Significance of Coagulase Negative Staphylococci with Special Reference to Species Differentiation and Antibiogram.

Coagulase negative staphylococci (CoNS)are part of normal human flora increasingly recognized as significant nosocomial pathogens, infection often associated with implanted devices, joint prosthesis and different indwelling devices, especially in very young, old immunocompromised patients. Aims: To identify CoNS species, their distribution and antibiotic susceptibility pattern from different clinical samples. Method: A total 185 CoNS isolates were collected from various clinical samples followed for species identification by a practical scheme adapted using simple ,useful test selected from various references. Antibiotic susceptibility done by Kirby Bauer disc diffusion method. Results: The study yield that 185 CoNS,strains were isolated out of 1514 positive cultures from various clinical specimens. Among species ; S. epidermidis was the most commonly isolated species (68.65%), followed by S. heamolyticus (16.75%),followed by S. saprophyticus(9.8%)and few other species also identified. The antibiotic susceptibility pattern against commonly used antibiotic showed multidrug resistance with more than 90% resistance to penicillin and no strains was resistance to vancomycin. The methicillin resistance was 63% among all isolates of CoNS. Conclusions: Study suggest increasing pathogenic potential of CoNS as well as emerging of drug resistance amongst them, that necessitates the need to adopt simple laboratory procedure to identify CoNS species and understand definitive therapy for CoNS isolates from various clinical samples. This scheme was able to identified 98.9% isolates up to species level.

Controle clínico de pacientes acometidos por infecções superficiais recorrentes pelo Staphylococcus aureus / Clinical control of patients attacked by superficial recurrent infections by Staphylococcus aureus

As infecções epidérmicas superficiais em pacientes portadores do Staphylococcus aureus na cavidade nasal representam um problema clínico relativamente comum, mas o seu manejo continua um desafio. Foi realizado um estudo descritivo, entre janeiro/94 e janeiro/96, com 60 pacientes de 18 a 70 anos de idade, em nível ambulatorial, onde foram avaliadas a eficácia terapêutica e a tolerância da associação rifampicina, mupirocina e gluconato de clorexidina a 2% no tratamento e controle dos portadores do Staphylococcus aureus. O resultado obtido mostrou que os paciente que completaram o esquema terapêutico proposto obtiveram melhora clínica e bacteriológica significativas (96% e 87%, respectivamente), onde conclui-se que a associação desses medicamentos apresenta-se como uma alternativa a ser considerada.

The epidermics superficials infections in patients carriers by Staphylococcus aureus in the cavit nasal represents a clinic problems relatively common, but that your management continue a challenge. A descriptive study was realized, between January 94/January 96, in 60 patients of 18-70 years old, at ambulatory level, where evaluated the eficacy and tolerance therapeutic of drug association rifampicina 300mg, mupirocin 2% and clorexidin 2%, in treatment and control of carriers to Staphylococcus aureus by realizated of swab intranasal. The result obtained point out the patients that concluded plan therapeutic proposed, got improvement clinic and bacteriology significant (96% and 87%, respectively) where conclude that drug association may be an alternative to be considered.

Bacteria in surface infections of neonates.

A bacteriological work on surface infections was done among live births (study group I) and neonates admitted in hospital (study group II). Out of 134 cases of conjunctivitis in group I Gram-negative bacilli predominated (48.5%) with Escherichia coli accounting for 29 (14.9%) cases, Klebsiella species 15 (11.2%) cases, Citrobacter freundii 3 (2.2%) cases, Pseudomons aeruginosa 18 (13.4%) cases and Aeromonas hydrophila 3 (2.2%) amongst pure isolates (73.9%). Gonococcus was noted in 2 (1.5%) cases. In group II, 41.7% were Staphylococcus aureus in pure growth (75%), compared to only 9.0% in group I. Skin infections were caused by both Staphylococcus aureus and Staphylococcus epidermidis. Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were the principal insolates from umbilical sepsis. Pseudomonas aeruginosa was isolated as pure growth from local site of noma neonatorum. Anaerobic cultures were negative in all except in 2 cases of umbilical sepsis with tetanus neonatorum revealing Clostridium tetani which however proved to be non-toxigenic. Blood cultures were positive in 4 out of 14 cases bearing 50% correlation with bacteria from surface infections. A source study established partial correlation with the cases of pseudomonas conjunctivitis. Phage typing of Staphylococcus aureus and biochemical typing failed to detect any definite marker of clinical entities, except that the skin infections were caused by group III phages predominantly (65.0%).

Staphylococcus saprophyticus como agente etiológico de la infección del tracto urinario

Se determino la presencia de Staphylococcus saprophyticus como agente etiológico de la infección del tracto urinario (ITU) en 1343 pacientes sintomáticos ambulatorios, la mayoría de ellos del sexo femenino, con edades entre 30 y 50 años. A todas las muestras sin centrifugar, se les practicó coloración de Gram y urocultivo. La identificación de los microorganismos aislados incluyo las técnicas que permiten diverenciar a S. saprophyticus de otros cocos coagulasa negativos. El 20.7 por ciento de los urocultivos resulto positivo para bacterias, de los cuales 3.6 por ciento lo fue para S. saprophyticus, ocupando este el tercer lugar en nuestra serie, despues de E. coli y K pneumoniae. En todos los pacientes con ITU y con S. saprophyticus se observaron al Gram, cocos grampositivos adheridos a células. Por su frecuencia el S. saprophyticus debe tenerse en cuenta como agente causal de la ITU.