacterial reactions against Gram-positive bacteria, including drug-resistant and spore-forming bacteria, while no effect was observed against Gram-negative bacteria. In this paper we discuss a new potential antimicrobial agent, ticagrelor.

Detection of Antibiotic Resistance and Biofilm-Producing Ability of Staphylococcus Species in Clinical Isolates

Background: Staphylococci are responsible for life-threatening infections in hospitals and community. Their ability to produce multiple virulence factors and antibiotic resistance is an important reason of high mortality in staphylococcal infections. Biofilm production by these organisms makes it difficult to treat. Most of the treating antibiotics are failing and making it a matter of concern. Aims?This study aims to detect the increased antibiotic resistance in biofilm-producing Staphylococcus and to compare the performance of three potential methods of detection. Methods?A total of 81 isolates of staphylococci including coagulase negative staphylococci (CoNs), methicillin resistant S. aureus (MRSA), and methicillin sensitive S. aureus (MSSA) are included in this study. After the identification, an antibiotic sensitivity test was performed. Biofilm detection was done by three different methods: Congo red agar method, tube adherence method, and microtiter plate method. Result?Out of the 81 samples, 37 CoNs, 17 MRSA, and 27 MSSA were identified. Out of them we got 43 (53%) biofilm producers by Congo red agar method, 40 (49%) by tube adherence method, and 52 (64%) producers by tissue culture plate/microtiter plate method. Most of the biofilm producers showed multiple drug resistance. Conclusion?We found out that the microtiter plate method is sensitive and reliable as compared with the other two methods. Antibiotic resistance was found to be very common in biofilm producers. This was due to the resistance developed as a result of the matrix that does not let the antibiotic bind with the organisms. This can make the treatment of Staphylococcus very difficult in the future as the rate of drug resistance is faster as compared with newly emerging antibiotics.

Identification and antibiotic susceptibility pattern of Staphylococcus aureus with special reference to methicillin resistant Staphylococcus aureus in tertiary care hospital

Background: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. It is responsible for a wide range of infections including superficial skin infections, food poisoning, osteomyelitis and septicemia. Aim of this study was to identify and to determine antibiotic susceptibility pattern of Staphylococcus aureus from various clinical samples. Materials and methods: Different clinical specimens were collected and processed for routine culture and antibiotic sensitivity test by standard microbiology techniques. Results: A total of 129 S. aureus strains were isolated from various clinical specimens out of which 84 (65.12%) were Methicillin Resistance Staphylococcus aureus (MRSA). 66(51.16%) S. aureus were obtained from indoor (IPD) patients. S. aureus was found higher in male than female. S. aureus was found highly resistant to Benzylpenicillin (94.57%) followed by ciprofloxacin (77.51%), Erythromycin (61.24%), and Cotrimoxazole (51.94%), Clindamycin (44.19%), and Gentamicin (17.05%). 1 (0.78%) of the isolates were resistance to Vancomycin and Linezolid. For urine isolates Nitrofurantoin was drug of choice. Conclusion: Methicillin resistant Staphylococcus aureus was found 65.12% of Staphylococcus aureus isolates. It was most common in males and hospitalized patients. Teicoplanin or Tigecyline seems to be drug of choice followed by Vancomycin, Linezolid, Tetracycline and Gentamicin. It would be helpful to formulating and monitoring the antibiotic policy and ensure proper empiric treatment.

Microbiological profile of bloodstream infections and antimicrobial resistance patterns at a tertiary referral hospital in Amazon, Brazil

ABSTRACT Background: Bloodstream infections (BSI) are a global health issue, leading to high mortality and morbidity among hospitalized patients. Methods: A retrospective, observational and descriptive study was conducted by reviewing blood culture records collected from patients with suspected BSI, between January 2017 and December 2019. Results: The most frequent antimicrobial resistant (AMR) pathogens were methicillin-resistantStaphylococcus aureus(MRSA) (40%), methicillin-resistantS. epidermidis (MRSE) (9.5%), and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (35.3%). Conclusions: Our findings underscore the importance of continued vigilance and advocate for the rational use of antimicrobial agents.

Antimicrobial and toxicological evaluation of Origanum vulgare: an in vivo study / Avaliação antimicrobiana e toxicológica de Origanum vulgare: um estudo in vivo

Abstract Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin alongwith marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.

Resumo Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.

Antibacterial and Wound Healing Activity of 2% Formulation of 2-Medpy-3-CN on Infected Burn Wounded Animal Model

@#Introduction: Humans have learned to recognize and process plants into medicinal forms through centuries. Burns can spread to other tissues, especially when infected with bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSA). The study aimed to assess the in vivo antibacterial and wound healing activity of 2% formulation of 2-Medpy-3-CN on infected burn wounded animal model. Methods: In vitro antibacterial activity of the Alsti was done by broth dilution and disc diffusion methods. Alsti 2% ointment was prepared for the infected burn wound treatment. A total of 18 rats are grouped into A, B, C, and D, the first three groups (A-C) were injured thermally, and Group D was used as healthy controls. The three test Groups were exposed to MRSA ATCC 43300 at 105 CFU/mL. Group A was treated with 2% Alsti, Group B with Silver sulfadiazine 1% (SSD), and Group C was untreated. Wounds healing was assessed by the healed area and microscopic identification of hematoxylin and eosin (H&E)-stained skin tissue. Results: Wound healing progresses with application of Alsti 2% ointment as observed through wound diameter and histopathological changes of the skin. Wound diameter decreases with treatments, while the contrary was observed in the non-treated group. Microscopic observation of the stained skin showed that epidermal development, and collagen formation progress with treatment days. Untreated wounds showed marked inflammation, progressive ulceration, and necrosis. Conclusion: Alsti 2% formulation showed antibacterial and wound healing activities, hence, can be used as alternative in burn wound infections.

Antimicrobial and toxicological evaluation of Origanum vulgare: an in vivo study / Avaliação antimicrobiana e toxicológica de Origanum vulgare: um estudo in vivo

Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin along with marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.

Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.

Antimicrobial and toxicological evaluation of Origanum vulgare: an in vivo study

Abstract Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin alongwith marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.

Resumo Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.

Prevalence and Susceptibility of Staphylococcus aureus Nasal Carriage Strains Isolated from Haemodialysis Patients

@#Introduction: Staphylococcus aureus is part of the normal human flora that can commonly be found on the skin and mucous membranes of the nasal area. However, in immunosuppressed patients such as those with kidney failures, colonization can potentially lead to infection. There is a concern of increasing antibiotic resistance in S. aureus. This study aimed to determine the prevalence of S. aureus nasal colonization and its antimicrobial susceptibility among haemodialysis-dependent populations. Methods: A cross-sectional study at the Nephrology Unit, Hospital Canselori Tuanku Mukhriz (HCTM) was conducted among haemodialysis-dependent patients between February 2017 to February 2018. Nasal swabs were obtained and cultured on mannitol salt agar. S. aureus isolates were identified by gram staining, tube coagulase and Deoxyribonuclease (DNase). Cefoxitin disc (30 µg) were used to identified the presence of MRSA (methicillin-resistance S. aureus). The S. aureus colonies were further tested against six antibiotics using Kirby Bauer disc diffusion. Result: A total of 134 patients were recruited. S. aureus isolates were detected from 27 patients (20.1%). All S. aureus were phenotypically identified as methicillin-sensitive S. aureus (MSSA) based on the cefoxitin disc. Teicoplanin and linezolid were the most effective with 100% susceptibility. S. aureus exhibited a high resistance rate towards erythromycin (29.6%). No MRSA was isolated in this study. Conclusion: This study highlighted the high prevalence of S. aureus nasal colonization in haemodialysis patients. Teicoplanin and linezolid were found to be the most effective antibiotics against isolated S. aureus.

Systemic infection caused by the methicillin-resistant Staphylococcus aureus USA300-LV lineage in a Brazilian child previously colonized

ABSTRACT The methicillin-resistant Staphylococcus aureus (MRSA) USA300-Latin American variant (USA300-LV) lineage is well documented in northern Latin American countries. It has replaced established clones in hospital environments. We herein report a systemic infection caused by a USA300-LV isolate in a 15-year-old boy, from a low-income area of Rio de Janeiro, previously colonized by the same strain. During hospital stay, seven pvl-positive MRSA USA300-LV isolates were recovered by nasal swab, blood and abscess secretion. The patient underwent intravenous vancomycin, daptomycin, and oral sulfamethoxazole/trimethoprim, and was discharged after 45 days after full recovery. This is the first documented case of a community-acquired MRSA infection caused by the USA300-LV variant in Brazil in a previously colonized adolescent with no history of recent travel outside of Rio de Janeiro. The need for improved surveillance programs to detect MRSA colonization in order to control the spread of hypervirulent lineages among community and hospital settings is highlighted.

Phenotypic and genotypic characterization of oxacillin-susceptible and mecA positive Staphylococcus aureus strains isolated in Uruguay / Caracterización fenotípica y genotípica de cepas de Staphylococcus aureus sensibles a oxacilina y mecA positivas aisladas en Uruguay

Abstract The aim of this study was to characterize phenotypically and genotypically 27 mecApositive Staphylococcus aureus strains with oxacillin MICs of ≤2 g/ml by Vitek 2, isolated indifferent regions of Uruguay. Susceptibility to oxacillin and cefoxitin was studied by gradient dif-fusion, disk diffusion to cefoxitin, and Phoenix and MicroScan systems. PBP2a was determined.SCCmec typing was performed and the isolates were compared by PFGE. Twenty-six isolateswere susceptible to oxacillin; one strain was susceptible to cefoxitin by disk diffusion and 3strains by gradient diffusion. Phoenix and MicroScan panels detected methicillin resistance in25 and 27 strains, respectively. Twenty-six strains tested positive for PBP2a. Twenty-six strainscarried SCCmec V and 24 belonged to pulsotype A. One strain carried SCCmec IV and did notbelong to pulsotype A. Cefoxitin disk diffusion test and PBP2a detection correctly identified 26of these 27 strains as MRSA. PFGE results suggest the dissemination of a cluster of MRSA carryingSCCmec V.

Resumen El objetivo de este estudio fue caracterizar fenotípicamente y genotípicamente 27 cepas de Staphylococcus aureus positivas para mecA y con CIM de oxacilina <2 pg/ml según Vitek 2, obtenidas en diferentes regiones del país. La sensibilidad frente a la oxacilina y la cefoxitina se estudió por difusión en gradiente, por disco-difusión (cefoxitina) y por los sistemas Phoenix y MicroScan. Se analizó la portación de PBP2a, se realizó la tipificación de SCCmec y las cepas se compararon mediante PFGE. Resultaron sensibles a oxacilina por difusión en gradiente 26 cepas; una fue sensible a cefoxitina por disco-difusión y 3 lo fueron por difusión en gradiente. Los sistemas Phoenix y MicroScan detectaron resistencia a meticilina en 25 y 27 cepas, respectivamente. Asimismo, 26 cepas portaban PBP2a y 26 cepas mostraron presencia de SCCmec V, 24 correspondieron al pulsotipo A. Una portaba SCCmec IV y no perteneció al pulsotipo A. La prueba de disco-difusión con cefoxitina y la detección de PBP2a identificaron 26 de 27 cepas como MRSA. La PFGE sugiere la diseminación de un grupo MRSA con SCCmec V. © 2022 Asociación Argentina de Microbiología. Publicado por Elsevier Espana, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Programa de Segurança do Paciente Focado nas Estratégias do Stewardship de Antimicrobianos para Staphylococcus Spp / Patient safety program focused on antimicrobial stewardship strategies for Staphylococcus spp

Introdução: A sedimentação do Programa de Stewardship de Antimicrobianos (ATMs), além de reduzir a indução da resistência bacteriana, assegura maior segurança aos pacientes. Este estudo teve por objetivo descrever o perfil de sensibilidade do Staphylococcus aureus e Staphylococcus coagulase negativo (S. CON) nas unidades de internação adulta do hospital para instrumentalizar as equipes e realizar o gerenciamento de ATMs. Métodos: Este estudo retrospectivo foi realizado através de busca em prontuário eletrônico de culturas laboratoriais com S. aureus e S. CON, independentemente do foco, dos anos de 2017, 2018 e 2019, das unidades de internação adultas não críticas e UTI adulto. Para análise, foi realizado o cálculo de coeficiente de sensibilidade absoluto e de médias. As variáveis qualitativas foram apresentadas em relação ao agente etiológico, antibiótico e local de isolamento, com posterior identificação de variabilidade e possibilidades terapêuticas disponíveis. Resultados: Apesar de ocorrer similaridade na distribuição das cepas de Staphylococcus spp. nos locais analisados do hospital, observou-se divergência entre os perfis de sensibilidade do S. aureus e S. CON. Existe superioridade no perfil de sensibilidade do S. aureus em comparação com o S. CON em relação a todos ATMs. A sensibilidade do S. aureus à oxacilina, ainda, possibilita tratamento com ß-lactâmicos; entretanto, a escolha de outras classes de ATMs torna-se necessária em casos de infecções complexas e graves. Conclusão: A análise periódica do perfil de sensibilidade aos ATMs é uma estratégia a ser alcançada para um eficaz programa de gerenciamento de ATMs, com fundamentação de protocolos e melhor assistência dos pacientes.

Introduction: The sedimentation of the antimicrobial stewardship program (ASP) reduces the induction of bacterial resistance and ensures greater patient safety. This study aimed to describe the sensitivity profile of Staphylococcus aureus and negative-coagulase Staphylococcus (CoNS) in adult inpatient units of the hospital to instrumentalize the teams and perform ASP management. Methods: This retrospective study was conducted by searching electronic medical records for laboratory cultures with S. aureus and CoNS, regardless of the focus, from 2017, 2018, and 2019, from the adult non-critical inpatient units and adult ICU. For the analysis, the study calculated the absolute sensitivity coefficient and means. Qualitative variables were related to the etiologic agent, antibiotic, and isolation site, with subsequent identification of variability and available therapeutic possibilities. Results: Although similarity occurred in the distribution of Staphylococcus spp. strains in the analyzed hospital sites, divergence was observed between the sensitivity profiles of S. aureus and CoNS. There is superiority in the sensitivity profile of S. aureus over CoNS concerning all ASP. The sensitivity of S. aureus to oxacillin still allows treatment with ß-lactams. However, the choice of other classes of ASP becomes necessary in cases of complex and severe infections. Conclusion: Periodic analysis of the ASP sensitivity profile is a strategy to achieve an effective ASP management program to support protocols and better patient care.

Prevalence and in vitro susceptibility pattern of MRSA,VRSA, VISA isolates from various clinical samples in tertiary care hospital

Background: Staphylococcus is notorious for its ability to become resistant to antibiotics. MRSA emerged as nosocomial pathogen in the early 1960. Methicillin Resistant Staphylococcus aureus are implicated in serious infections and nosocomial infection outbreaks, thus limiting the treating options to very few agents such as vancomycin and teicoplanin. Vancomycin has been regarded as the first line drug for the treatment for MRSA but its irrational use lead to emergence of vancomycin resistance. The Aim was to determine the prevalence and resistance of MRSA ,VRSA,VISA isolates from various clinical samples in a tertiary care hospital.Material & Methods:This present prospective study was done in the Microbiology department of Government Medical College. The study was conducted for a period of one and half year i.e from January 2019 to June 2020. All the samples (pus, urine, blood, body fluids, sputum etc) were processed as per standard protocols.Results:Out of 26,471 samples, 6578(24.85%) were found to be culture positive. 1583 isolates were identified as Staphylococcus aureus. Among them 1278(80.7%) were MRSA, 21(1.3%) were VISA and 8(0.5%) were VRSA. Maximum number of MRSA isolates were obtained from orthopaedics ward (22.7%) and Intensive Care Unit and most of them were isolated from pus(45%) followed by blood (19.09%)samples. Among them highest resistance were observed against azithromycin (85.6%), followed by ciprofloxacin (63.5%) and least resistance to rifampicin and doxycycline. Majority of the VISA and VRSA strains were isolated from ICU followed by orthopaedics, surgery. Most of them were isolated from pus followed by blood and urine specimen and most were found to be multidrug resistant while they retained their sensitivity to Linezolid and Teicoplanin.Conclusions:As there is high prevalence of MRSA isolates so the treatment options are limited to vancomycin. Overuse of vancomycin can lead to emergence of VRSA strains. So the need for rational use in the infection-control practices to prevent transmission of MRSA as well as VISA strains. Strict implementation of hand hygiene, decolonization of MRSA carriers,and education of healthcare team will be quite helpful.

Colonización nasal por Staphylococcus aureus y Staphylococcus aureusresistente a meticilina (SARM) en auxiliares de enfermería / Nasal carriage of Staphylococcus aureus and Methicillin-resistant Staphylococcusaureus (MRSA) among nursing assistants

Introducción: Staphylococcus aureus, es la principal causa de bacteriemia infecciosa y endocarditis, así como de infecciones osteoarti-culares, de piel y tejidos blandos, su reservorio principal es la mucosa nasal. Los trabajadores de la salud son una fuente importante de transmisión de S. aureus y S. aureus resistente a la meticilina (SARM). Objetivo: determinar la presencia de Staphylococcus aureus y SARM en la fosa nasal de auxiliares de enfermería en la ciudad de Bogotá. Materiales y métodos: estudio descriptivo de corte transversal, en auxiliares de enfermería de diferentes instituciones hospitalarias y clínicas en la ciudad de Bogotá, Colombia. Se realizó un muestreo aleatorio. El tamaño de la muestra fue de 491 hisopados de la fosa nasal derecha de igual número de auxiliares de enfermería que al momento del estudio se encontraban laborando a nivel clínico. Se tomó un intervalo de confianza del 95% y error máximo admisible del 5%, se consideró el valor de p= 0,5. Se realizó un estudio de frecuencias y determinación de prevalencias mediante un análisis univariado. Resultados: la presente investigación encontró queel 28,5% de los participantes fueron portadores del Staphylococcus aureus y el 6,1% fueron SARM. Conclusiones: la colonización por Staphylococcus aureus y SARM es frecuente en auxiliares de enfermería.

Introduction: Staphylococcus aureus is a human pathogen of clinical severe relevance, it is the leading cause of infectious bacteremia and endocarditis, as well as osteoarticular, skin, and soft tissue infections; its, main reservoir is the nasal mucosa. Healthcare workers are a significant source of transmission of S. aureus and methicillin-resistant S. aureus (MRSA). Objective: To determine the presence of Staphylococcus aureus and MRSA in the nostrils of nursing assistants in Bogotá's city. Materials and methods: a descriptive cross-sec-tional study in nursing assistants from different hospitals and clinical institutions in Bogotá's city, Colombia. Random sampling was carried out. The sample size was 491 swabs from the right nostril from the same number of nursing assistants working at the clinical level at the time of the study. A confidence interval of 95% and maximum permissible error of 5% were taken, the value of p = 0.5 was considered. A study of frequencies and determination of prevalence was carried out through univariate analysis. Results: the present investigation found that 28.5% of the participants were carriers of Staphylococcus aureus, and 6.1% were methicillin-resistant S. aureus(MRSA). Conclusions: colonization by Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) is common in nursing assistants.

Methicillin resistant Staphylococcus aureus-importance of appropriate empirical therapy in serious infections

India has been titled the capital of antimicrobial resistance in the world with the centre for disease dynamics, economics andpolicy (CDDEP) predicting two million deaths in India by 2050. As per the World Health Organisation抯 global priority pathogen list of 2017, methicillin resistant Staphylococcus aureus(MRSA)has been classified as a 慼igh priority� pathogen due to its association with increased mortality rate, rising prevalence of resistance and increased burden on healthcare settings. A recent report by Indian Council of Medical Research signifies the exponential rise in the prevalence of MRSA in India, from 29% in 2009 to 39% in 2018. Serious MRSA infections are commonly associated with poor clinical outcomes coupled with increased hospitalisation stay and cost. Therefore, early identification and appropriate empiric treatment of MRSA plays a crucial role in healthcare settings. However, the constant rise in multi-drug resistance to the currently available anti-MRSA agents as well as their compromised safety profile limits its clinical use to manage severe MRSA infections. This review article explores the implications of severe MRSA infections and inappropriate empirical therapy on the clinical as well as economic outcomes. In addition, it also highlights limitations of the currently available anti-MRSA agentsand the need for newer agents to manage multi drug resistant (MDR)gram positive infections.

Phenotypic Characterisation of Staphylococcus aureus Isolated from Patients in Healthcare Institutions in Zaria Metropolis, Kaduna State, Nigeria

BACKGROUND: Staphylococcus aureus is a cosmopolitan and pathogenic microorganism associated with various diseases spectra and antimicrobial resistance of public health importance.Aim: This study determined the phenotypic characteristics of S. aureus isolated from patients in healthcare institutions in Zaria metropolis.STUDY DESIGN: A cross-sectional hospital-based study was carried out in 5 healthcare institutions. Four hundred and twenty clinical samples were collected and analyzed. RESULTS: Majority of the patients (54.3%) were within the age range 21­40 years and mean age of 26.04 ± 12 years. Approximately, 70% of the respondents had history of antibiotic use prior to consultation in the hospitals and wereselfprescribed, and 91.2% were outpatients. The most commonly abused antibiotics were ampicillin-cloxacillin (19.5%) and cotrimoxazole (10.0%), and the mean duration of their use was 3.5 ± 1.3 days. The detection rate for S. aureus was 10% and 5.2% for MRSA. The S. aureus isolates showed the highest frequency of resistance against ampicillin 42 (100%), followed by penicillin G 39 (92.9%) and least was to gentamicin 5 (11.9%). The frequency of resistance for the MRSA were ampicillin 22 (100%), penicillin G 21(95.5%) and least was to gentamicin 2 (9.1%). The minimum inhibitory concentrations of oxacillin were greater than 128 µg /ml. CONCLUSION: The detection rate of S. aureus and MRSA strains are of great public health concern which requires continuous health education on rational use of antibiotics among others

The pharmaceutical care by clinical pharmacists for a foot injury patient with postoperative MRSA infection / 药学实践杂志

Objective To explore the clinical pharmacist’s role in drug therapy and monitoring for the patient with postoperative MRSA infection. Methods Clinical pharmacists participated in planning anti-infective treatment, antimicrobial medication selection, identification of high-risk factors for MRSA infection, evaluation of vancomycin efficacy, dosage adjustment using TDM technology, monitoring and management of vancomycin adverse reactions. Results With the pharmaceutical care provided by clinical pharmacists, the patient received effective treatment with minimal vancomycin-related adverse reactions. Conclusion Clinical pharmacists played an important role in accelerating patient recovery by rational and safe medication use.

Biological analysis of an innovative biodegradable antibiotic eluting bioactive glass/gypsum composite bone cement for treating experimental chronic MRSA osteomyelitis / 药物分析学报

A multi-barrier antibiotics loaded biodegradable composite bone cement for resolving chronic osteo-myelitis has been studied to understand the physico-mechanical properties,drug loading/eluting effi-ciency,and different merits and demerits prior to clinical application.After successful induction of bone infection in 28 rabbits using methicillin-resistant Staphylococcus aureus(MRSA)strains,calcium sulfate/bioactive glass based composite cement was implanted in 12 defects to assess its performance over parenteral therapy with microscopic and radiological examination for 90 days.The composite cement revealed acceptable physico-mechanical properties and controlled drug elution kinetics.Furthermore,the antibiotics concentrations in bone up to 42 days were sufficient to kill MRSA without eliciting adverse drug reactions.The striking feature of platelets aggregation by composite cement could assist bone healing.The controlled degradation with simultaneous entrapment of composite cement within the osteoid tissues and complete repair of infected cortical defects(holes)in rabbit tibia at 6 weeks indicated the excellent anti-infective and osteoconductive properties of composite cement.Thus,the animal study demonstrated the superiority of composite over injectable antibiotic therapy based on infection reso-lution and bone regeneration.We thereby conclude that the composite cement can be effectively applied in the treatment of resistant cases of chronic osteomyelitis.

Factors affecting the outcome of adult patients with Methicillin-resistant Staphylococcus aureus and Non- Methicillin resistant Staphylococcus aureus pneumonia: A retrospective, cross-sectional cohort study

@#<p style="text-align: justify;"><strong>Introduction:</strong> Pneumonia continues to be a leading cause of morbidity and mortality worldwide. Locally, pneumonia is the 3rd cause of death (2016). Currently, one of the concerns is the rise of resistant microorganisms particularly MRSA. Knowledge regarding MRSA pneumonia is mostly from international data. This study aims to determine the factors that may affect the outcome of MRSA and non-MRSA pneumonia as well as describe the susceptibility patterns of its etiologic agents.</p><p style="text-align: justify;"><strong>Methods:</strong> This is a retrospective, cross-sectional cohort study. The setting is a tertiary government hospital. The target subjects are patients 18 y/o and above, with bacteriologically-confirmed pneumonia, and were admitted in 2017.</p><p style="text-align: justify;"><strong>Results:</strong> The results revealed a high rate of MRSA pneumonia (88.2%), most are community-acquired (90%), and factors associated with mortality were: male, Type 2 DM, smoking history, radiographic findings of congestion, and significant difference was noted. For Non-MRSA pneumonia factors associated with mortality were: erythrocytosis, kidney and liver disease, cancer, previous cerebrovascular disease, previous admission (ARMMC), number of comorbidities, findings of altered sensorium, chest retractions, DBP ? 60 mmHg, radiographic findings of pulmonary congestion, and classification of CAP-MR. Morbidity factors included: anemia, trauma, multiple comorbidities, radiographic findings of bilateral infiltrates, unilateral/bilateral consolidation, unilateral/bilateral minimal pleural effusion, subcutaneous emphysema, congestion, and infection with multiple bacteria. The first antibiogram for the institution revealed a poor susceptibility pattern for the usually used empiric treatment.</p><p style="text-align: justify;"><strong>Conclusion:</strong> This study reveals a high rate of MRSA pneumonia, with several factors associated with its mortality. In terms of morbidity, no significant difference was noted from the variables measured. For Non-MRSA pneumonia which is seen in the majority of the subjects, several factors associated with mortality were noted and unlike MRSA pneumonia the morbidity is affected by the presence of anemia, trauma, multiple comorbidities, etc.<br />The antibiogram showed a poor susceptibility to the usually used empiric treatment.</p>

Characterization of the virulence, agr typing and antimicrobial resistance profile of Staphylococcus aureus strains isolated from food handlers in Brazil

Abstract Staphylococcus aureus is one of the main pathogens associated with foodborne outbreaks in Brazil and food handlers can carry toxigenic and resistant S. aureus strains. The aims of this study were to verify the frequency of virulence genes, to identify the agr groups and to determine the antimicrobial resistance profile of S. aureus strains isolated from food handlers of pilot kitchens located in São Paulo, Brazil. A total of 74 strains of the Staphylococcus genus were detected and 50% were identified as of the species S. aureus. The enterotoxin genes detection, tst and luk-PV detection, agr typing, mecA detection, ccr complex detection and SCCmec typing were performed using PCR. The antimicrobial resistance testing was performed by the disk diffusion method. The enterotoxin genes were identified in 36 S. aureus, including sea (83.8%). The tst gene was detected in 18.92% of the strains and the luk-PV was detected in only one isolate. Agr typing classified 58.3% of the strains as type I. Seven (18.92%) strains were classified as MRSA and the ccr2 complex was detected in six of these isolates. The SCCmec typing characterized strains as type II, III, IV and V. Moreover, there were also a greater number of resistant strains to penicillin (83.78%) and clarithromycin (67.57%). In conclusion, the study revealed a significant prevalence of S. aureus, and the presence of different virulence genes and a worrying resistance profile in S. aureus strains isolated from food handlers in this country.