Coagulase-negative Strains Research Articles

Prevalence of Coagulase Negative Strains of Staphylococcus aureus in Clinical Specimens at the University of Benin Teaching Hospital, Benin City, Nigeria

The test for coagulase activity is a simple and non-expensive test for the identification of S. aureus strains from clinical samples in resource-poor settings. The results of these tests have been reported to vary with the source of plasma and with some atypical strains that test negative with the coagulase test. The study was carried out to determine if misidentification of strains of S. aureus exists on account of the reliance on the coagulase tests. Clinical isolates of Staphylococci that tested negative by the coagulase tests from wounds, pus, aspirates, blood cultures and urogenital samples were collected and re-tested by the slide and tube coagulase tests and confirmed to be negative. Each isolate was inoculated onto mannitol sat agar and DNAse agar plates and incubated at 37oC for 18 h. Isolates that fermented mannitol and showed a positive DNAse test were 25/366 (6.8%). The highest number of coagulase-negative Staphylococcus aureus (CNSA) occurred within blood culture samples 25.7% and in wound, pus and aspirates, 6.9% and the least proportion, 2.9% from urogenital samples. The generation of CNSA strains is strongly associated with severely-ill patients and the potential for the administration of cell-wall inhibiting antibacterial agents may have important roles to play in the emergence CNSA. The inclusion of DNAse test in the routine identification of staphylococci is advocated especially when an isolate has tested coagulase-negative.

ISOLATION, IDENTIFICATATION, AND DETERMINATION OF THE ANTIBIOTIC SUSCEPTIBILITY PATTERN OF BACTERIA ASSOCIATED WITH DIABETIC FOOT ULCER

Objective: This study involved isolating, identifying, and determining the susceptibility patterns of bacteria from diabetic patients who were hospitalized for diabetic foot ulcers. Methods: The specimen was collected using a deep swabbing approach from the feet of forty hospitalized patients with diabetes. The two sample swabs were delivered to the microbiology laboratory as soon as they were collected. One swab was used for microscopic examinations, and the other was utilized for culture. Three aseptically prepared agars – chocolate, MacConkey, and sheep blood were used for culture. In accordance with accepted clinical standards, the pathogens were identified. By performing the Kirby–Bauer disc diffusion method on Mueller–Hinton Agar medium, the isolates’ antibiotic sensitivity patterns were examined. Results: Twenty-five patients had microorganisms in their foot ulcers, whereas 15 patients had sterile samples (no pathological growth). Gram-negative (10) and positive (15) bacteria were recovered, with some patients having both types. Pseudomonas aeruginosa (32%), Klebsiella species (8%), and methicillin-resistant (10), sensitive (2), and coagulase-negative (3) strains of Staphylococcus aureus were identified. Conclusion: Imipenem was the antibiotic most sensitive to almost all of the isolates, whereas Penicillin G had more resistance to all of the isolates, and the other antibiotics had more variation. Our findings lead us to recommend that patients with diabetes be empirically given imipenem.

Staphylococcus brunensis sp. nov. isolated from human clinical specimens with a staphylococcal cassette chromosome-related genomic island outside of the rlmH gene bearing the ccrDE recombinase gene complex.

Novel species of coagulase-negative staphylococci, which could serve as reservoirs of virulence and antimicrobial resistance factors for opportunistic pathogens from the genus Staphylococcus, are recognized in human and animal specimens due to advances in diagnostic techniques. Here, we used whole-genome sequencing, extensive biotyping, MALDI-TOF mass spectrometry, and chemotaxonomy to characterize five coagulase-negative strains from the Staphylococcus haemolyticus phylogenetic clade obtained from human ear swabs, wounds, and bile. Based on the results of polyphasic taxonomy, we propose the species Staphylococcus brunensis sp. nov. (type strain NRL/St 16/872T = CCM 9024T = LMG 31872T = DSM 111349T). The genomic analysis revealed numerous variable genomic elements, including staphylococcal cassette chromosome (SCC), prophages, plasmids, and a unique 18.8 kb-long genomic island SbCIccrDE integrated into the ribosomal protein L7 serine acetyltransferase gene rimL. SbCIccrDE has a cassette chromosome recombinase (ccr) gene complex with a typical structure found in SCCs. Based on nucleotide and amino acid identity to other known ccr genes and the distinct integration site that differs from the canonical methyltransferase gene rlmH exploited by SCCs, we classified the ccr genes as novel variants, ccrDE. The comparative genomic analysis of SbCIccrDE with related islands shows that they can accumulate virulence and antimicrobial resistance factors creating novel resistance elements, which reflects the evolution of SCC. The spread of these resistance islands into established pathogens such as Staphylococcus aureus would pose a great threat to the healthcare system. IMPORTANCE The coagulase-negative staphylococci are important opportunistic human pathogens, which cause bloodstream and foreign body infections, mainly in immunocompromised patients. The mobile elements, primarily the staphylococcal cassette chromosome mec, which confers resistance to methicillin, are the key to the successful dissemination of staphylococci into healthcare and community settings. Here, we present a novel species of the Staphylococcus genus isolated from human clinical material. The detailed analysis of its genome revealed a previously undescribed genomic island, which is closely related to the staphylococcal cassette chromosome and has the potential to accumulate and spread virulence and resistance determinants. The island harbors a set of conserved genes required for its mobilization, which we recognized as novel cassette chromosome recombinase genes ccrDE. Similar islands were revealed not only in the genomes of coagulase-negative staphylococci but also in S. aureus. The comparative genomic study contributes substantially to the understanding of the evolution and pathogenesis of staphylococci.

Staphylococcus aureus coa gene sequence analysis can prevent misidentification of coagulase-negative strains and contribute to their control in dairy cow herds.

Accurate and precise differentiation of staphylococci isolated from milk is of importance for udder health management. In particular, the rapid and specific identification of Staphylococcus aureus plays an essential role in the prevention and treatment programs for bovine mastitis. Plasma gelatinization in coagulase assays is routinely used to discriminate S. aureus from other species by detecting the presence of extracellular free staphylocoagulase. However, rarely occurring coagulase-deficient S. aureus strains can be responsible for clinical and subclinical mastitis cases. By investigating S. aureus isolates from a single herd over a 10-year period we identified the persistence of a phenotypically coagulase-negative S. aureus strain and pinpointed the possible cause to a single base pair deletion in the coa gene sequence. Our results support the need to integrate primary biochemical tests with molecular/sequence analysis approaches for correctly identifying and discriminating atypical S. aureus in bovine herds, as the coagulase test alone may fail to detect persistent mastitis-causing strains.

Detection of Malaria Parasites in Different Age and Gender Groups Using a Light Microscopy

Introduction: The most frequent pathogens responsible for renal failure in hospitalised patients are Staphylococcus species, particularly in those receiving hemodialysis. The aim was to isolate and identified the Staphylococcus species from hemodialysis patients. Methodology: The research was carried out between November 2021 and February 2022. This study included participants who were receiving maintenance hemodialysis for end-stage renal illness. Each patient's demographic information was gathered using a structured questionnaire that had been evaluated beforehand. Blood samples from both sexes were taken (28 males and 22 females). The blood samples were sent directly to the research lab for processing after being inoculated into the Brain Heart Infusion broth under aseptic circumstances. Gram stain and biochemical assays were used to determine the bacteria's identity. Result :Overall, there were 44 percent female patients and 56 percent male patients. Out of all the blood samples analyse, 26% of samples showed evidence of bacterial development in the Brain Heart Infusion broth. S. aureus species (62 percent), S. epidermidis (15 percent), and S. saprophyticus were the Staphylococcus species that were detected 23 percent). Conclusion According to the findings, coagulase-positive Staphylococci were the most often isolated species from hemodialysis patients who had bacteremia, but coagulase-negative strains were identified far less frequently. The findings of the current study need to be confirmed by more research. Keywords: S. aureus, Kidney Failure, Hemodialysis, Femoral Double Lumen Catheter

Frequency of Staphylococcus Aureus Infection Associated with Femoral Double Lumen Catheter in Kidney Failure Patients

Introduction: The most frequent pathogens responsible for renal failure in hospitalised patients are Staphylococcus species, particularly in those receiving hemodialysis. The aim was to isolate and identified the Staphylococcus species from hemodialysis patients. Methodology: The research was carried out between November 2021 and February 2022. This study included participants who were receiving maintenance hemodialysis for end-stage renal illness. Each patient's demographic information was gathered using a structured questionnaire that had been evaluated beforehand. Blood samples from both sexes were taken (28 males and 22 females). The blood samples were sent directly to the research lab for processing after being inoculated into the Brain Heart Infusion broth under aseptic circumstances. Gram stain and biochemical assays were used to determine the bacteria's identity. Result :Overall, there were 44 percent female patients and 56 percent male patients. Out of all the blood samples analyse, 26% of samples showed evidence of bacterial development in the Brain Heart Infusion broth. S. aureus species (62 percent), S. epidermidis (15 percent), and S. saprophyticus were the Staphylococcus species that were detected 23 percent). Conclusion According to the findings, coagulase-positive Staphylococci were the most often isolated species from hemodialysis patients who had bacteremia, but coagulase-negative strains were identified far less frequently. The findings of the current study need to be confirmed by more research. Keywords: S. aureus, Kidney Failure, Hemodialysis, Femoral Double Lumen Catheter

Occurrence of bacteria belonging to the genus Enterococcus and Staphylococcus on inanimate surfaces of selected hospital facilities and their nosocomial significance.

This work aimed to determine the representation and resistance of bacteria belonging to the genus Staphylococcus and Enterococcus on inanimate surfaces of two selected workplaces of the University Hospital of L. Pasteur in Košice (UHLP) and to investigate their importance in the hospital environment. The men's ward of the Department of Internal Medicine (DIM) and the Department of Anaesthesiology and Intensive Care (DAIC) were chosen. Using sterile sampling kits, a total of 182 swabs were collected from the inanimate surfaces of both UHLP workplaces. The swabs were then transported to a microbiological laboratory and inoculated onto sterile culture media (blood agar containing 5% ram erythrocytes). After culturing (24-48 hours, in a thermostat at constant temperature 37 °C), bacterial colonies were identified by mass spectrometry on a MALDI TOF MS. Bacteria belonging to the genera Staphylococcus and Enterococcus were subsequently separated from the spectrum of identified bacteria. Nosocomial significant strains of staphylococci (Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus aureus) and all isolated enterococci were subjected to susceptibility testing for selected antibiotics using the disk diffusion method - E-tests. Several members of the genus Staphylococcus were identified from the inanimate surfaces of both workplaces. These were mainly coagulase-negative strains - Staphylococcus epidermidis (45), Staphylococcus capitis (34), Staphylococcus haemolyticus (20), Staphylococcus hominis (45), Staphylococcus pasteuri (2), Staphylococcus sroph (1), Staphylococcus simulans (3), and Staphylococcus warneri (4). Staphylococcus aureus strains were also identified (2). Nosocomial significant isolates were tested for susceptibility to the antibiotics cefoxitin (FOX) and oxacillin (OXA). Two members of the genus Enterococcus - Enterococcus faecium (7) and Enterococcus faecalis (8) were isolated. All strains were subject to vancomycin susceptibility testing using the disk method.

Dynamics of resistance to antibiotics in nosocomial staphylococci from multidisciplinary hospital

Background. Staphylococci are still the leading causative agents of infections associated with healthcare, and the study of their antibiotic resistance is still relevant.
 Aim. The research is aimed at study of antibiotic resistance of hospital strains of staphylococci in dynamics.
 Materials and methods. Susceptibility to 16 antimicrobial agents was studied in 554 Staphylococcus strains, isolated from patients in a multidisciplinary medical centre. The method of serial microdilutions was used.
 Results. Antibiotic-resistant strains prevailed (85.4%). Methicillin-resistance and multy-resistance were found to be more typical for coagulase-negative strains 75.2% and 74.1% respectively, than for Staphylococcus aureus 14.2% and 15.4% respectively. Methicillin-resistance and poly-resistance in S. aureus was found to decrease it was 11.1% and 12.8% in 20152016 (17.1% and 17.9% respectively in 20112012). On the contrary, methicillin-resistance in coagulase-negative staphylococci strains during the same period increased 1.5 times. Totally, methicillin-resistant strains composed a half of the isolates 48.7%. The studied Staphylococcus strains were susceptible to vancomycin, daptomycin, tigecycline. Resistance to linezolid and amikacin was 2.2% and 2.7% respectively. S. aureus strains were all susceptible to linezolid, fusidic acid, rifampicin, trimethoprim-sulfamethoxazole. Minimum inhibitory concentrations (MIC) of antibiotics for staphylococci varied in wide ranges from 0.06 to 128 mg/l. For S. aureus and S. epidermidis, the MIC50 and MIC90 of only five drugs (benzylpenicillin, tigecycline, vancomycin, linezolid, and daptomycin) were the same, while the MIC50 and MIC90 of most of the other studied drugs against S. epidermidis were significantly higher compared to S. aureus.
 Conclusion. The variability of resistance of staphylococci to antimicrobial drugs in a multidisciplinary hospital confirms the need for continuous monitoring of their antibiotic resistance.

Diversity and Distribution of Staphylococcal Chromosomal Cassettes Mec (SCCmec) Types I, II and III in Coagulase-Negative Staphylococcal Strains Isolated from Surfaces and Medico-Technical Materials of the University Hospital of Abomey-Calavi/Sô-Ava

Diversity and Distribution of Staphylococcal Chromosomal Cassettes Mec (SCCmec) Types I, II and III in Coagulase-Negative Staphylococcal Strains Isolated from Surfaces and Medico-Technical Materials of the University Hospital of Abomey-Calavi/Sô-Ava

Main laboratory methods used for the isolation and identification of Staphylococcus spp.

Introduction: Laboratory diagnosis related to clinical microbiology is highly complex, due to subjectivity when interpreting the results. Among bacterial pathogens, those linked to the Staphylococcus genus are relevant from a clinical and epidemiological point of view. Aim: To review the literature relative to the main laboratory methods used for the isolation and identification of microorganisms of the genus Staphylococcus. Methodology: The study was based on a literature search between 2000 and 2020, in the BVS, PubMed, Scielo, ScienceDirect and CAPES Periodical databases. Regarding its laboratory diagnosis, microscopy is used by the Gram method to verify the bacterium’s morphology; novobiocin test, aiming to trace coagulase negative strains; use of biochemical tests, such as coagulase and catalase tests; identification through the use of selective and nonspecific culture media, such as blood agar (in which the hemolytic patterns of pathogens are observed), salty mannitol agar (specific to the species of Staphylococcus aureus) and DNAse agar (selective to S. aureus strains , S. intermedius and S. hyicus). Results: The Staphylococcus genus is of great clinical importance in the field of public health. Thus, the quality and speed of diagnosis are essential to promote measures to combat these pathogens, contributing to the well-being and survival of those affected.

Detection of mecA gene and drug-resistance analysis

Objective To determine whether coagulase-negative non-epidermal staphylococcus is methicillin-resistant coagulase-negative staphylococcus by mecA gene test, when the minimal inhibitory concentration(MIC)of oxacillin is between 0.5-2.0 mg/L. Methods The mecA gene was detected and analyzed by the cefoxitin disk diffusion, E-test, VITEK-2 Compact and polymerase chain reaction(PCR)purification. Results A total of 300 strains of coagulase-negative staphylococci were screened from 4032 patients(7.4%), of which 45 strains of Staphylococcus saprophyticus and 80 strains of Staphylococcus hemolyticus were identified by Compact VITEK-2.There was a statistically significant difference in the positive rate of mecA gene detection between Staphylococcus saprophyticus and Staphylococcus hemolyticus(P<0.05). The results of detection of cefoxitin disk diffusion(inhibitory zone diameter ≥25 mm), E-test(MIC of oxacillin between 0.5-2.0 mg/L)and Compact VITEK-2(MIC of oxacillin between 0.5-2.0 mg/L)showed that there were 81 strains of coagulase-negative non-Staphylococci, of which 10 strains with positive mecA gene were confirmed by PCR. Conclusions When the minimal inhibitory concentration(MIC)of oxacillin against coagulase-negative non-Staphylococci stains is between 0.5-2.0 mg/L, the guidelines of the American clinical laboratory standardization institute(CLSI)should be strictly implemented in clinical microbiology laboratory and the mecA gene must be tested.Based on the wide dissemination of the mecA gene in Staphylococcus aureus population, if the mecA gene test is negative, it is reported as methicillin-susceptible coagulase-negative Staphylococcus(MSCNS), and the reverse result is reported as methicillin-resistant coagulase-negative staphylococcus(MRCNS). Key words: Coagulase; Methicillin resistant; Staphylococcus; mecA gene

Diversity of Staphylococcus coagulase- positive and negative strains of coalho cheese and detection of enterotoxin encoding genes

Three hundred samples of coalho cheese, from 15 different brands, of which seven were handmade made and eight industrialized, were evaluated in relation to the contamination profile by Staphylococcus coagulase-positive and negative and the occurrence of staphylococcal enterotoxin encoding genes. Two hundred and eight isolates of Staphylococcus sp. were subjected to phenotypic identification and 95 were subjected to genotypic identification through femA gene research and detection of genes (sea, seb, sec, sed, see, seg, seh, sei and sej) encoding enterotoxins, using the polymerase chain reaction technique (PCR). A total of 14 species of Staphylococcus were identified, of which three were coagulase-positive and eleven negative, especially: S. aureus, S. xylosus, S. cohnni spp. cohnii, S. saprophyticus, S. epidermidis, S. hyicus, S. lentus, S. sciuri, S. cohnii spp. urealyticus, S. haemolyticus, S. chromogenes, S. lugdunensis, S. hominis e S. intermedius. In all the samples of handmade coalho cheese handmade there was a prevalence of S. aureus; while in the industrial samples S. xylosus (87.5%) and S. cohnii spp cohnii (50%) were predominant. The presence of the femA gene was detected in 95% (38/40) isolates of positive Staphylococcus coagulase and 16.4% (9/55) of coagulase-negative isolates. Among the enterotoxin encoding genes evaluated, there was prevalence of the seh gene (53.2%) in coagulase-positive strains and of the sec gene (46.8%) in coagulase-negative strains. The results suggest a re-evaluation of the Brazilian microbiological standards in relation to the genus Staphylococcus in foods.

Slime-producing staphylococci as causal agents of subclinical mastitis in sheep

Hitherto, research work in slime production from staphylococcal strains of mastitis origin has focused in laboratory properties of these organisms. Objective of present work was to study subclinical mastitis in sheep, caused specifically by slime-producing staphylococci: to investigate its frequency and to identify potential factors playing a role therein. Slime production was evaluated in 708 staphylococcal isolates recovered from cases of subclinical mastitis in a field study in 2198 ewes performed in an extensive countrywide field investigation across Greece. Isolates were studied by means of microbiological and molecular methods. Of these strains, 262 were characterised as slime-producing, 227 as weak slime-producing and 219 as non slime-producing. Most frequently detected genes were eno and icaB; Staphylococcus aureus possessed more genes than coagulase-negative strains; greater number of genes was detected in slime-producing than in weak slime-producing or non-slime-producing strains. Subclinical mastitis caused specifically by slime-producing staphylococci was detected in 337 ewes: prevalence in population sampled was 0.153. A multivariable mixed-effects model revealed that milking mode (highest prevalence in hand-milked flocks) and flock management system (highest prevalence in semi-intensive flocks) were the two factors associated with increased prevalence of mastitis in flocks. The results confirmed the significance of slime producing staphylococcal strains of importance in the aetiology of subclinical mastitis of sheep. Hand-milking was identified as the most important factor predisposing to that infection.

Biopsy-proven vancomycin-induced acute kidney injury: a case report and literature review

BackgroundVancomycin is the first-line antibiotic for methicillin-resistant Staphylococcus aureus and coagulase-negative strains. The risk of vancomycin-induced acute kidney injury increases with plasma vancomycin levels. Vancomycin-induced acute kidney injury is histologically characterized by acute interstitial nephritis and/or acute tubular necrosis. However, only 12 biopsy-proven cases of vancomycin-induced acute kidney injury have been reported so far, as renal biopsy is rarely performed for such cases. Current recommendations for the prevention or treatment of vancomycin-induced acute kidney injury are drug monitoring of plasma vancomycin levels using trough level and drug withdrawal. Oral prednisone and high-flux haemodialysis have led to the successful recovery of renal function in some biopsy-proven cases.Case presentationWe present the case of a 41-year-old man with type 1 diabetes mellitus, who developed vancomycin-induced acute kidney injury during treatment for Fournier gangrene. His serum creatinine level increased to 1020.1 μmol/L from a baseline of 79.6 μmol/L, and his plasma trough level of vancomycin peaked at 80.48 μg/mL. Vancomycin discontinuation and frequent haemodialysis with high-flux membrane were immediately performed following diagnosis. Renal biopsy showed acute tubular necrosis and focal acute interstitial nephritis, mainly in the medullary rays (medullary ray injury). There was no sign of glomerulonephritis, but mild diabetic changes were detected. He was discharged without continuing haemodialysis (serum creatinine level, 145.0 μmol/L) 49 days after initial vancomycin administration.ConclusionsThis case suggests that frequent haemodialysis and renal biopsy could be useful for the treatment and assessment of vancomycin-induced acute kidney injury, particularly in high-risk cases or patients with other renal disorders.

Research on the Phenotypic Characterization of Mrsa Strains Isolated from Animals

Keywords: chromogen, methicillin, MRSA, resistanceIntroduction: Currently, both in staphylococci isolated from animals with different diseases, as well as in humans, the MRSA strains (Methicillin Resistant S. aureus) are monitored, as the methicillin resistance is associated with the resistance to other antibiotic groups.Methicillin resistance is encoded by mec staphylococcal chromosomal cassettes (SCCmec), which are islands of resistance. These strains can be identified by molecular biology tests and tests that reveal several phenotypic characteristics.The research was made in order to characterize and identify phenotypically the MRSA staphylococci strains isolated from animals.Materials and Methods: Researches were made on 240 coagulase positive and coagulase negative strains of staphylococci. Mannitol fermentation was tested on Champan medium, free coagulase was revealed on Baird-Parker medium and to identify S. aureus subsp. aureus was used the chromogenic medium Chromatic Staph.Methicillin-resistant strains were detected by disc diffusion method, using biodiscs with methicillin, oxacillin and cefoxitin. Also, to identify the MRSA strains, was used the chromogenic medium Chromatic MRSA.Results: The isolates were positive to mannitol and produced complete haemolysis or were unhaemolytic. A total of 44 strains produced free coagulase on Baird-Parker medium, considered coagulase positive strains, while 196 were coagulase negative strains.The isolates conducted differently to methicillin: 22,08% of strains were resistant, 51,25% of strains were susceptible and 26,66% had intermediate resistance, while the resistant strains to oxacillin were 42,91%.The increased frequency of methicillin-resistant strains of staphylococci and, particularly, MRSA strains, determined using the cefoxitin disk diffusion test, which is more reliable than methicillin and oxacillin.On the MRSA chromogenic medium, the methicillin-resistant strains of staphylococci formed colonies with pigment from mauve to orange mauve.Conclusion: The obtained results by disk diffusion test on resistance patterns to 3 beta-lactams, resistant to penicillinase, indicated a different frequency of the resistant strains to these antibiotics.Cefoxitin disk diffusion test revealed a frequency of 2,51% of resistant strains, that can be considered MRSA strains.

The micro-ecology of burn hospitals.

The article analyzes agents of wound burn infection on departments of the Privolzhskii` Federal medical research center during last 2.5 years. The leading role in infection etiology in the burnt ones belongs to staphylococci. At that, in adult patients more frequently S.aureus is separated and in children - coagulase-negative strains. During current year, the second place in the structure of wound burn infection factually is divided in equal proportions A. baumannii, P. aeruginosa and K. pneumoniae. About 80% of isolates of K. pneumoniae are produced by β-lactamase. No producers of metallo-β-lactamases were detected among Klebsiella. Annually, number of wound enterococci increases, making up to 15.3% in children and 11.1% in adults.

Methicillin-resistant Staphylococcus spp. isolated from curd cheese “requeijão” and “especialidade láctea type requeijão” sold in Brazil

ABSTRACT: This study focused on counting Staphylococcus spp. in curd cheeses “requeijão” and “especialidade láctea type requeijão” sold in Brazil, assessing the presence of mecA gene in obtained isolates and establishing antimicrobial resistance profile of the mecA gene positive isolates. To this, a set of 200 samples of these dairy products were evaluated. Low counts of Staphylococcus spp. were observed in these dairy products. All the isolates were determined as coagulase-negative strains using coagulase test and PCR. However, two isolates (3.70%) were carriers of mecA gene and they can be considered as risk for public health. These isolates presented resistance to penicillin, oxacillin and erythromycin. In conclusion, low counts of Staphylococcus were detected in curd cheese “requeijão” and “especialidade láctea type requeijão” sold in Brazil. However, coagulase-negative methicillin-resistant Staphylococcus spp. was detected in these dairy products. This is the first report of the detection of methicillin-resistant Staphylococcus spp. in heat-treated dairy products in Brazil. Results served as a warning to public sanitary authorities to control multidrug-resistant strains in veterinary and human medicine.

Perfil de sensibilidade de Staphylococcus spp. e Streptococcus spp. isolados de brinquedos de brinquedoteca de um hospital de ensino

ObjectiveTo evaluate the presence of microorganisms of the genus Staphylococcus and Streptococcus on toys in the playroom of a teaching hospital, as well to as analyze the antimicrobial from the isolated strains. MethodsSamples were collected from 60 toys, using wet swabs, soon after being used by the children. The samples were inoculated in enriched and selective agar for isolation and later identification of the microorganisms. Antibiogram testing was performed by agar diffusion technique. ResultsThe genus Staphylococcus was present in 87.0% (52/60) of the toys. Seventythree strains were isolated, with 29.0% (21/73) coagulase-positive and 71.0% (52/73) coagulase-negative. Among the coagulase-negative strains, 90.4% were resistant to penicillin, 65.4% to oxacillin, 28.8% to clarithromycin, 61.5% to clindamycin, and none to vancomycin. Among the coagulase-positive strains, 76.2% were resistant to penicillin, 23.8% to oxacillin, 23.8% to clarithromycin, 47.6% to clindamycin, and none to vancomycin. The genus Streptococcus was not detected in any of the evaluated toys. ConclusionsToys can be contaminated with potentially pathogenic bacteria with antimicrobial resistance, representing a possible source of nosocomial infection for patients who are already debilitated.

Sensitivity profile of Staphylococcus spp. and Streptococcus spp. isolated from toys used in a teaching hospital playroom

ObjectiveTo evaluate the presence of microorganisms of the genus Staphylococcus and Streptococcus on toys in the playroom of a teaching hospital, as well to as analyze the antimicrobial resistance from isolated strains. MethodsSamples were collected from 60 toys, using wet swabs, soon after being used by the children. The samples were inoculated in enriched and selective agar for isolation and later identification of the microorganisms. Antibiogram testing was performed by agar diffusion technique. ResultsThe genus Staphylococcus was present in 87.0% (52/60) of the toys. Seventy-three strains were isolated, with 29.0% (21/73) coagulase-positive and 71.0% (52/73) coagulase-negative. Among the coagulase-negative strains, 90.4% were resistant to penicillin, 65.4% to oxacillin, 28.8% to clarithromycin, 61.5% to clindamycin, and none to vancomycin. Among the coagulase-positive strains, 76.2% were resistant to penicillin, 23.8% to oxacillin, 23.8% to clarithromycin, 47.6% to clindamycin, and none to vancomycin. The genus Streptococcus was not detected in any of the evaluated toys. ConclusionsToys can be contaminated with potentially pathogenic bacteria with antimicrobial resistance, representing a possible source of nosocomial infection for patients who are already debilitated.

Etiological Factors of Infections in Diabetic Foot Syndrome – Attempt to Define Optimal Empirical Therapy

Diabetic foot syndrome (DFS) represents one of the most frequent reasons for lower limb amputation in developed countries. In most cases, it is associated with bacterial infection, requiring optimal antibiotic therapy. The aim of this study was to identify the most frequent pathogens responsible for infections associated with DFS, establish the optimal protocol of empirical therapy, and ascertain the clinical variables that may determine the choice of the appropriate antibacterial agent. The analysis included hospital records of patients treated at the Department between 2008 and 2010. A total of 102 individuals were identified; their material was cultured and tested for antibiotic susceptibility. A total of 199 bacterial strains were isolated. There was a predominance of Gram-positive bacteria, particularly Staphylococcus aureus, Staphylococcus coagulase-negative strains, and Enterococcus faecalis. Of note was the high percentage of E. faecalis infection (16.08%). One can speculate on the potential etiological factors in the case of some bacteria, e.g. patients infected with S. aureus were characterized by higher monocytosis and lymphocytosis as compared to other patients. Analysis of drug susceptibility revealed that ciprofloxacin has the highest (but still only 44%) efficacy of all agents tested as monotherapy, and a combination of piperacillin and tazobactam or amoxicillin and clavulanate with aminoglycosides is particularly beneficial. Staphylococcus spp. predominates amongst the etiological factors of DFS infection; however, the rate of E. faecalis infection is alarmingly high. Monotherapy enables effective treatment in a minority of cases; therefore, at least two-drug protocols should be implemented from the very beginning of the therapy.