Rapid containment of nosocomial transmission of a rare community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone, responsible for the Staphylococcal Scalded Skin Syndrome (SSSS).

BACKGROUND: The aims of this study were to identify the source and the transmission pathway for a Staphylococcal Scalded Skin Syndrome (SSSS) outbreak in a maternity setting in Italy over 2 months, during 2014; to implement appropriate control measures in order to prevent the epidemic spread within the maternity ward; and to identify the Methicillin-Resistant Staphylococcus aureus (MRSA) epidemic clone. METHODS: Epidemiological and microbiological investigations, based on phenotyping and genotyping methods, were performed. All neonates involved in the outbreak underwent clinical and microbiological investigations to detect the cause of illness. Parents and healthcare workers were screened for Staphylococcus aureus to identify asymptomatic carriers. RESULTS: The SSSS outbreak was due to the cross-transmission of a rare clone of ST5-CA-MRSA-SCCmecV-spa type t311, exfoliative toxin A-producer, isolated from three neonates, one mother (from her nose and from dermatological lesions due to pre-existing hand eczema) and from a nurse (colonized in her nose by this microorganism). The epidemiological and microbiological investigation confirmed these as two potential carriers. CONCLUSIONS: A rapid containment of these infections was obtained only after implementation of robust swabbing of mothers and healthcare workers. The use of molecular methodologies for typing was able to identify all carriers and to trace the transmission.

Severe invasive pulmonary zygomycosis by Rhizomucor pusillus and concomitant severe bacterial endocarditis in acute promyelocytic leukaemia.

We describe a severe pulmonary invasive zygomycosis sustained by Rhizomucor pusillus and concomitant bacterial endocarditis in a woman diagnosed with acute promyelocytic leukaemia.

Are E-test and Vitek2 good choices for tigecycline susceptibility testing when comparing broth microdilution for MDR and XDR Acinetobacter baumannii?

This study reports the results of antimicrobial susceptibility testing of 10 MDR and 74 XDR Acinetobacter bauman- nii clinical isolates from our hospital routine. We used three different methods: two automated systems (Sensititre and VITEK 2) and one standardized manual method (E-test). Since many published papers refer to in vitro tests performed by E-test, the aim of this study was to test if this method is reliable for testing tigecycline. The results obtained show that E-test significantly overestimates the MIC of the broth microdilution (reference test), thus ob- taining a significant number of major errors (resistant instead of sensitive). VITEK 2 also shows the same problem, but it is less critical. We therefore conclude that these methods do not seem to be very reliable in the performance of susceptibility testing of MDR and XDR Acinetobacter baumannii against tigecycline.

[Study on in-vitro susceptibility of ESBL-positive Escherichia coli isolated from urine specimens]. / Studio sulla sensibilità in vitro di ceppi di Escherichia coli ESBL-produttori isolati da campioni urinari.

Treatment of infections by beta-lactamase-producing microorganisms is very difficult. Our aim was to determine the in vitro susceptibility of 430 ESBL-positive Escherichia coli strains isolated from urinary tract infections. All the microorganisms were isolated in the Microbiology Unit at the Ospedale dell'Angelo in Mestre (Venice) between May 2008 and September 2009 and were confirmed by the double-disk test. All microorganisms were sensitive to imipenem and meropenem, 98.4% to tigecycline, 95.1% to amikacin, 89.3% to nitrofurantoin, 67.5% to gentamycin and 63.2% to piperacillin/tazobactam. Only 22.6% were sensitive to cotrimoxazole, while fluoroquinolone (norfloxacin and levofloxacin) activity was found to be very low (6%).