ABSTRACT
OBJECTIVES: Healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) is a common pathogen worldwide and its multidrug resistance is a major concern. This study aimed to determine the clinical characteristics and antibiotic susceptibility profile of healthcare-associated MRSA with emphasis on resistance to macrolide-lincosamide-streptogramin B (MLSB) phenotypes and vancomycin. METHODS: This cross-sectional study was carried out between February 2014 and February 2015 across four tertiary care hospitals in Mangalore, South India. Healthcare-associated infections among 291 inpatients at these hospitals were identified according to the Centers for Disease Control and Prevention guidelines. Clinical specimens were collected based on infection type. S. aureus and MRSA isolates were identified and antibiotic susceptibility tests performed using the Kirby-Bauer disk diffusion method. The minimum inhibitory concentration of vancomycin was determined using the Agar dilution method and inducible clindamycin resistance was detected with a double-disk diffusion test (D-test). RESULTS: Out of 291 healthcare-associated S. aureus cases, 88 were MRSA (30.2%). Of these, 54.6% were skin and soft tissue infections. All of the isolates were susceptible to teicoplanin and linezolid. Four MRSA isolates exhibited intermediate resistance to vancomycin (4.6%). Of the MRSA strains, 10 (11.4%) were constitutive MLSB phenotypes, 31 (35.2%) were inducible MLSB phenotypes and 14 (15.9%) were macrolide-streptogramin B phenotypes. CONCLUSION: Healthcare-associated MRSA multidrug resistance was alarmingly high. In routine antibiotic susceptibility testing, a D-test should always be performed if an isolate is resistant to erythromycin but susceptible to clindamycin. Determination of the minimum inhibitory concentration of vancomycin is necessary when treating patients with MRSA infections.
Subject(s)
Anti-Bacterial Agents/pharmacology , Community-Acquired Infections/microbiology , Drug Resistance, Multiple, Bacterial , Methicillin-Resistant Staphylococcus aureus/drug effects , Pyoderma/microbiology , Soft Tissue Infections/microbiology , Staphylococcal Skin Infections/microbiology , Adolescent , Adult , Carrier State/microbiology , Child , Clindamycin/pharmacology , Cross-Sectional Studies , Disk Diffusion Antimicrobial Tests , Female , Humans , Male , Nasal Cavity/microbiology , Young AdultABSTRACT
Enterobacter sakazakii is a rare but important cause of necrotizing enterocolitis, bloodstream infection and central nervous system infections in humans, with mortality rates of 40-80%. It has not been reported to cause urinary tract infection. We report a case of urinary tract infection due to E. sakazakii in a 63-year-old lady with chronic renal failure.
Subject(s)
Cronobacter sakazakii/isolation & purification , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/pathology , Renal Insufficiency/complications , Urinary Tract Infections/microbiology , Urinary Tract Infections/pathology , Enterobacteriaceae Infections/microbiology , Female , Humans , Middle AgedABSTRACT
In a randomized trial of 56 patients, topical application of garlic paste for 14 days was found to be as effective as that of clotrimazole solution in suppressing clinical signs of oral candidiasis. The results of this preliminary study explore the possible role of garlic paste in the treatment of oral candidiasis.
