Prevalence Of MRSA Research Articles

Prevalence and Antibiotic-Sensitivity of Methicillin-Resistant Staphylococcus aureus (MRSA) in Pyogenic Skin Affections of Animals and Human

MRSA infections commonly present as skin and soft tissue infections in man and animals. Treatment usually includes opening of abscess and drainage with or without antibiotic therapy. MRSA is usually resistant to certain antibiotics including methicillin, oxacillin, penicillin and ampicillin. Therefore, the aim of the present study was to investigate the prevalence of MRSA in man and animals with suppurative skin affections in Assiut Governorate and to test the phenotypic and genotypic antibiotic susceptibility of the isolated MRSA strains to the commonly-used antibiotics in Egyptian medical practices. MRSA were detected in 3.0% of tested sheep and goat, 27.3% of equines, 7.7% of cows and in 14.3% of tested humans in the same area. All animal and man MRSA strains were positive to erm(A), TetK and TetM genes, but erm(C) gene could only be detected in 80% of human MRSA isolates. human and animal MRSA isolates were resistant to penicillin and ampicillin antibiotics with MIC ranging from 8 to 128 µg/ml. Sheep and cow MRSA isolates were resistant to oxytetracycline, while equine isolates were sensitive to it. About 44.4% of human isolates were resistant to oxytetracycline. All animal-derived MRSA isolates were resistant to cefixime and more than of 55% of human isolates were also resistant to the same drug. All MRSA isolates were sensitive to clindamycin except for strains isolated from cows. Enerofloxacin and ciprofloxacin were the most effective antibiotics against all MRSA isolates. None of the 16 MRSA isolates had reduced susceptibility to vancomycin with MICs laying in the 0.5-4 µg/mL range. The similarity in phenotypic and genotypic antibiotic susceptibility of MRSA isolates recovered from both humans and animal cases, despite the difference in the frequently used antibiotics in veterinary and human hospitals, suggesting the possibility of zoonotic circulation of those isolates between them.

Prevalence of Methicillin-resistant Staphylococcus Aureus in Saudi Arabia Revisited: A Meta-analysis

Background:The dramatic increase in the prevalence of methicillin-resistantStaphylococcus aureusas a source of nosocomial and community-associated infections in Saudi Arabia has attracted the attention of many researchers and public health workers. Hence, the aim of this meta-analysis is to assess the extent of the problem in Saudi Arabia at large.Methodology:PubMed database was searched for articles about the prevalence of MRSA in Saudi Arabia, and the relevant data from all eligible studies were analyzed to assess the overall prevalence rate by ProMeta3.Results:Seven articles were included in this meta-analysis with the sample size of 8433 individual. The overall prevalence of MRSA was 38% (95% CI: 28 – 50). The prevalence of MRSA according to the region was 32% (95%CI: 21 – 46) for the central region and 42% (95% CI: 33 – 52) for the western region.Conclusion:The findings of this study indicate that the overall prevalence of MRSA in Saudi Arabia is relatively high, with the western region showing the highest prevalence rates, which necessitates the urgent implementation of preventive and educative strategies.

Prevalence of Methicillin Resistant Staphylococcus Aureus Among Food Handlers in Duhok City

Food handlers harbouring S. aureus on their noses or in hands are considered as the main source of food contamination. Antibiotic resistance in S. aureus is a serious issue. The study aimed to find out the prevalence of methicillin-resistant S. aureus among food handlers in restaurants of Duhok city. Nasal and hand swabs were taken from 200 food handlers. The collected swabs inoculated on mannitol salt agar and incubated at 37oC for 24-48h. Isolates identified as S. aureus underwent antimicrobial sensitivity testing to methicillin and vancomycin on Mueller Hinton agar. A total of 74 (37%) out of 200 cultures of food handlers were found to be colonized with S. aureus.53 (26.5%) isolated from the nose, compared with 8 (4.0%) from hands and 13 (6.5%) from both. 27% of the food handlers were found to be MRSA carrier, and none of the isolates were resistant to Vancomycin. The study revealed a high prevalence of MRSA among food handlers in Duhok city. Food handlers in public places are required to go through regular screening for both nasal and skin carriage of S. aureusfor the early detection and treatment of carriers. So as to protect the community from staphylococcal food poisoning and the spread of resistant S. aureus strains among the population.

Deteksi molekuler mecA pada isolat klinis methycilin resistant Staphylococcus aureus (MRSA) dengan menggunakan teknik polymerase chain reaction (PCR) di RSUP Sanglah Denpasar

Introduction: MRSA is a bacteria that has experienced resistance to antibiotics, which generally has a function in killing Staphylococcus aureus, for the example Methicillin. In the worldwide MRSA prevalence is increasing, while the factors that cause the increase of the prevalence of MRSA is increasing the length of time of treatment in hospital, the misuse of antibiotics and poor infection control in the hospital. Laboratory tests were good and accurate were needed to identify MRSA as soon as possible so as to enable to conduct appropriate infection control. The aim of this study was to determine that the PCR can be used to confirm MRSA isolates.Methods: This study used a cross sectional design on all isolated Staphylococcus aureus isolates from all clinical specimens examined at the Laboratory of Clinical Microbiology, Sanglah General Hospital, Denpasar from 2011 until 2012.Results: A total of 38 samples were used, 32 (84.2%) positive S. aureus confirmed mecA genes using PCR technique. However, there are still 15.8% who are misidentified, where the possibility of the bacteria is not MRSA or the retrieval technique from the bacteria itself when conducting the research.Conclusion: MecA gene examination using PCR method is an examination that can be used to detect MRSA bacteria.Â

Nasal Carriage Rate, Antimicrobial Susceptibility Pattern, and Associated Factors of Staphylococcus aureus with Special Emphasis on MRSA among Urban and Rural Elementary School Children in Gondar, Northwest Ethiopia: A Comparative Cross-Sectional Study.

Introduction Staphylococcus aureus is a Gram-positive, catalase-positive, and coagulase-positive bacterial species commonly found on the skin and in the nose of most healthy individuals. The anterior nares of nose are the most frequent carriage sites for S. aureus in both adults and children. Methicillin resistance among S. aureus isolates has steadily increased worldwide. Objective The main objective of this study was to determine nasal carriage rate, antimicrobial susceptibility pattern, and associated risk factors of Staphylococcus aureus with special emphasis on MRSA among urban and rural elementary school children in Gondar, Northwest Ethiopia. Method A community based comparative cross-sectional study was conducted on 622 urban and rural elementary school children in Gondar from January 1st to March 30th, 2018. Data was collected using a questionnaire and nasal swab samples were collected by sterile cotton tip swab moistened with sterile normal saline. Collected samples were inoculated on mannitol salt agar and incubated aerobically at 37°C for 24 hrs. S. aureus was confirmed by observing colony characteristics and biochemical tests. MRSA was detected using cefoxitin disc by Modified Kirby-Bauer disk diffusion technique. Finally data was entered, cleared, and checked using Epi-info version 7 and exported to SPSS version 20 for analysis. Odds ratio and logistic regression were used for statistical association. P-value ≤ 0.05 at 95% CI was considered for statistical association. Result Of the 622 school children, the overall prevalence of S. aureus was 143/622 (23%). Of them, 14/143 (9.79%) were MRSA. The carriage rate in urban schools was 83/622 (13.3%) whereas it was 60/622 (9.6%) in rural schools. The prevalence of MRSA among urban schools, 9.1%, was higher than their urban counterparts, 0.7%. Gentamycin, clindamycin, and ciprofloxacin were the most effective whereas penicillin and tetracycline were resistant. Children's fathers' educational status and number of children in class room were significantly associated with S. aureus but only living in urban of children significantly associated with MRSA. Conclusion This study showed high prevalence of S. aureus and MRSA, 143/622 (23%) and 14/143 (9.79%), respectively. So, decolonization of nasal carriers of MRSA and reducing the number of students per classroom should be addressed. Moreover, regular large scale survey should be conducted to assess the burden and intervene accordingly.

Antibiotic resistance is lower in Staphylococcus aureus isolated from antibiotic-free raw meat as compared to conventional raw meat.

The frequent use of antibiotics contributes to antibiotic resistance in bacteria, resulting in an increase in infections that are difficult to treat. Livestock are commonly administered antibiotics in their feed, but there is current interest in raising animals that are only administered antibiotics during active infections. Staphylococcus aureus (SA) is a common pathogen of both humans and livestock raised for human consumption. SA has achieved high levels of antibiotic resistance, but the origins and locations of resistance selection are poorly understood. We determined the prevalence of SA and MRSA in conventional and antibiotic-free (AF) meat products, and also measured rates of antibiotic resistance in these isolates. We isolated SA from raw conventional turkey, chicken, beef, and pork samples and also from AF chicken and turkey samples. We found that SA contamination was common, with an overall prevalence of 22.6% (range of 2.8–30.8%) in conventional meats and 13.0% (range of 12.5–13.2%) in AF poultry meats. MRSA was isolated from 15.7% of conventional raw meats (range of 2.8–20.4%) but not from AF-free meats. The degree of antibiotic resistance in conventional poultry products was significantly higher vs AF poultry products for a number of different antibiotics, and while multi-drug resistant strains were relatively common in conventional meats none were detected in AF meats. The use of antibiotics in livestock contributes to high levels of antibiotic resistance in SA found in meat products. Our results support the use of AF conditions for livestock in order to prevent antibiotic resistance development in SA.

159. Genomic Epidemiology of MRSA at Intake to a Large Inner-City Jail: Evidence for Community Transmission Networks?

BackgroundUSA300 is endemic in the community, with congregate settings potentially facilitating spread. The impact of community MRSA transmission networks on importation of MRSA into urban jails is unknown. We examined MRSA colonization isolates entering the jail and determined whether there are community transmission networks for MRSA that precede incarceration.MethodsHIV-infected and HIV-negative males incarcerated at the Cook County Jail were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, and groin) were collected to determine prevalence of MRSA colonization. A survey was administered to identify predictors of colonization. Whole-genome sequencing (WGS) and phylogenetic analysis were integrated with epidemiologic data to identify community transmission networks.ResultsA total of 800 males were enrolled (83% AA and 9% Hispanic); 58% were HIV-infected. The prevalence of MRSA colonization at intake was 19%. In multivariate analysis, methamphetamine use (METH), unstable housing, and prior jail incarceration were significant predictors of MRSA. Among HIV patients, injection drug use and HIV care at outpatient Clinic A that emphasize comprehensive care to the LGBTQ community were significant predictors of MRSA. Of the 31 (45%) patients with care at Clinic A, 14 had MRSA colonization. We sequenced 145 isolates from unique individuals, with 102 and 13 closely related to USA300 and USA500 reference genomes, respectively. USA300 strains from intake were diverse (median pairwise SNV distance = 109), with several small clusters noted. WGS revealed the high prevalence of MRSA in Clinic A was not due to clonal spread but rather an intermingling of distinct community transmission networks (strains were highly diverse; median pairwise SNV distance = 410). We did identify a 13-member community transmission network underlying spread of USA500 (figure). Members of this network were more likely to be HIV-infected (P < 0.004), MSM (P < 0.001), and METH (P < 0.001).ConclusionA high proportion of individuals enter jail already colonized with MRSA and colonization risk factors provide clues to community reservoirs for MRSA. WGS extended epidemiologic analysis and revealed community transmission networks that could be a potential focus for an intervention. Disclosures All authors: No reported disclosures.

1229. Prevalence and Acquisition of MRSA in Females During Incarceration at a Large Inner-City Jail

BackgroundUSA300 MRSA is endemic in the community, with congregate settings such as urban jails potentially facilitating spread. It has been reported previously that males have a higher risk for MRSA carriage and bacteremia than females. However, it is unclear if there is differential risk for MRSA based on gender in high-risk populations. We determined the prevalence of MRSA colonization at jail entrance in females and defined an acquisition rate during incarceration.MethodsFemales incarcerated at the Cook County Jail, one of the largest US single-site jails, were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine prevalence of MRSA colonization. A survey was administered to identify predictors of colonization. Detainees in jail at Day30 had cultures repeated to determine MRSA acquisition. Univariate and multivariate analyses were performed to identify predictors of MRSA colonization.Results250 women were enrolled (70% AA, 15% Hispanic) with 70% previously in jail (21% in the past 6 months). The prevalence of MRSA colonization at intake was 20% (50/250), with 42% of those colonized solely in the throat or groin. This intake prevalence is comparable to the 19% for male detainees in a parallel study. 9% (2/23) of initially negative women who remained in jail for 30 days acquired MRSA; five remained colonized and no one lost colonization. Univariate predictors (table) of MRSA at entrance to the jail were: illicit drug use (including using needles), unstable housing, engaging in anal sex, and recent exchange of sex for drugs/money. Women who exchange sex for drugs/money (vs. not) reported higher rates of needle use (35% vs. 4%, P < 0.001) and unstable housing (80% vs. 20%, P < 0.001). With multivariate adjustment for race/ethnicity, needles for illicit drugs was a significant predictor of MRSA (OR 5.89, 95% CI, 1.66, 20.94, P = 0.006).ConclusionWe found that a high proportion (20%) of females entered jail colonized with MRSA, comparable to rates in males, suggesting that previously reported gender disparities in MRSA may not exist in high-risk populations. Entrance colonization risk factors suggest high-risk activities or venues in the community, with potential for directing gender-specific interventions. Disclosures All authors: No reported disclosures.

Biology and management of methicillin resistant Staphylococcus aureus in cystic fibrosis.

Staphylococcus aureus is one of the earliest bacteria isolated from the respiratory tract in people with cystic fibrosis (CF). Its methicillin resistant form, MRSA, has gained attention due to the rapid increase in the last decades and worse outcomes with chronic infection. In the United States, prevalence of MRSA in CF is around 27%, but is much lower (3-18%) in most other countries. Methicillin is typically genetically encoded by the mecA gene, which encodes for an alternative penicillin binding protein (PRBa). This PRBa has low affinity to β-lactams, thereby enabling growth of S. aureus in the presence of penicillinase resistant penicillins and most other β-lactams. Non-mecA positive strains of MRSA, so-called borderline resistant (BORSA) have also been described. In addition to production of toxins, the virulence of S. aureus is conferred by its adaptability allowing persistence in face of antibiotic therapies and host defense. These adaptive growth mechanisms include small colony variants, biofilms, and growth under anaerobic conditions. Several reports have described successful eradication of MRSA, yet only two randomized trials of eradication during early infection have been conducted. A list of MRSA specific antibiotics with dosing relevant to CF patients is presented here. Many of these require special dosing in people with CF. Novel antibiotics are in trials for skin and soft tissue infections and it is unclear if and when those might be available for lung infections. Thus the best strategies for MRSA would be primary prevention.

Characterization of pathogens isolated from cutaneous abscesses in patients evaluated by the dermatology service at an emergency department

Objective: Emergency department (ED) visits for the treatment of skin abscesses have increased with the emergence of community-associated methicillin-resistant Staphylococcus aureus (CAMRSA). There is limited information about the bacteriology of cutaneous abscesses evaluated in ED in Puerto Rico. The purpose of our study was to characterize the pathogens cultured from abscesses of patients in the ED consulted to the Dermatology Service of University of Puerto Rico School of Medicine. Methods: Patients with skin abscesses consulted to the Dermatology Service by the ED of P.R. Medical Center from 2012 to 2017 were included. Data retrieved included demographic information, past medical history, prior antibiotic use, distribution of lesions, and treatment provided. Bacteriology results and antimicrobial susceptibility patterns from cultured skin lesions were recorded. Results: Ninety patients diagnosed with skin abscess were evaluated. All patients underwent incision and drainage; this was the sole treatment in two patients. The most frequently administered systemic therapy was oral clindamycin in 32 patients (36%). A total of 66 patients (73%) had S. aureus isolates, most of them (85%) MRSA. Among the isolates with MRSA, 14.3% were resistant to clindamycin. All MRSA strains were susceptible to tetracycline and vancomycin. Conclusion: There is a high prevalence of MRSA causing abscesses in the Hispanic population evaluated in an ED in Puerto Rico. Systemic antibiotic use for the treatment of skin abscesses after incision and drainage remains high despite published guidelines arguing against their widespread use. Clindamycin resistance in our patient population appears to be more frequent than previously reported.

Mechanistic modelling of interventions against spread of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) within a Danish farrow-to-finish pig herd.

Knowledge on successful interventions against livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) within pig herds is sparse. In situations like this, a mechanistic simulation model can be a valuable tool for assessing the effect of potential intervention strategies, and prioritising which should be tested in the field. We have simulated on-farm interventions in a farrow-to-finish pig herd, with a previously published LA-MRSA spread model, within four different areas: 1) Reduced antimicrobial consumption, 2) Reduced number of pigs within each section, 3) Reduced mixing of pigs, and 4) Improved internal biosecurity. To model a decrease in the selective pressure, the transmission rates were reduced after LA-MRSA had become fully established within a herd, which resulted in a marked decrease in the prevalence within all stable units. However, LA-MRSA rarely disappeared completely from the herd; this was only observed in scenarios where the transmission rates were reduced to ≤ 30% of the original level. While changes in antimicrobial consumption patterns might be a very important step towards reducing the spread of LA-MRSA, the simulation results indicate that it may need to be paired with other preventive or intervention measures. Reducing the number of pigs within each section, reducing mixing of pigs, or improving internal biosecurity after LA-MRSA had become established within the herd only resulted in marginal changes in the median prevalence within the herd. However, these factors might be important in relation to being able to achieve or maintain a low level of antimicrobial consumption, and thus still indirectly influence the LA-MRSA prevalence within the herd. The results of a sensitivity analysis indicated the assumptions regarding the existence of pigs persistently shedding MRSA have a noticeable influence on the model results. The assumptions regarding transmission from sow to offspring at the day of birth also had a considerable influence on the MRSA prevalence within the farrowing unit but did not cause any marked changes in the simulated effect of interventions. Effects might differ between different farm types contaminated in different levels and this simulation study highlights a strong need for more knowledge from on-farm trials.

Trends in antibiotic resistance patterns of methicillin resistant and methicillin sensitive Staphylococcus aureus in Khwaja Yunus Ali Medical College Hospital

Background: Antimicrobial resistance in pathogens is a growing concern for health. It is a great concern around the globe about the threat of increasing antimicrobial resistance. In response to this concerns, medical experts have proposed initiatives to curtail the spread of antimicrobial resistance in pathogenic bacteria. We have taken this surveillance study in KYAMCH to contain the spread of antimicrobial resistance.Objectives: To determine the prevalence of MRSA from different clinical samples and to record its current status to commonly used anti Staphylococcus antibiotics.Methods: The clinical samples were taken to the laboratory and within four hours cultured for isolates and identification pathogens. Finally, antibiotic sensitivity testing of the isolated Staphylococcus aureus was performed. Results: More than 80% of MRSA isolates were resistant to ampicillin (98%) followed by amoxicillin, cefixime and azithromycin with 94%, 93.5% and 85% respectively and maximum sensitivity toward tobramycin with 86% followed by 85% gentamicin and 79% meropenem.Conclusion: The detected trend in antibiotic resistance patterns of methicillin-resistant and methicillin-sensitive Staphylococcus aureus in this study is alarming. This has created a huge clinical burden in the hospital settings as well as in the community.KYAMC Journal Vol. 9, No.-1, April 2018, Page 6-10

A systematic review of transmission dynamic studies of methicillin-resistant Staphylococcus aureus in non-hospital residential facilities

BackgroundNon-hospital residential facilities are important reservoirs for MRSA transmission. However, conclusions and public health implications drawn from the many mathematical models depicting nosocomial MRSA transmission may not be applicable to these settings. Therefore, we reviewed the MRSA transmission dynamics studies in defined non-hospital residential facilities to: (1) provide an overview of basic epidemiology which has been addressed; (2) identify future research direction; and (3) improve future model implementation.MethodsA review was conducted by searching related keywords in PUBMED without time restriction as well as internet searches via Google search engine. We included only articles describing the epidemiological transmission pathways of MRSA/community-associated MRSA within and between defined non-hospital residential settings.ResultsAmong the 10 included articles, nursing homes (NHs) and correctional facilities (CFs) were two settings considered most frequently. Importation of colonized residents was a plausible reason for MRSA outbreaks in NHs, where MRSA was endemic without strict infection control interventions. The importance of NHs over hospitals in increasing nosocomial MRSA prevalence was highlighted. Suggested interventions in NHs included: appropriate staffing level, screening and decolonizing, and hand hygiene. On the other hand, the small population amongst inmates in CFs has no effect on MRSA community transmission. Included models ranged from system-level compartmental models to agent-based models. There was no consensus over the course of disease progression in these models, which were mainly featured with NH residents /CF inmates/ hospital patients as transmission pathways. Some parameters used by these models were outdated or unfit.ConclusionsImportance of NHs has been highlighted from these current studies addressing scattered aspects of MRSA epidemiology. However, the wide variety of non-hospital residential settings suggest that more work is needed before robust conclusions can be drawn. Learning from existing work for hospitals, we identified critical future research direction in this area from infection control, ecological and economic perspectives. From current model deficiencies, we suggest more transmission pathways be specified to depict MRSA transmission, and further empirical studies be stressed to support evidence-based mathematical models of MRSA in non-hospital facilities. Future models should be ready to cope with the aging population structure.

Effect of an intervention targeting inappropriate continued empirical parenteral vancomycin use: a quasi-experimental study in a region of high MRSA prevalence

BackgroundDespite vancomycin use is a major risk factor for the emergence of vancomycin resistance, it is frequently inappropriately prescribed, especially as empirical treatment. We evaluated the effect of an antimicrobial stewardship intervention targeting for inappropriate continued empirical vancomycin use.MethodsThis was a quasi-experimental study comparing vancomycin use in a 6-month pre-intervention and 6-month intervention period. If empirical vancomycin was continued for more than 96 h without documentation of beta-lactam-resistant gram-positive microorganisms, it was considered inappropriate continued empirical vancomycin use. The intervention consisted of the monitoring of appropriateness by a pharmacist and direct discussion with the prescribing physicians by infectious disease specialists when empirical vancomycin was continued inappropriately. An interrupted time series analysis was used to compare vancomycin use before and during the intervention.ResultsFollowing implementation of the intervention, overall vancomycin consumption decreased by 14.6%, from 37.6 defined daily doses (DDDs)/1000 patient-days in the pre-intervention period to 32.1 DDDs/1000 patient-days in the intervention period (P < 0.001). The inappropriate consumption of vancomycin also declined from 8.0 DDDs/1000 patient-days to 5.8 DDDs/1000 patient-days (P = 0.009).ConclusionInterventions such as direct communication with prescribing physicians and infectious disease clinicians can help reduce the inappropriate continued use of vancomycin.

Bacteriological Profile and Prevalence of ESBL and MRSA in Different Risk Categories in Diabetic Foot Infections (DFI) in a Teaching Hospital, Visakhapatnam, A.P.

Bacteriological Profile and Prevalence of ESBL and MRSA in Different Risk Categories in Diabetic Foot Infections (DFI) in a Teaching Hospital, Visakhapatnam, A.P.

MRSA prevalence among patient transport staff in Hamburg.

Introduction: Patient transport employees frequently come into contact with multidrug-resistant organisms (MDROs) and therefore are at a greater risk of infection than the general population. These pathogens pose a significant challenge for employees of patient transport services since they can spread over long distances through patient transfers. To date, little is known about the occupational risk of MRSA infection in patient transport settings.Methods: A cross-sectional study was conducted to investigate the prevalence of MRSA in patient transport personnel, including taxi drivers, as well as the potential risk factors for MRSA colonization. For screening, nasal swabs were taken. When an individual was tested positive, a control swab was taken; if this confirmed a positive result, decolonization measures were offered. A molecular biological examination of the MRSA samples was performed. Results: A total of 222 patient transport employees were screened and 7 employees tested positive, putting the MRSA prevalence at 3.2% (95% CI 1.4–6.5). Significant risk factors among patient transport staff (PTS) for testing positive were the use of antibiotics (OR 11.9; 95% CI 1.8–78.4) and hospital admission (OR 6.9; 95% CI 1.1–45.9). MRSA swabs were also performed on a total of 102 taxi drivers who provide patient transport services. The MRSA prevalence was 0.98 (95% CI <0.01–5.9). Significant group differences between PTS and taxi drivers, with respect to potential risk factors for MRSA colonization, were identified as inpatient treatment (p=0.09), chronic respiratory illnesses (p=0.01), and knowingly transporting patients/passengers with MRSA (p=0.03).Conclusion: This study is the first to make data on the MRSA risk of patient transport employees in Hamburg available. The prevalence data are low in all areas and indicate a somewhat low risk of infection. A good infection control at the facilities is highly recommendable and the employees should acquire in-depth knowledge of infection prevention to improve compliance with personal protective measures.

Prevalence of Staphylococcus spp. nasal colonization among doctors of podiatric medicine and associated risk factors in Spain

BackgroundThis study aimed to estimate the prevalence of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) nasopharyngeal carriage among Doctors of Podiatric Medicine (Podiatrists) and to determine the potential risk factors.MethodsA cross-sectional study was carried out in 2016–2017 among 239 podiatrists in Spain. The presence of MSSA, MRSA, and MRSE was determined by microbiological analysis of nasal exudate and antimicrobial susceptibility was determined. Each podiatrist completed a questionnaire. The questionnaire comprised various parameters such as sex, age, podiatry experience duration, underlying diseases, prior antibiotic treatment, hospitalization during the last year, and use of a protective mask, an aspiration system, or gloves.ResultsThe prevalence of MSSA, MRSA, and MRSE was 23.0%, 1.3%, and 23.8%, respectively. The MSSA prevalence was higher among podiatrists who did not use an aspiration system (32.3%) compared to those who did (19.3%; p = 0.0305), and among podiatrists with respiratory diseases (36.8%) compared to those without (20.8%; p = 0.0272). The MRSE prevalence was higher among men (33.7%) compared to women (8.6%; p = 0.0089), podiatrists aged ≥50 (38.5%) compared to ≤35 (17.8%; p = 0.0101), and podiatrists with ≥15 (39.3%) compared to ≤5 years of podiatry experience (12.5%; p = 0.0015). Among the S. aureus strains, 84.5% were resistant to penicillin, 22.4% to erythromycin, 20.7% to clindamycin, and 12.7% to mupirocin. The MRSE strains were resistant to penicillin (93.0%), erythromycin (78.9%), and mupirocin (73.7%).ConclusionsThe prevalence of S. aureus and S. epidermidis nasal carriage is low among Spanish podiatrists compared to other health professionals.

Staphylococcus aureus in two municipal abattoirs in Nigeria: Risk perception, spread and public health implications

Staphylococcus aureus is a zoonotic pathogen of significant public health concern. Information on the prevalence and risk factors facilitating bacterial colonization and spread under abattoir settings in Nigeria are scarce. This cross-sectional study was designed to determine prevalence of S. aureus as well as risk factors on knowledge and practices facilitating pathogen carriage among workers and slaughter animals in two municipal abattoirs of Ilorin and Ibadan, Nigeria. Swab samples (n = 1671) from nostrils of cattle, goats, pigs and abattoir workers, and from meat tables and abattoir walls were collected for detection of S. aureus. A questionnaire was administered to 275 workers to elucidate risk factors of pathogen carriage applying a logistic regression model. S. aureus prevalence was 6.5%. In total, MSSA and MRSA were detected at a frequency of 5.4% and 1.1%. Molecular analysis of the isolates revealed 19 different spa types, including a novel spa type (t16751). Gender, marital status, occupation and abattoir location were factors influencing worker’s practices in relation to pathogen carriage and spread in the abattoir setting. This present study detected not only low MSSA and MRSA prevalence, in both abattoirs but also low risk perception and hygiene practices employed by abattoir workers. Good practices among workers at Nigerian abattoirs are needed to mitigate S. aureus carriage. Further studies expounding the antibiotic resistance and relationships of MSSA and MRSA strains detected in this study are needed to complement understanding of the spread of S. aureus in the abattoir food chain.

Respiratory Failure in Pneumonia with Diabetic Ketoacidosis (DKA)

The annual incidence rate of KAD is estimated to be between 4.6 and 8 per 1000 patients with diabetes. Based on the results of the physical examination, the patient was diagnosed as pneumonia with KAD. The mortality rate for community pneumonia on outpatients was 2%, inpatients was 5-20%, more so in patients in intensive care that was more than 50%. The problem in the patient is pneumonia. Resulting in pulmonary dysfunction which causes overload. Infections that can increase morbidity and mortality may be associated with Streptococcus infection (group B, S, pneumonia), Legionella and viral infections (influenza). The most common infections are pneumonia and urinary tract infections which account for between 30% and 50% of cases. Therefore, the choice of empiric antimicrobial therapy in diabetic patients with evidence of staphylococcal pneumonia (consistent with sputum smear results or associated soft tissue infection) should be guided by the prevalence of MRSA in the associated institutions. Respiratory failure is a complication of KAD and increases the mortality rate. and morbidity. Based on the high nasal carriage rate, there is an increased risk of staphylococcal pneumonia infection in diabetic patients. Community pneumonia is acute inflammation due to infection of the lung parenchyma acquired in the community. (J Respir Indo 2018; 38(1): 57-63)

Identical genotypes of community-associated MRSA (ST59) and livestock-associated MRSA (ST9) in humans and pigs in rural China.

This study investigated the prevalence of MRSA in samples taken in households, with and without backyard pigs in villages in a rural area of Shandong Province, China. Community-associated MRSA and livestock-associated MRSA, belonging to ST59 and ST9, respectively, were identified in both humans and pigs. The genotypic and phenotypic comparison of isolates indicates that bidirectional transmission of MRSA has occurred between humans and pigs in the villages.