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1.
Rev. chil. infectol ; 37(1): 37-44, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092720

ABSTRACT

Resumen Introducción: Staphylococcus aureus es uno de los patógenos con mayor prevalencia en el mundo, asociado a una alta tasa de mortalidad y un rápido desarrollo de resistencia a los antimicrobianos. A pesar de su patogenicidad, su seguimiento epidemiológico en México es escaso. Objetivo: Analizar la epidemiología molecular local y determinar el origen clonal de cepas resistentes a meticilina (RM) aisladas de pacientes internados en el Hospital Central "Dr. Ignacio Morones Prieto". Métodos: Se llevó a cabo un estudio prospectivo de corte transversal, de julio a diciembre de 2016. La caracterización de las cepas se realizó mediante genotipificación Spa, la determinación por RPC punto final de la frecuencia de genes de virulencia específicos y su antibiograma. Resultados: A partir de estos datos, se obtuvo que la prevalencia de S. aureus RM fue de 25,7%, destacando la presencia del tipo Spa t895 en 76% de las cepas resistentes y un patrón similar de susceptibilidad a antimicrobianos. Conclusión: Los resultados de este estudio indican que la prevalencia regional de SARM no se ha modificado en los últimos 10 años y proporcionan información valiosa del origen clonal y los factores de virulencia de las cepas de S. aureus aisladas en la región.


Abstract Background: Staphylococcus aureus is one of most prevalent pathogens in the world associated with a high mortality rate and a rapid development of resistance to antibiotics. Despite its pathogenicity, epidemiological monitoring in Mexico is scarce. Aim: To analyze the local molecular epidemiology and determine the clonal origin of methicillin-resistant (MR) strains isolated from patients admitted to Hospital "Dr. Ignacio Morones Prieto". Methods: A cross-sectional prospective study was carried out from July to December 2016. The characterization of the strains was carried out by Spa genotyping, frequency of specific virulence genes by PCR and antibiogram. Results: The prevalence of MRSA was 25.7%, highlighting the presence of the Spa type t895 in 76% of the resistant strains and a similar pattern of susceptibility to antibiotics. Conclusion: The results of this study indicate that the regional prevalence of MRSA has not changed in the last 10 years and provide valuable information on the clonal origin and the virulence factors of the strains of S. aureus isolated in the region.


Subject(s)
Humans , Staphylococcal Infections/microbiology , Staphylococcal Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus/classification , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/genetics , Microbial Sensitivity Tests , Prevalence , Cross-Sectional Studies , Prospective Studies , Virulence Factors/genetics , Genotype , Mexico/epidemiology , Anti-Bacterial Agents/pharmacology
2.
Rev. Col. Bras. Cir ; 47: e20202471, 2020. tab, graf
Article in English | LILACS | ID: biblio-1136576

ABSTRACT

ABSTRACT Purpose: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center. Methods: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients. During the surgical procedures, specimens of tissue of the infected foot lesions were biopsied to be cultured, and for bacterial resistance analysis. Results: the sample consisted of 105 patients. The majority of patierns were men, over 50 years of age, married and with low educational level. There was bacterial growth in 95 of the 105 tissue cultures. In each positive culture only one germ was isolated. There was a high prevalence of germs of the Enterobacteriaceae family (51,5%). Gram-negative germs were isolated in 60% of cultures and the most individually isolated germs were the Gram-positive cocci, Staphylococcus aureus (20%) and Enterococcus faecalis (17,9%). Regarding antibiotic resistance rates, a high frequency of Staphylococcus aureus resistant to methicillin (63,0%) and to ciprofloxacin (55,5%) was found; additionally, 43,5% of the Gram-negative isolated germs were resistant to ciprofloxacin. Conclusions: the majority of patients were men, over 50 years of age, married and with low educational level. The most prevalent isolated germs from the infected foot lesions were Gram-negative bacteria, resistant to ciprofloxacin, and the individually most isolated germ was the methicillin resistant Staphylococcus aureus.


RESUMO Objetivo: identificar o perfil sociodemográfico, microbiológico e de resistência bacteriana em pacientes com pé diabético infectado. Métodos: tratou-se de estudo observacional, transversal que avaliou os perfis sóciodemográfico e microbiológico de pacientes portadores de pé diabético infectado internados em Pronto Socorro de referência. Os dados sociodemográficos foram coletados por meio de entrevista. Foram colhidos, durante os procedimentos cirúrgicos, fragmentos de tecidos das lesões podais infectadas para realização de cultura/antibiograma. Resultados: a amostra foi composta por 105 pacientes. O perfil sociodemográfico mais prevalente foi o de pacientes do sexo masculino, acima dos 50 anos, casados e com baixa escolaridade. Das 105 amostras de fragmentos de tecidos colhidos para realização de cultura e antibiograma, 95 foram positivas, com crescimento de um único germe em cada um dos exames. Houve predomínio de germes da família Enterobacteriaceae (51,5%). Germes Gram-negativos foram isolados em 60,0% das culturas e os espécimes mais isolados individualmente foram os cocos Gram-positivos, Staphylococcus aureus (20,0%) e Enterococcus faecalis (17,9%). Considerando-se os perfis de resistência bacteriana, verificou-se alta taxa de Staphylococcus aureus resistente à meticilina (63,0%) e à ciprofloxacino (55,5%); verificou-se, também, que 43,5% dos germes Gram-negativos eram resistentes à ciprofloxacino. Conclusões: o perfil sociodemográfico majoritário, foi o de homens, com mais de 50 anos e com baixa escolaridade. Concluímos que os germes mais prevalentes nas lesões podais dos pacientes diabéticos foram os Gram-negativos, resistentes ao ciprofloxacino e que o germe mais isolado individualmente foi o Staphylococcus aureus resistente à meticilina.


Subject(s)
Humans , Male , Female , Aged , Gram-Positive Bacterial Infections/microbiology , Gram-Positive Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/drug therapy , Skin Diseases, Bacterial/microbiology , Diabetic Foot/microbiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Anti-Bacterial Agents/therapeutic use , Staphylococcal Skin Infections/microbiology , Staphylococcal Skin Infections/drug therapy , Staphylococcal Skin Infections/epidemiology , Drug Resistance, Microbial , Microbial Sensitivity Tests , Skin Diseases, Bacterial/drug therapy , Diabetic Foot/drug therapy , Diabetes Complications , Diabetes Mellitus , Methicillin-Resistant Staphylococcus aureus/drug effects , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Infections , Middle Aged , Anti-Bacterial Agents/pharmacology
3.
Rev. cuba. med. trop ; 71(2): e427, mayo.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093560

ABSTRACT

Introducción: Staphylococcus aureus resistente a meticilina constituye la causa principal de bacteriemia relaciona a catéter en pacientes con enfermedad renal crónica avanzada en hemodiálisis. Objetivos: Estimar la tasa de incidencia de bacteriemia relaciona con catéter por Staphylococcus aureus resistente a meticilina en pacientes con enfermedad renal crónica avanzada en el Hospital General Freyre de Andrade, Cuba, y vigilar los valores de concentración mínima inhibitoria de vancomicina frente a los aislados recuperados de bacteriemia. Métodos: El estudio se realizó entre mayo 2017 y febrero 2018, el cual incluyó 64 pacientes con Staphylococcus aureus resistente a meticilina (total de los atendidos en hemodiálisis). De cada uno se recogió información acerca de tipo de acceso vascular y tiempo de uso; de los que desarrollaron un episodio sugerente de bacteriemia se obtuvieron muestras de sangre para hemocultivo. Se informó bacteriemia relacionada con catéter utilizando los criterios de Bouza y otros 2004 y estas se confirmaron debidas a Staphylococcus aureus resistente a meticilina tras determinar la concentración mínima inhibitoria de oxacilina, empleando el método de microdilución en caldo y los criterios del CLSI 2017. Asimismo se evaluó la concentración mínima inhibitoria de vancomicina. Resultados: Las tasas de incidencia de bacteriemia relaciona con catéter por S. aureus y Staphylococcus aureus resistente a meticilina fueron de 0,66 y 0,59/1000 días-catéter, respectivamente. Predominaron las bacteriemia relacionada con catéter en los pacientes con accesos vasculares temporales. No se observó incremento en la concentración mínima inhibitoria de vancomicina (1 y 2 (g/mL) para los aislados responsables de bacteriemia a repetición y persistente. Conclusiones: La tasas de incidencia de bacteriemia relacionada con catéter indican que en la unidad de hemodiálisis se mantienen buenas prácticas clínicas. Los valores de concentración mínima inhibitoria de vancomicina sugieren una reducción en la eficacia de la droga en el tratamiento(AU)


Introduction: Methicillin-resistant Staphylococcus aureus is the leading cause of catheter-related bacteremia in patients with advanced chronic kidney disease undergoing hemodialysis. Objective: Estimate the incidence rate of catheter-related bacteremia by methicillin-resistant Staphylococcus aureus in patients with advanced chronic kidney disease from General Freyre de Andrade Hospital in Cuba, and survey the vancomycin minimum inhibitory concentration values for isolates obtained from bacteremia. Methods: A study was conducted of 64 patients with methicillin-resistant Staphylococcus aureus (total of those undergoing hemodialysis) from May 2017 to February 2018. For each one of them, information was collected about vascular access type and time of use. Blood culture samples were obtained from patients who developed an episode suggesting bacteremia. Catheter-related bacteremia was reported using Bouza et al (2004) criteria, and it was confirmed as due to methicillin-resistant Staphylococcus aureus after determining oxacillin minimum inhibitory concentration by broth microdilution and CLSI 2017 criteria. Vancomycin minimum inhibitory concentration was also evaluated. Results: The incidence rates for catheter-related bacteremia by S. aureus and methicillin-resistant Staphylococcus aureus were 0.66 and 0.59/1000 catheter-days, respectively. A predominance was found of catheter-related bacteremia in patients with temporary vascular accesses. No increase was observed in vancomycin minimum inhibitory concentration (1 and 2 g/mlL for the isolates responsible for recurrent and persistent bacteremia. Conclusions: The incidence rates for catheter-related bacteremia show that good clinical practices are maintained in the hemodialysis unit. Vancomycin minimum inhibitory concentration values suggest a decrease in the efficacy of the drug during treatment(AU)


Subject(s)
Humans , Staphylococcal Infections/drug therapy , Bacteremia/epidemiology , Methicillin-Resistant Staphylococcus aureus/drug effects , Renal Insufficiency, Chronic/complications , Catheter-Related Infections/complications
4.
Rev. chil. infectol ; 36(4): 455-460, ago. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1042662

ABSTRACT

Resumen Introducción: El método de difusión de doble disco se presenta como una alternativa diagnóstica que permite identificar aislados de Staphylococcus aureus susceptibles a clindamicina, ante el aumento de resistencia a meticilina, reduciendo así la posibilidad de fallo en el tratamiento. Objetivo: Determinar la frecuencia de resistencia a clindamicina inducida por eritromicina en S. aureus resistentes a meticilina (SARM) aislados de niños paraguayos. Materiales y Métodos: Estudio observacional, descriptivo, de corte transversal. Se colectaron 145 aislados S. aureus que causaron infecciones de piel y tejidos blandos y osteo-articulares en pacientes pediátricos del Hospital Central del Instituto de Previsión Social en el período de diciembre-2012 a noviembre-2013. La resistencia a clindamicina se determinó por métodos automatizados y de difusión de doble disco. Se realizó reacción de polimerasa en cadena para genes ermA, ermB, ermC y msrA de aislados representativos. Resultados: La resistencia global a meticilina y clindamicina fue de 67 y 13%, respectivamente (11% atribuible al mecanismo de resistencia a clindamicina inducible). Los genes ermC y msrA fueron detectados individualmente en 25 y 17% de los aislados, respectivamente, mientras que un aislado presentó ambos genes en simultáneo. Discusión: La frecuencia de mecanismo de resistencia inducible a clindamicina señala la importancia de los métodos de difusión de doble disco en la práctica microbiológica, así como se encuentran en los límites de puntos de cortes considerados como aceptables para el uso de este antimicrobiano para infecciones cutáneas y osteo-articulares causadas por SARM.


Background: The double disc diffusion method is an alternative diagnostic that allows the identification of Staphylococcus aureus isolates apparently susceptible to clindamycin but that may develop resistance due to an induction phenomena, mainly asociated to the increase in resistance to methicillin, thus increasing the possibility of failure in the treatment. Aim: To determine the frequency of induced clindamycin resistance in methicillin-resistant S. aureus (MRSA) isolated from Paraguayan children. Materials and Methods: In this cross sectional study, we collected 145 S. aureus isolates that caused skin and soft tissue and osteoarticular infections in pediatric patients of the Central Hospital I.P.S. in the period from December-2012 to November-2013. Resistance to clindamycin was determined by automated methods and double disc diffusion. PCR was performed for ermA, ermB, ermC and msrA genes from representative isolates. Results: The global resistance to methicillin and clindamycin was 67 and 13%, respectively (11% attributable to the inducible mechanism). The ermC and msrA genes were detected individually in 25 and 17% of the isolates respectively while an isolate presented both genes simultaneously. Discussion: The frequency of inducible resistance to clindamycin indicates the importance of double disc diffusion methods in microbiological practice, as well as being within the cut off points considered acceptable for the use of this antibiotic for skin infections. and osteoarticular caused by MRSA.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Staphylococcal Infections/microbiology , Clindamycin/pharmacology , Drug Resistance, Bacterial/genetics , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology , Paraguay , Polymerase Chain Reaction , Cross-Sectional Studies , Drug Resistance, Bacterial/drug effects , Disk Diffusion Antimicrobial Tests , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Genes, Bacterial
5.
Braz. j. infect. dis ; 23(2): 139-142, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1039225

ABSTRACT

ABSTRACT Introduction: This study aimed to characterize Staphylococcus aureus isolates from bloodstream infections in patients attending a teaching hospital, between 2011 and 2015. Methods: The minimum inhibitory concentration for daptomycin, linezolid, oxacillin, teicoplanin, vancomycin, and trimethoprim/sulfamethoxazole was accessed by broth microdilution. SCCmec type and clonal profile were determined by molecular tests. Vancomycin heteroresistance was evaluated using screening tests and by population analysis profile/area under the curve. Results: Among 200 S. aureus isolates, 55 (27.5%) were MRSA, carrying SCCmec II (45.5%) or IV (54.5%). The most frequent MRSA lineages were USA100 (ST5-II) (45.5%) and USA800 (ST5-IV) (30.9%). Six isolates were confirmed as vancomycin heteroresistant, showing area under the curve ratio 1.1, 1.2 or 1.3 (four USA100, one USA800 and one USA1100 isolates). Conclusions: Daptomycin and vancomycin non-susceptible MRSA clonal lineages were found in bloodstream infections over five years, highlighting the importance of continuous surveillance of multiresistant bacteria in hospitals.


Subject(s)
Humans , Vancomycin/pharmacology , Bacteremia/microbiology , Daptomycin/pharmacology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology , Staphylococcal Infections/microbiology , Brazil , Microbial Sensitivity Tests , Cross Infection/microbiology , Hospitals, Teaching
7.
Braz. j. infect. dis ; 23(1): 8-14, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001504

ABSTRACT

ABSTRACT Introduction: Bacterial tonsillitis is an upper respiratory tract infection that occurs primarily in children and adolescents. Staphylococcus aureus is one of the most frequent pathogens in the etiology of tonsillitis and its relevance is due to its antimicrobial resistance and persistence in the internal tissues of the tonsils. Tonsillectomy is indicated in cases of recurrent tonsillitis after several failures of antibiotic therapy. Material and methods: In this study we evaluated 123 surgically removed tonsils from patients who had history of recurrent tonsillitis. The tonsils were submitted to microbiological analysis for detection of S. aureus. The isolates were identified by PCR for femA gene. Antimicrobial susceptibility of the isolates was determined by disk diffusion tests. All isolates were submitted to PCR to detect mecA and Panton-Valentine leucocidin (PVL) genes. The genetic similarity among all isolates was determined by pulsed field gel electrophoresis. Results: Sixty-one S. aureus isolates were obtained from 50 patients (40.7%) with mean age of 11.7 years. The isolates showed high level resistance to penicillin (83.6%), 9.8% had inducible MLSb phenotype, and 18.0% were considered multidrug resistant (MDR). mecA gene was detected in two isolates and the gene coding for PVL was identified in one isolate. The genetic similarity analysis showed high diversity among the isolates. More than one genetically different isolate was identified from the same patient, and identical isolates were obtained from different patients. Conclusions: MDR isolates colonizing tonsils even without infection, demonstrate persistence of the bacterium and possibility of antimicrobial resistance dissemination and recurrence of infection. A specific clone in patients colonized by S. aureus was not demonstrated.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Staphylococcal Infections/microbiology , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/genetics , Tonsillitis/microbiology , Staphylococcus aureus/drug effects , Tonsillectomy/methods , Tonsillitis/surgery , Polymerase Chain Reaction , Cross-Sectional Studies , Electrophoresis, Gel, Pulsed-Field , Drug Resistance, Multiple, Bacterial/drug effects , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology
8.
Rev. cuba. pediatr ; 90(4): e621, set.-dic. 2018. graf
Article in Spanish | LILACS | ID: biblio-978471

ABSTRACT

Introducción: La parotiditis supurativa aguda se presenta con poca frecuencia en el período neonatal. Objetivo: Aportar un nuevo caso de parotiditis supurativa aguda por Staphylococcus aureus resistente a la Meticillina. Presentación del caso: El presente caso tiene la particularidad de que presentó foco de infección inicial (impétigo y conjuntamente mastitis bilateral), en el que se demostró el mismo microorganismo causal de la infección: Staphylococcus aureus resistente a la Meticillina. La mastitis bilateral evolucionó hacia la formación de absceso. En la literatura revisada solo se encontraron tres publicaciones que tratan de neonatos con un foco inicial de infección en sitios diferentes de la parotiditis. Estos aspectos fueron los que motivaron la presentación del caso. Conclusiones: Staphylococcus aureus resistente a la Meticillina ha emergido en los últimos años como agente causal de parotiditis supurativa aguda, que puede diseminarse hacia otro foco infeccioso, habitualmente se logra la curación con tratamiento antibiótico ajustado al agente causal, concretamente con Vancomicina, aunque puede requerir también tratamiento quirúrgico si ocurre abscedación(AU)


Introduction: Acute suppurative parotitis occurs infrequently in the neonatal period. Objective: To provide information of a new case of acute suppurative parotitis caused by Methicillin- resistant Staphylococcus aureus. Case presentation: The present case has the particularity that the patient presented a source of initial infection (impetigo and jointly bilateral mastitis), in which the same causal microorganism of the infection was found: Methicillin resistant Staphylococcus aureus. Bilateral mastitis evolved to the formation of abscess. In the literature reviewed, there were only 3 publications on neonates who presented an initial source of infection in sites different from parotitis. These aspects are those that motivated the presentation of this case. Conclusions: Methicillin resistant Staphylococcus aureus has emerged in the last years as a causal agent of acute suppurative parotitis that can lead to dissemination of another source of infection. Normally, the cure is achieved with antibiotic treatment adjusted to the causal microorganism, specifically with Vancomycin; although it can require surgical treatment if abscesses occurs(AU)


Subject(s)
Humans , Female , Infant, Newborn , Parotitis/complications , Parotitis/drug therapy , Vancomycin/therapeutic use , Methicillin-Resistant Staphylococcus aureus/drug effects , Staphylococcal Infections/complications , Case Reports , Mastitis/complications , Mastitis/drug therapy
9.
Rev. Soc. Bras. Med. Trop ; 51(5): 603-609, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-957466

ABSTRACT

Abstract INTRODUCTION: The behavior of methicillin-resistant Staphylococcus aureus (MRSA) isolated from central venous catheter-related infection was evaluated to determine its biofilm potential, antimicrobial resistance, and adhesion genes. METHODS: A total of 1,156 central venous catheters (CVC) were evaluated to screen for pathogens. Antimicrobial sensitivity, biofilm formation potential, and molecular analysis of MRSA were examined following standard guidelines. RESULTS: Of the 1,156 samples, 882 (76%) were colonized by bacteria or candida. Among the infected patients, 69% were male and 36% were female with median age of 32 years. Staphylococcus aureus infected 39% (344/882) of CVCs in patients. Of the 59% (208/344) of patients with MRSA, 57% had community acquired MRSA and 43% had hospital acquired MRSA. Linezolid and vancomycin killed 100% of MRSA; resistance levels to fusidic acid, doxycycline, clindamycin, azithromycin, amikacin, trimethoprim-sulfamethoxazole, gentamycin, tobramycin, and ofloxacin were 21%, 42%, 66%, 68%, 72%, 85%, 95%, 97%, and 98% respectively. Strong biofilm was produced by 23% of samples, moderate by 27%, and weak by 50% of MRSA. The presence of adhesion genes, sdrC and sdrD (90%), eno (87%), fnbA (80%), clfA and sdrE (67%), fnbB, sdrD (61%), and cna (51%), in most MRSA samples suggested that the adhesion genes are associated with biofilm synthesis. CONCLUSIONS: The superbug MRSA is a major cause of CVC-related infection. Antibiotic resistance to major classes of antibiotics and biofilm formation potential enhanced superbug MRSA virulence, leading to complicated infection. MRSA causes infection in hospitals, communities, and livestock.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Staphylococcal Infections/microbiology , Cross Infection/microbiology , Community-Acquired Infections/microbiology , Biofilms/growth & development , Methicillin-Resistant Staphylococcus aureus/physiology , Catheter-Related Infections/microbiology , Anti-Bacterial Agents/pharmacology , Bacterial Adhesion/genetics , Microbial Sensitivity Tests , Biofilms/drug effects , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Genes, Bacterial/genetics , Middle Aged
10.
Braz. j. otorhinolaryngol. (Impr.) ; 84(4): 441-447, July-Aug. 2018. graf
Article in English | LILACS | ID: biblio-951855

ABSTRACT

Abstract Introduction Methicillin-resistant staphylococcus aureus is an emerging problem for the treatment of chronic suppurative otitis media, and also for pediatric tympanostomy tube otorrhea. To date, there are no effective topical antibiotic drugs to treat methicillin-resistant staphylococcus aureus otorrhea. Objective In this study, we evaluated the ototoxicity of topical KR-12-a2 solution on the cochlea when it is applied topically in the middle ear of guinea pigs. Methods The antimicrobial activity of KR-12-a2 against methicillin-resistant staphylococcus aureus strains was examined by using the inhibition zone test. Topical application of KR-12-a2 solution, gentamicin and phosphate buffered saline were applied in the middle ear of the guinea pigs after inserting ventilation tubes. Ototoxicity was assessed by auditory brainstem evoked response and scanning electron microscope examination. Results KR-12-a2 produced an inhibition zone against methicillin-resistant staphylococcus aureus from 6.25 µg. Hearing threshold in the KR-12-a2 and PBS groups were similar to that before ventilation tube insertion. However, the gentamicin group showed elevation of the hearing threshold and there were statistically significant differences compared to the phosphate buffered saline or the KR-12-a2 group. In the scanning electron microscope findings, the KR-12-a2 group showed intact outer hair cells. However, the gentamicin group showed total loss of outer hair cells. In our experiment, topically applied KR-12-a2 solution did not cause hearing loss or cochlear damage in guinea pigs. Conclusion In our experiment, topically applied KR-12-a2 solution did not cause hearing loss or cochlear damage in guinea pigs. The KR-12-a2 solution can be used as ototopical drops for treating methicillin-resistant staphylococcus aureus otorrhea; however, further evaluations, such as the definition of optimal concentration and combination, are necessary.


Resumo Introdução O staphylococcus aureus resistente à meticilina é um problema emergente não só para a otite média supurativa crônica, mas também para casos de otorreia crônica em crianças com tubo de ventilação. Até o momento, não há antibióticos tópicos efetivos para a otorreia causada por staphylococcus aureus resistente à meticilina. Objetivo Nesse estudo, avaliamos a ototoxicidade da solução tópica de KR-12-a2 na cóclea quando aplicada topicamente na orelha média de cobaias. Método A atividade antimicrobiana de KR-12-a2 contra cepas de staphylococcus aureus resistente à meticilina foi avaliada utilizando-se o teste de zona de inibição de crescimento. Foram aplicados na orelhas médias de 3 grupos de cobaias, ou solução tópica de KR-12-a2, ou gentamicina ou solução salina tamponada com fosfato após timpanostomia. A ototoxicidade foi avaliada através do exame auditivo de potencial evocado auditivo de tronco encefálico e por microscopia eletrônica de varredura. Resultados O KR-12-a2 produziu uma zona de inibição contra o staphylococcus aureus resistente à meticilina a partir de 6,25 µg. Alterações do limiar de audição no grupo KR-12-a2 e no grupo com solução salina foram semelhantes aos observados antes da inserção do tubo de ventilação. No entanto, o grupo gentamicina apresentou um limiar auditivo mais elevado, estatisticamente significativo em comparação ao grupo solução salina ou ao grupo KR-12-a2. Nos achados da microscopia eletrônica, o grupo KR-12-a2 apresentou células ciliadas externas intactas. No entanto, o grupo gentamicina apresentou perda total das células ciliadas externas. Em nosso experimento, a solução de KR-12-a2 aplicada topicamente não causou perda auditiva ou dano coclear em cobaias. Conclusão Em nosso experimento, a solução de KR-12-a2 aplicada topicamente não causou perda auditiva ou dano coclear em cobaias. A solução de KR-12-a2 pode ser utilizada como gotas otológicas para o tratamento da otorreia causada por staphylococcus aureus resistente à meticilina; no entanto, são necessárias outras avaliações, para a definição da concentração e das associações ideais.


Subject(s)
Animals , Male , Peptide Fragments/toxicity , Cochlea/drug effects , Cathelicidins/toxicity , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/toxicity , Otitis Media, Suppurative/microbiology , Peptide Fragments/administration & dosage , Auditory Threshold , Staphylococcal Infections/drug therapy , Microscopy, Electron, Scanning , Microbial Sensitivity Tests , Reproducibility of Results , Administration, Topical , Evoked Potentials, Auditory, Brain Stem , Treatment Outcome , Cochlea/physiopathology , Disease Models, Animal , Cathelicidins/administration & dosage , Guinea Pigs , Hair Cells, Auditory/drug effects , Anti-Bacterial Agents/administration & dosage
11.
Braz. j. infect. dis ; 22(1): 55-59, Jan.-feb. 2018. tab
Article in English | LILACS | ID: biblio-1039208

ABSTRACT

ABSTRACT To characterize methicillin-resistant Staphylococcus aureus isolates from an intensive care unit of a tertiary-care teaching hospital, between 2005 and 2010. A total of 45 isolates were recovered from patients admitted to the intensive care unit in the study period. Resistance rates higher than 80% were found for clindamycin (100%), erythromycin (100%), levofloxacin (100%), azithromycin (97.7%), rifampin (88.8%), and gentamycin (86.6%). The SCCmec typing revealed that the isolates harbored the types III (66.7%), II (17.8%), IV (4.4%), and I (2.2%). Four (8.9%) isolates carried non-typeable cassettes. Most (66.7%) of the isolates were related to the Brazilian endemic clone from CC8/SCCmec III, which was prevalent (89.3%) between 2005 and 2007, while the USA100/CC5/SCCmec II lineage emerged in 2007 and was more frequent in the last few years. The study showed high rates of antimicrobial resistance among methicillin-resistant S. aureus isolates and the replacement of Brazilian clone, a well-established hospital lineage, by the USA100 in the late 2000s, at the intensive care unit under study.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Intensive Care Units/statistics & numerical data , Reference Values , Brazil , Microbial Sensitivity Tests , Interspersed Repetitive Sequences , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Hospitals, Teaching/statistics & numerical data , Anti-Bacterial Agents/pharmacology
12.
Braz. j. med. biol. res ; 51(2): e6736, 2018. tab, graf
Article in English | LILACS | ID: biblio-889017

ABSTRACT

Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, studies have determined that screening for this pathogen prior to surgery and diminishing staphylococcal infections at the surgical site will dramatically reduce surgical site infections. A nasal mupirocin treatment is shown to significantly reduce the colonization of the pathogen. However, this treatment is expensive and is currently not available in China. Thus, in this study, we first sought to determine the prevalence of MSSA/MSRA in patients undergoing elective orthopedic surgery in northern China, and then, we treated the positive patients with a nasal povidone-iodine swab. Here, we demonstrate a successful reduction in the colonization of S. aureus. We propose that this treatment could serve as a cost-effective means of eradicating this pathogen in patients undergoing elective orthopedic surgery, which might reduce the rate of surgical site infections.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Povidone-Iodine/therapeutic use , Elective Surgical Procedures/economics , Orthopedic Procedures/economics , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Infective Agents, Local/therapeutic use , Nasal Cavity/microbiology , Postoperative Complications/prevention & control , Administration, Intranasal , China , Cross-Sectional Studies , Prospective Studies , Treatment Outcome , Antibiotic Prophylaxis/economics , Antibiotic Prophylaxis/methods , Methicillin-Resistant Staphylococcus aureus/growth & development , Anti-Infective Agents, Local/economics , Nasal Cavity/drug effects
13.
Rev. chil. infectol ; 35(1): 7-14, 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-899771

ABSTRACT

Resumen Desde el inicio de la era antimicrobiana se han ido seleccionando gradualmente cepas de Staphylococcus aureus resistentes a antimicrobianos de amplio uso clínico. Es así como en 1960 se describen en Inglaterra las primeras cepas resistentes a meticilina, y algunos años después son informadas en hospitales de Chile. Actualmente, S. aureus resistente a penicilinas antiestafilocóccicas es endémico en los hospitales de nuestro país y del mundo, siendo responsable de una alta morbimortalidad. La resistencia es mediada habitualmente por la síntesis de una nueva transpeptidasa, denominada PBP2a o PBP2' que posee menos afinidad por el β-lactámico, y es la que mantiene la síntesis de peptidoglicano en presencia del antimicrobiano. Esta nueva enzima se encuentra codificada en el gen mecA, a su vez inserto en un cassette cromosomal con estructura de isla genómica, de los cuales existen varios tipos y subtipos. La resistencia a meticilina se encuentra regulada, principalmente, por un mecanismo de inducción de la expresión del gen en presencia del β-lactámico, a través de un receptor de membrana y un represor de la expresión. Si bien se han descrito mecanismos generadores de resistencia a meticilina mec independientes, son categóricamente menos frecuentes.


Staphylococcus aureus isolates resistant to several antimicrobials have been gradually emerged since the beginning of the antibiotic era. Consequently, the first isolation of methicillin-resistant S. aureus occurred in 1960, which was described a few years later in Chile. Currently, S. aureus resistant to antistaphylococcal penicillins is endemic in Chilean hospitals and worldwide, being responsible for a high burden of morbidity and mortality. This resistance is mediated by the expression of a new transpeptidase, named PBP2a or PBP2', which possesses lower affinity for the β-lactam antibiotics, allowing the synthesis of peptidoglycan even in presence of these antimicrobial agents. This new enzyme is encoded by the mecA gene, itself embedded in a chromosomal cassette displaying a genomic island structure, of which there are several types and subtypes. Methicillin resistance is mainly regulated by an induction mechanism activated in the presence of β-lactams, through a membrane receptor and a repressor of the gene expression. Although mec-independent methicillin resistance mechanisms have been described, they are clearly infrequent.


Subject(s)
Bacterial Proteins/genetics , Genetic Structures/genetics , Penicillin-Binding Proteins/genetics , Methicillin-Resistant Staphylococcus aureus/genetics , Bacterial Proteins/drug effects , Molecular Structure , Chromosomes, Bacterial/drug effects , Penicillin-Binding Proteins/drug effects , Methicillin-Resistant Staphylococcus aureus/drug effects , Genes, Bacterial/drug effects , Methicillin/pharmacology , Methicillin/chemistry , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry
14.
Rev. chil. infectol ; 34(5): 487-490, oct. 2017. tab
Article in Spanish | LILACS | ID: biblio-899746

ABSTRACT

Resumen Introducción: El principal microorganismo implicado en las infecciones de piel y tejidos blandos (IPTB) es Staphylococcus aureus, con incremento en las cepas resistentes a meticilina en los últimos años. Objetivo: Identificar la frecuencia de S. aureus resistente a meticilina (SARM) en IPTB en niños que consultaron a un hospital de cuarto nivel en la ciudad de Medellín. Métodos: Estudio descriptivo, retrospectivo, a partir de la revisión de historias clínicas. Se incluyeron pacientes menores de 18 años con IPTB causadas por S. aureus que no cumplieran con criterios de enfermedad invasora. Resultados: La prevalencia de SARM en esta población fue de 31%. El principal diagnóstico fue absceso cutáneo (68%), seguido por infección de sitio quirúrgico (15%) y celulitis no purulenta (6%). Tenían alguna co-morbilidad 85% de los pacientes. Todos los aislados fueron sensibles a rifampicina y cotrimoxazol. Ocho por ciento de los aislados fueron resistentes a clindamicina. Se encontró mayor prevalencia de SARM en lactantes comparado con los mayores de 2 años (60 vs 23%, p = 0,0109). Conclusión: Ante la alta prevalencia de SARM en IPTB se recomienda incluir en el tratamiento empírico antimicrobianos con cobertura para estas cepas, principalmente para lactantes.


Background: Skin and soft tissue infections (SSTI) are very common in children and Staphylococcus aureus is the main agent, with an increase of methicillin resistant strains (MRSA) in recent years. Aim: To identify the frequency of MRSA in skin and soft tissue infections (SSTI) in children from a high complex hospital in Medellin, Colombia. Methods: This is a descriptive, retrospective study, information was obtained from medical records. We included patients younger than 18 years with SSTI due to S. aureus who did not meet criteria for invasive disease. Results: The prevalence of MRSA in this population was 31%. The main diagnosis was cutaneous abscess (68%), followed by surgical site infection (15%) and non-purulent cellulitis (6%). Eighty five percent of the patients had at least 1 comorbidity. All isolates were sensitive to rifampicin and cotrimoxazole and 8% of the isolates were resistant to clindamycin. There was a higher prevalence of MRSA in patients under 2 years compared to older (60 vs 23%, p = 0,0109). Conclusion: In view of the high prevalence of MRSA in SSTI, empirical treatment with adequate coverage for MRSA is recommended, especially for patients under 2 years of age.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Staphylococcal Skin Infections/epidemiology , Soft Tissue Infections/epidemiology , Skin/microbiology , Staphylococcal Infections/microbiology , Staphylococcal Infections/drug therapy , Staphylococcus aureus/drug effects , Staphylococcal Skin Infections/microbiology , Staphylococcal Skin Infections/drug therapy , Prevalence , Retrospective Studies , Methicillin Resistance/drug effects , Age Factors , Sex Distribution , Colombia/epidemiology , Soft Tissue Infections/microbiology , Soft Tissue Infections/drug therapy , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Hospitals , Anti-Bacterial Agents/therapeutic use
15.
Braz. j. infect. dis ; 21(4): 464-467, July-Aug. 2017. tab
Article in English | LILACS | ID: biblio-1039197

ABSTRACT

Abstract Nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) have increasingly been reported in healthy communities. This study aimed to assess the rate of S. aureus in general and MRSA in particular from nasal secretion of children in daycare centers in Vitória da Conquista, Brazil. The isolates were identified based on morphology, biochemical tests and by PCR. Detection of virulence genes, biofilm production, and susceptibility test by disk diffusion agar were performed. MRSA isolates were characterized by spa, SCCmec, and multilocus sequence typing (MLST). S. aureus were recovered from 70 (47.3%) of 148 children. Among the 11 MRSA strains (15.7%), two SCCmec types (IV and V) were detected. MLST identified four STs related to three clonal complexes (CC): 5, 45, and 398. Four spa types were found circulating in this setting. Resistance of S. aureus isolates to ampicillin, erythromycin, ciprofloxacin, clindamycin, and tetracycline was 80%, 32.8%, 7.1%, 7.1% and 4.3%, respectively. One isolate presented intermediate resistance to vancomycin detected by Etest methodology. All strains were biofilm producers. The virulence genes seb, sec, spa, and pvl were detected in some isolates. This study revealed a high rate of children carrying MRSA among healthy attendees in daycare centers in Vitória da Conquista, Brazil.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Staphylococcal Infections/microbiology , Child Day Care Centers , Nose/microbiology , Community-Acquired Infections/microbiology , Biofilms/growth & development , Virulence Factors , Disk Diffusion Antimicrobial Tests , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/pathogenicity , Genotype , Anti-Bacterial Agents/pharmacology
16.
Braz. j. microbiol ; 48(2): 237-241, April.-June 2017. tab
Article in English | LILACS | ID: biblio-839383

ABSTRACT

Abstract The distinction between healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) infections has become increasingly blurred. We assessed the molecular characterization and antimicrobial resistance profile for MRSA isolates from blood. Most of all (81.9%) isolates are related to known HA-MRSA and CA-MRSA epidemic lineages, such as, USA300, USA400, USA600, USA800 and USA1100. This is the first multicenter study in Rio de Janeiro.


Subject(s)
Staphylococcal Infections/microbiology , Bacteremia/microbiology , Drug Resistance, Bacterial , Methicillin-Resistant Staphylococcus aureus/drug effects , Multilocus Sequence Typing , Anti-Bacterial Agents/pharmacology , Brazil , Microbial Sensitivity Tests , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Genotype
17.
Braz. j. otorhinolaryngol. (Impr.) ; 83(2): 201-206, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-839418

ABSTRACT

Abstract Introduction: Suppurative otitis media is a critical disease causing perforation of the tympanic membrane associated with changes of the mucoperiosteum of the middle ear cleft. Objective: To isolate causative bacteria from chronic suppurative ear discharges and to ascertain their antibiotic profiles, of patients attending outpatients department in 3 years. Methods: For isolation of bacteria, samples of ear discharges were grown in suitable media and bacteria were subjected to antibiotic profiling by the Kirby-Bauer's method with presently used antibiotics. Results: A total of 1043 bacteria were isolated, including Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus, along with 121 fungal isolates. Among 371 P. aeruginosa isolates, tobramycin 30 had the highest susceptibility rate 93.2%, followed by ceftazidime 30, 91.5% and amikacin 10 µg/disk 64.4%. Of 359 S. aureus isolates, there were 236 coagulase negative S. aureus + methicillin sensitive S. aureus isolates, while 123 isolates were methicillin resistant Staphylococcus aureus with 95.2% isolates susceptible to cloxacillin 15, 83.3% isolates to erythromycin 15 and 78.5% isolates to gentamicin 30 µg/disk. Of 1164, 49 patients presented post aural abscess, 12 patients had intracranial complications, 9 patients had facial palsy and 3 patients had labyrinthitis. More than 90% P. aeruginosa and 90% S. aureus isolates were sensitive to tobramycin 30 and cloxacillin 30 µg/disk, respectively. Conclusion: Multidrug resistant strains of P. aeruginosa were more prevalent than those of S. aureus in ear discharges. Tobramycin and cloxacillin may be included in the formulatory antibiotic regimen to overcome bacterial infections in chronic suppurative otitis media.


Resumo Introdução: Otite média supurativa é uma doença importante que causa perfuração da membrana timpânica, além de alterações do mucoperiósteo da orelha média. Objetivo: Isolar as bactérias causadoras a partir da secreção auricular crônica e verificar seus perfis de sensibilidade aos antibióticos em pacientes ambulatoriais durante três anos. Método: Para o isolamento das bactérias, as amostras de secreções auriculares foram cultivadas em meios adequados e as bactérias foram submetidas à detecção de perfis de sensibilidade aos antibióticos com o método de Kirby-Bauer para antibióticos usados na atualidade. Resultados: No total, 1.043 bactérias, incluindo Pseudomonas aeruginosa resistente à meticilina e Staphylococcus aureus, e 121 fungos isolados foram identificados. Entre 371 isolados de P. aeruginosa, tobramicina 30 µg/disco apresentou a maior taxa de suscetibilidade (93,2%), seguida por ceftazidima 30 µg/disco (91,5%) e amicacina 10 µg/disco (64,4%). De 359 isolados de S. aureus, 236 eram S. aureus coagulase-negativos + S. aureus sensíveis à meticilina (MSSA), enquanto 123 eram MRSA com 95,2% de suscetibilidade à cloxacilina 15 µg/disco, 83,3% sensíveis à eritromicina 15 µg/disco e 78,5% à gentamicina 30 µg/disco. Entre 1.164 pacientes, 49 apresentaram abscesso aural, 12 complicações intracranianas, nove paralisia facial e três labirintite. Mais de 90% das P. aeruginosa isoladas e de 90% de S. aureus eram sensíveis à tobramicina 30 µg/disco e cloxacilina 30 µg/disco, respectivamente. Conclusão: Cepas multirresistentes de P. aeruginosa foram mais prevalentes do que as de S. aureus nas secreções auriculares. Tobramicina e cloxacilina podem ser consideradas na formulação de regime de antibióticos para tratar as infecções bacterianas na OMCS.


Subject(s)
Humans , Otitis Media, Suppurative/microbiology , Pseudomonas aeruginosa/drug effects , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology , Pseudomonas aeruginosa/isolation & purification , Microbial Sensitivity Tests , Chronic Disease , Methicillin-Resistant Staphylococcus aureus/isolation & purification
18.
Braz. j. infect. dis ; 21(2): 185-189, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-1039190

ABSTRACT

Abstract Staphylococcus aureus is an important cause of bloodstream infections. Therefore, the main purpose of this work was to characterize a collection of 139 S. aureus isolates from bloodstream infections in two public hospitals in relation to their antimicrobial susceptibility profile, staphylococcal cassette chromosome mec types, and clonal relationship. Methicillin resistance and resistance to other 12 agents were accessed by the disk diffusion test. Minimum inhibitory concentration to mupirocin was also determined. The SCCmec types were accessed by multiplex PCR, and the clonal relationship was determined by pulsed field gel electrophoresis method and restriction modification system characterization. Besides, multilocus sequence typing was performed for representative methicillin-resistant S. aureus isolates. The military hospital showed a dissemination of the New York/Japan (USA100/ST5/CC5/SCCmecII) lineage associated to multidrug resistance, including mupirocin resistance, and the teaching hospital presented polyclonal and non-multidrug resistant MRSA isolates. Complete substitution of the Brazilian endemic clone by other lineages was found in both hospitals. These findings can highlight differences in policy control and prevention of infections used in the hospitals and a change in the epidemiological profile of MRSA in Brazilian hospitals, with the replacement of BEC, a previously well-established clone, by other lineages.


Subject(s)
Humans , Staphylococcal Infections/microbiology , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology , Brazil , DNA, Bacterial/genetics , Bacterial Typing Techniques , Mupirocin/pharmacology , Electrophoresis, Gel, Pulsed-Field , Disk Diffusion Antimicrobial Tests , Methicillin-Resistant Staphylococcus aureus/genetics , Multilocus Sequence Typing , Genotype , Hospitals, Public
19.
Acta cir. bras ; 32(3): 219-228, Mar. 2017. tab, graf
Article in English | LILACS | ID: biblio-837687

ABSTRACT

Abstract: Purpose: To investigate the microbiological, inflammatory and oxidant effects of adjuvant ozone administration in experimental rat vascular graft infection model which has not been previously investigated. Methods: Forty adult Wistar rats were divided into Sham, Control, Vancomycin, Ozone, Vancomycin+Ozone groups. Grafts were inoculated with Methicillin-resistant Staphylococcus aureus (MRSA) strain and implanted subcutaneously. Rats were treated intraperitoneally with ozone and /or intramuscularly with vancomycin for 10 days. Grafts were evaluated by quantitative bacterial cultures. Blood samples were harvested for determination of thiol-disulphide and cytokine profiles. Results: There was no significant difference in bacterial counts between Control and Ozone Groups. In the Ozone Group median colony count was significantly higher than the Vancomycin and Vancomycin+Ozone Groups. Total thiol and disulphide levels increased and disulphide/native thiol and disulphide/total thiol ratios decreased in Ozone Group significantly. Albumin levels decreased significantly in Vancomycin and Vancomycin+Ozone Groups compared to the Sham Group. IL-1 and TNF-alpha levels significantly increased in infected rats. Decreased levels of VEGF due to infection reversed by ozone therapy in control and vancomycin groups. Conclusions: We didn't observe any benefit of the agent on MRSA elimination in our model. Likewise, effects of ozone on thiol-disulphide homeostasis and inflammatory cytokines were contradictory.


Subject(s)
Animals , Male , Oxidants, Photochemical/pharmacology , Ozone/pharmacology , Staphylococcal Infections/drug therapy , Disulfides/blood , Methicillin-Resistant Staphylococcus aureus/drug effects , Vascular Grafting , Reference Values , Time Factors , Vascular Diseases/microbiology , Serum Albumin/analysis , Vancomycin/pharmacology , Colony Count, Microbial , Random Allocation , Reproducibility of Results , Cytokines/blood , Treatment Outcome , Rats, Wistar , Transplants/microbiology , Methicillin-Resistant Staphylococcus aureus/growth & development , Homeostasis/drug effects , Anti-Bacterial Agents/pharmacology
20.
Med. infant ; 24(1): 63-65, marzo 2017.
Article in Spanish | LILACS | ID: biblio-879294

ABSTRACT

Trimetoprima-sulfametoxazol (TMP-SMX) tiene actividad in vitro contra cepas de Staphylococcusaureus, en especial las cepas resistentes a la meticilina de la comunidad (SAMR-Co), Éste es considerado un antibiótico útil debido a su bajo costo, amplio espectro y posibilidad de administración por vía oral dada su adecuada biodisponibilidad y sabor agradable. Se realizó esta revisión narrativa de la literatura para evaluar el uso de TMP-SMX en comparación con otras opciones disponibles en el tratamiento de las infecciones por SAMR-Co en niños (AU)


Trimethoprim/sulfamethoxazole (TMP-SMX) has in vitro activity against Staphylococcus aureus, especially against community-acquired methicillin-resistant (CAMR) strains. It is considered to be a useful antibiotic because of its low cost, broad spectrum, and possibility of oral administration because of its adequate bioavailability and agreeable flavor. A review of the literature was performed to evaluate the use of TMP-SMX compared to available options for the treatment of CAMR infections in children (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Community-Acquired Infections , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/drug therapy , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
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