Nasal Swab Cultures Research Articles

Atypical bacteria in pediatric sickle cell patients with acute chest syndrome

Abstract The purpose of this study was to quantify the frequency of Mycoplasma pneumoniae or Chlamydia pneumoniae in a large contemporary real-world data set. This was a retrospective database analysis utilizing data collected from the TriNetX Global Collaborative Network, which provided access to electronic medical records for patients from 78 different healthcare organizations. Data were collected using ICD-10 codes and laboratory test order codes from TriNetX. Inclusion criteria are patients less than or equal to 18 years old with SCD with an ICD-10 code for ACS or pneumonia. Patients were included in the primary outcome analysis if they had a laboratory code for a rapid diagnostic test for M. pneumoniae and/or C. pneumoniae performed by either nasal swab or respiratory culture. There were 6762 pediatric sickle cell patients with an ICD-10 code for ACS or pneumonia identified. Of these patients, only 16.3% were tested for M. pneumoniae and 17.1% were tested for C. pneumoniae. The patients who were tested for these atypical organisms were further investigated for positivity on rapid diagnostic testing, and the positivity rate in these patients was 1.1% for M. pneumoniae and less than or equal to 0.87% for C. pneumoniae. Pediatric patients with ACS who were tested for M. pnuemoniae and C. pnuemoniae had low rates of positivity for these organisms. Most of these patients did not have recorded microbiologic testing, showing evidence of a large underutilization of diagnostic tools available that could assist with de-escalation of antibiotics.

CHRONIC RHINITS WITH BRONCHITIS IN DOMESTIC CAT

Chronic rhinitis in cats is a syndrome associated with inflammation of the nasal cavity; it is often associated with secondary infection of the frontal sinuses, and usually lasts more than 1 month. This case study aims to determine the conclusion of several supporting examinations performed to diagnose chronic rhinitis in cats and its treatment. Examination was made on a 3-year-old female local cat with a body weight of 2.65 kg with a history of nasal discharge since approximately 2 years ago, sneezing, and occasionally followed by coughing with harsh-sounding breath. Physical examination showed a rough sound or stridor when the cat breathed, mucopurulent discharge in both nostrils, sneezing with high frequency and occasionally followed by coughing. Cytologic examination of nasal swab revealed rod-shaped bacteria, degenerate and non-degenerate infiltration of neutrophils, lymphocytes, monocytes and plasma cells. Mild interstitial pattern in the lung, and increased opacity or ring-like opacities ("donuts") at some bronchial ends were observed on radiographic examination. Bacterial growth and identification tests were positive for Proteus sp. bacteria. The cat was diagnosed with chronic rhinitis with bronchitis and treated with Cefixime antibiotic (12 mg/kg BW; q12 h; PO), anti-inflammatory corticosteroid Methylprednisolone (2 mg/kg BW; q24 h; PO) with tappering off dose, mucolytic decongestant Bromhexin HCL (1 mg/kg BW; q24 hours; PO), and immunomodulator Caviplex (2 ml; q24 hours; PO). Treatment for 14 days showed an improvement in the cat's condition where nasal discharge that was previously mucopurulent became serous and at certain times no discharge was found, the frequency of sneezing and coughing decreased, and the cat could eat and drink comfortably. The decision to select an antibacterial agent to treat rhinitis should be made based on the results of pharyngeal and nasal discharge swab cultures.

Prevalence of Methicillin Resistant Staphylococcus aureus Colonisation in Patients undergoing Total Joint Arthroplasty: A Retrospective Observational Study

Introduction: Methicillin Resistant Staphylococcus aureus (MRSA) presents a significant, yet preventable, complication in Total Joint Arthroplasties (TJAs). Surgical Site Infections (SSIs) of prosthetic joints resulting from MRSA lead to substantial patient morbidity, mortality, and impose a significant burden on healthcare budgets. One method to mitigate these risks is to screen for MRSA colonisation prior to elective surgeries. The prevalence of MRSA colonisation in nasal mucosa ranges from 0.18-7.2% in different patient populations, with a nosocomial prevalence of 1.7%. Aim: To determine the prevalence of MRSA colonisation in all patients undergoing elective TJA, including Total Hip Replacement (THR) or Total Knee Replacement (TKR). Materials and Methods: A retrospective observational study was conducted on a total of 407 patients scheduled for elective TJAs. Data from 407 patients who underwent elective TJA between January 2020 and December 2022 (a period of three years) were selected for the study. Data compilation and analysis of the study subjects were performed retrospectively until March 2023 at the Sanjay Gandhi Institute of Trauma and Orthopaedics, a tertiary care Orthopaedic centre in Bengaluru, Karnataka, India. The study subjects were screened for MRSA colonisation through nasal swab culture and sensitivity. Patients with positive MRSA culture results were treated with decolonisation therapy, which involved the local application of 2% mupirocin and chlorhexidine body wash for five days. Descriptive data analytics were employed in the study, and tables were generated using Microsoft Word 2010 and Microsoft Excel 2010 (Microsoft Corp, Redmond, WA, USA). Results: The prevalence rates of MRSA nasal colonisation were n1=8 (8.42%), n2=2 (2%), and n3=16 (7.55%) for the years 2020 (n1), 2021 (n2), and 2022 (n3), respectively, at the centre. The period prevalence rate of MRSA colonisation in the nasal mucosa over three years was N=26 (6.4%). Conclusion: The present study revealed a high period prevalence of MRSA colonisation (6.4%) in patients undergoing TJAs. Therefore, all elective TJAs should undergo MRSA screening and decolonisation using 2% intranasal mupirocin and daily chlorhexidine body wash for five days as a successful treatment modality for all patients with MRSA-positive nasal colonisation. This approach helps prevent postoperative SSIs caused by MRSA.

Evaluation of methicillin-resistant Staphylococcus aureus nasal swab screening at a large comprehensive cancer center.

The aim of this study is to determine the predictive values of MRSA swab screenings in patients with cancer. This is a retrospective cohort observational study of adult patients admitted to The University of Texas MD Anderson Cancer Center between January 2019 and October 2022. Data collected from patients with documented MRSA nasal swab screenings and clinical cultures taken within 7 days were collected. The first documented MRSA swab screening and culture results from unique patients were included for analysis to calculate sensitivity, specificity, positive predictive value, and NPV. A total of 6475 patients with MRSA nasal swab cultures had 13129 clinical cultures from different anatomical sites. Of the patients included, 57% had a solid tumor and 37% had a hematological malignancy, with 82% of patients receiving an anti-MRSA antibiotic prior to MRSA nasal swab. There were 167 documented positive MRSA cultures, most commonly from a wound (41.3%) or respiratory source (24%). Overall sensitivity and specificity for all culture sites were 50.9% and 98.4%, respectively, with an overall NPV of 99.4%. The NPV was 99.8% for bloodstream infections, 98.5% for respiratory infections, 92.6% for wound infections, and greater than 99% for other culture sites. The specificity and negative predictive value of MRSA swab screenings in patients with cancer was high overall and consistent with the literature in immunocompetent patients. These results may aid in antimicrobial stewardship activities that can help guide the discontinuation of empiric antibiotics in patients with cancer.

#3689 RELATIONSHIP BETWEEN STAPHYLOCOCCUS AUREUS NASAL CARRIAGE AND URAEMIC PRURITUS IN HAEMODIALYSIS PATIENTS AND ITS INFLUENCE ON INFECTION

Abstract Background and Aims Uraemic pruritus is a common and distressing comorbid disease among patients undergoing haemodialysis (HD). The aetiology of uraemic pruritus is multifactorial and not fully understood. The role of skin microbiota in chronic inflammatory skin disease has long been discussed, but evidence regarding the relationship between uraemic pruritus and Staphylococcus aureus (SA) colonization is limited. The rate of SA nasal carriage in HD patients was more than double that of healthy individuals, and the phage type of SA infection was often the same as the type of SA carried in the HD patients' nares. SA colonization is associated with greater skin barrier disruption, which suggests a possibility to increase the risk of infection in patients with uraemic pruritus. This study aimed to assess the role of SA nasal carriage in uraemic pruritus, as well as the interplay among SA colonization, uraemic pruritus, and SA infection in HD patients. Method We conducted a prospective cohort study to enrol adult HD patients in the Far Eastern Memorial Hospital, a tertiary medical centre in Taiwan, in April 2019. Eligible patients should had received maintenance HD for more than three months. Patients were excluded if they had active infection or primary skin diseases. The intensity of uraemic pruritus was assessed using a visual analogue scale (VAS) from 0 to 10 (0 = no pruritus, 10 = the worst pruritus imaginable). Nasal swab culture was performed to examine the status of SA nasal carriage. Patients were followed until SA infection, death, or January 2020, whichever had occurred earlier. The definition of SA infection should fulfil both the clinical diagnosis and the results of microbiological culture. Multivariate linear regression models were used to assess the potential predictors for a higher pruritus intensity. Multivariate Cox proportional hazard models were used to analyse the risk of SA nasal carriage on SA infection among the HD patients. Results A total of 100 HD patients were enrolled, the mean age was 61.7 years and 69% were men. The mean dialysis vintage was 6.7 years. Among the participants, 55% had uraemic pruritus and the mean VAS score of pruritus intensity was 4.0. The prevalence of SA nasal carriage was higher in patients with uraemic pruritus than that in patients without uraemic pruritus (33% vs 13%, P = 0.024). The multivariate linear regression model showed that SA nasal carriage was an independent predictor of a higher VAS score of pruritus intensity (parameter estimate, 1.18; 95% CI 0.05-2.30; P = 0.04) (Table 1). After follow-up for 10 months, there were four SA infection events in the pruritus patients and one event in the non-pruritus patients. The multivariate Cox proportional hazard model showed that patients with SA nasal carriage had a borderline higher risk for SA infection (adjusted hazard ratio, 50.9; 95% CI, 0.62-3689; P = 0.08) (Table 2). Conclusion SA nasal carriage is independently associated with uraemic pruritus, and is also an independent predictor for a higher pruritus intensity among HD patients. Moreover, SA colonization might predict SA infection in later follow-up period. This study provide evidence for future studies regarding the survey for SA colonization and application of nasal decolonization among HD patients with uraemic pruritus.

Prevalence of multidrug-resistant Escherichia coli isolated from Jember hospital food handler in Indonesia

Introduction: Foodborne illness is a significant global public health issue. Improper food handling and personal cleanliness can result in a few ailments. Over 400 food-related infections have been found by the CDC, of which food handlers cause 20%. Escherichia coli is often found in hospital food handler hand and nasal swabs. This study aimed to ascertain the prevalence of E. coli and the antibiotic susceptibility profile of food handlers working in hospitals in Jember City, Indonesia. Method: A cross-sectional investigation uses a total sampling method held between October and November 2022. Inclusion criteria are asymptomatic food handlers that have not taken antibiotics for the last three months and have already given informed consent. Exclusion criteria are food handlers who’s sick or with incomplete questionnaires. We performed hand and nasal swabs and continued with bacteria identification, culture, and antibiotic sensitivity tests. Result: Ten food workers (14.71%) and fourteen (20.59%) of the 68 who underwent hand and nasal swab culture screenings for E. coli were positive. All E. coli hand swab isolates were susceptible to levofloxacin and azithromycin antibiotics. Still, of the 10 E. coli hand swab isolates, 90% were resistant to the antibiotics; penicillin, Cefotaxime, and ceftriaxone, while 70% were resistant to erythromycin. For E. coli isolates originating from nasal swabs, 85.71% were resistant to Cefotaxime, 71.43% to Penicillin and Cefepime, and 57.14% were resistant to Ceftriaxone and Erythromycin. E. coli Multiple Antibiotic Resistance (MAR) index for hand and nasal swab specimens is 0.18 – 0.82. Most of the hand swab specimens (90%) are Multidrug Resistant (MDR), while nasal swab specimen shows 78.57% Multidrug Resistant (MDR). Conclusion: The predominance of multidrug-resistant E. coli among hospital food handlers makes it imperative to implement infection control measures, including better biosecurity, to ensure that they do not enter the food supply and limit alternatives to inpatient therapy.

The role of TAS2R38 genotype in surgical outcomes and culturable bacteria in chronic rhinosinusitis with or without nasal polyps.

Recent studies reported the relationship between genetic variations and TAS2R38, which is a bitter taste receptor expressed in the cilia of human sinonasal epithelial cells, among the predisposing factors playing role in immune response to upper respiratory tract bacterial infection. The present study aims to examine the relationship of TAS2R38 genotype with the active microorganism and the effect of genotype on the surgical outcomes among chronic rhinosinusitis patients. 34 patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis with or without polyps (23 CRSwNP, 11 CRSsNP) and 30 patients undergoing septoplasty surgery for isolated nasal septum deviation were included. All the patients were genotyped for TAS2R38. Scoring was made using endoscopic Modified Lund-Kennedy and radiological Lund-Mackay systems preoperatively. Sino-Nasal Outcome Test with 22 items (SNOT-22) was implemented preoperatively and postoperatively. Nasal swab culture samples were taken intraoperatively from CRS patients and the active microorganism were isolated. In the TAS2R38 genotyping of the study group, PAV/PAV was found in 32.4% of patients, PAV/AVI in 47.1%, and AVI/AVI in 20.6%. In the control group, PAV/PAV was found in 26.7%, PAV/AVI in 36.7%, and AVI/AVI in 36.7%. In the study group, there was no statistically significant difference between the CRS and CRS subgroups in terms of TAS2R38 genotype distributions. The changes in patients' preoperative and postoperative SNOT-22 scores were similar between the genotypes. Proliferation was detected in culture in the whole AVI-AVI group, 81.8% of PAV-PAV group, and 56.3% of PAV-AVI group but the difference was not found to be statistically significant. The proliferation level of Staphylococcus epidermidis by TAS2R38 genotype was found to be statistically significantly higher among patients, who had AVI-AVI genotype, in CRSwNP. We did not find a statistically significant relationship between the TAS2R38 genotype and CRS subtype, sinonasal bacterial infection risk increase and surgical success rate in CRS patients. Long-term and large-scale studies are needed, which are to be carried out by individual genotyping and sequencing to provide more information on the effects of these genetic variants.

Social network analysis of Staphylococcus aureus carriage in a general youth population

ObjectivesStaphylococcus aureus carriage increases the risk of infection. We used social network analysis to evaluate whether contacts have the same S. aureus genotype indicating direct transmission or whether contagiousness is an indirect effect of contacts sharing the same lifestyle or characteristics. MethodsThe Fit Futures 1 study collected data on social contact among 1038 high school students. S. aureus carriage was determined from two nasal swab cultures and the genotype was determined by spa-typing of positive throat swabs. ResultsS. aureus carriage and spa-type were transmitted in the social network (P < 0.001). The probability of carriage increased by 5% for each S. aureus positive contact. Male sex was associated with a 15% lower risk of transmission compared to the female sex, although the carriage prevalence was higher for men (36% vs 24%). Students with medium physical activity levels, medium/high alcohol use, or normal weight had a higher number of contacts and an increased risk of transmission (P < 0.002). ConclusionWe demonstrated the direct social transmission of S. aureus. Lifestyle factors are associated with the risk of transmission, suggesting the effects of indirect social groups on S. aureus carriage, such as friends having more similar environmental exposures. The male predominance in the carriage is determined by sex-specific predisposing host characteristics as the social transmission is less frequent in males than females. Information on social networks may add to a better understanding of S. aureus epidemiology.

Phenotypical resistance profile of Stenotrophomonas maltophilia insolated from farm amimals

Stenotrophomonas maltophilia is a multidrug‐resistant opportunistic pathogen. Infections caused by resistant strains of bacteria in animals are characterized by a more severe manifestation, increased duration of treatment and often leads to recurrence. Isolation, identification and determination of pathogens and interpretation of their antibioticograms are the basis of effective and rational antibiotic therapy. The aim of the study was to analyze the antibiotic resistance of Stenotrophomonas maltophilia cultures isolated in cases of respiratory diseases in livestock. The materials for the study were nose scrapings collected from 50 postpartum period cows and 69 newborn calves, and 30 horses up to 3 years old. Primary cultures of tracheal and nasal swabs from horses, cows, and calves were incubated on meat‐peptone broth with 1% glucose and horse serum at 37℃ for 24 hours. After that the culture was inoculated on nutrient media such as columbia ram blood agar, chocolate agar, Endo medium and then incubated at 37℃ for 24 hours. Identification of the isolated cultures and study of their biochemical properties were performed using Nefermtest 24 (Erba Lachema, Czech Republic) test systems. Antibiotics resistance measurement was carried out by the MIC method using MicroScan WalkAway 40 plus (Siemens, Germany) automatic analyzer and GN3F, RUSTEF, NF Sensititre (Trek Diagnostic Systems, Great Britain) plates. Disk diffusion test with Mueller‐Hinton agar was performed according to the recommendations of the European Committee for the determination of antibiotic susceptibility (EUCAST). Pathogenicity of cultures was studied by in vivo testing on white mice. The total number of multidrug resistant S. maltophilia isolates made up less than 5% of 149 clinical samples. Following groups of antibiotics were selected to test the antibiotic sensitivity of this bacterium based on the study’s results: penicillins combined with β‐lactamase inhibitors (co‐amoxiclav, ampicillin/sulbactam, ticarcillin/clavulanic acid), quinolone antibiotics (levofloxacin, moxifloxacin, ciprofloxacin, enrofloxamethacin (trimethoxoprimolamines), sulfanilamylamines (TMP/SMX), nitrofurans (nitrofurantoin), tetracyclines (doxycycline), and macrolides (erythromycin). S. maltophilia cultures isolated from livestock were sensitive only to levofloxacin and moxifloxacin. Interpretation of antibioticograms is one of the main factors that determine the effectiveness of antibiotic therapy.

Evaluation of the Negative Predictive Value of Methicillin-Resistant Staphylococcus aureus Nasal Swab Screening in the Medical Intensive Care Units and Its Effect on Antibiotic Duration

BackgroundIn addition to active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) carrier, MRSA nasal screening can be valuable for antibiotic de-escalation. This study aimed to assess the correlations between the MRSA nasal swab and subsequent culture results in patients admitted to medical intensive care units (MICU). The impact of MRSA nasal swab on the antibiotic duration was also evaluated.Materials and MethodsThis retrospective study enrolled patients who received glycopeptides in the MICU of a medical center in 2019. Patients treated with glycopeptides for over 2 days before MICU admission were excluded. The associated data were collected through the electronic medical record system. The negative predictive value (NPV) of MRSA nasal swabs for MRSA infection was calculated, and their influence on empirical glycopeptide treatment duration was analyzed.ResultsOf the 338 patients who met the inclusion criteria, 277 underwent MRSA nasal screening. The NPV of MRSA-negative nasal swab for subsequent MRSA infection was 98.4%. The glycopeptide treatment duration of the patients with and without nasal screening was not significantly different (4.2 ± 2.8 vs 4.4 ± 3.0 days, p = 0.577). Of the 120 patients with MRSA-negative nasal swab and no subsequent MRSA infection, 75 continued empirical glycopeptides therapy. The additional treatment time was 3 days (interquartile range: 2–6 days).ConclusionThe MRSA nasal swabs have high NPV for MRSA infection in critically ill patients. However, it has no impact on the empirical glycopeptide treatment duration. The value of MRSA nasal swabs should be advocated to optimize antibiotic therapy.

Akut Folikülit Tanılı Hastalarda Staphylococcus aureus Nazal Taşıyıcılığın Değerlendirilmesi: Olgu Kontrol Araştırması

Objective: The prevalence and incidence of Staphylococcus aureus nasal carriage vary according to the population studied. It is known that there is a link between recurrence of staphylococcal skin infections and nasal carriage. The study aimed to determine the prevalence of S. aureus nasal carriage and microbiological profile of the nasal cultures in patients with acute folliculitis without a history of recurrence, to compare the results with the control group, and to evaluate the demographic factors on bacterial growth. Material and Methods: A case-control study was conducted in a secondary state hospital between May and August 2021. A total of 120 patients diagnosed with acute folliculitis in a dermatology outpatient clinic were enrolled in the study. Patients' demographics including age, gender, job, having a family history of folliculitis, history of visiting a barber regularly, having a health care worker in the family, and localization sites of folliculitis were recorded. Patients' and control groups' microbiological data from nasal swab cultures were also recorded. Results: There was bacterial growth in 29.1% of the patients' nasal cultures. Methicillinsensitive S. aureus was the most frequently isolated microorganism both in the patient and control groups. There was no statistical difference between patients and controls in terms of microbiological profiles and bacterial growth in nasal swab culture. Conclusion: S. aureus nasal colonization of patients with acute folliculitis has similar rates with the healthy population. S. aureus nasal carriage does not appear to be a risk factor and reservoir in patients with acute folliculitis.

Nasal carriage of Staphylococcus aureus in children with grass pollen-induced allergic rhinitis and the effect of polyvalent mechanical bacterial lysate immunostimulation on carriage status: A randomized controlled trial.

ABSTRACTBackgroundNumerous studies indicate that Staphylococcus aureus (S. aureus) colonizing the nasal cavity plays a role in the pathogenesis of allergic rhinitis (AR). This bacterium is able to produce a variety of toxins with superantigenic properties that can exacerbate allergic inflammation.ObjectiveThe objective of the study was to evaluate the ability of polyvalent mechanical bacterial lysate (PMBL) to eliminate S. aureus nasal carriage in children with grass pollen‐induced AR.MethodsThis randomized, double‐blind, placebo‐controlled study included 80 children aged 5–17 years with seasonal AR (SAR). At the randomization visit and after 12 weeks of the study, a swab was taken from the region of the middle nasal meatus. Standard microbiology culture and identification techniques were used to analyze the swab contents.ResultsNasal colonization by S. aureus was confirmed in 29 children (42%), with Moraxella catarrhalis in three participants (4.4%). Physiological flora was detected in 37 children. No statistically significant differences were observed between the two measurement points in both the PMBL and placebo groups with respect to the number of patients whose nasal swab cultures showed a growth of S. aureus (p = 1). Both groups also showed no significant changes in the mean number of S. aureus colonies in nasal swab cultures taken at baseline and after 12 weeks of the study (PMBL group p = .41; placebo group p = .16).ConclusionAlmost every second child with SAR is S. aureus nasal carrier. Sublingual administration of PMBL in children with grass pollen‐induced AR did not affect S. aureus nasal colonization. Therefore, PMBL should not be used for the eradication of S. aureus from the nasal cavity.

In vitro activity of non-antibiotic drugs against Staphylococcus aureus clinical strains

We hypothesised that one or more of the non-antibiotic candidates selected for this study would demonstrate antibiotic activity against Staphylococcus aureus. We determined minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) for non-antibiotic drugs (amlodipine, azelastine, ebselen and sertraline) against five clinical S. aureus isolates and one quality control strain using the Microplate Alamar Blue Assay (MABA). Our research group selected clinical isolates obtained from nasal and wound swab cultures of patients with skin and soft-tissue infections who were seen at primary care clinics in the South Texas Ambulatory Research Network (STARNet). Three of the non-antibiotic drugs had identical MICs for all isolates: amlodipine, 64 μg/mL; azelastine, 200 μg/mL; and sertraline, 20 μg/mL. MICs for ebselen were 0.25 μg/mL (SA-29213, A1019 and J1019), 0.5 μg/mL (A32 and B60) and 1 μg/mL (B72). MBCs for amlodipine, azelastine and sertraline were within one dilution of their MICs, indicating bactericidal activity for all test isolates. Ebselen MBCs were one to two dilutions higher in most isolates, also indicating bactericidal activity for all test isolates. In summary, all four non-antibiotics demonstrated in vitro activity to varying degrees against S. aureus clinical isolates. Ebselen was the most potent of the four non-antibiotics tested.

Infectious keratitis after corneal crosslinking for keratoconus caused by levofloxacin-resistant microorganisms

IntroductionWe present seven cases of infectious keratitis after corneal crosslinking (CXL) to attenuate keratoconus progression.MethodsOf 524 consecutive patients who underwent CXL, 7 cases (4 males and 3 females; 21.5 ± 7.1 years) developed postoperative infectious keratitis were retrospectively reviewed. CXL was performed using the Dresden protocol or an accelerated protocol involving epithelial removal.ResultsAll cases appeared normal on the day after surgery, but subsequently developed eye pain, blurred vision, corneal infiltration, inflammation of the anterior chamber, and ciliary injection on day 2 or 3. Methicillin-resistant Staphylococcus aureus was cultured from two eyes, methicillin-sensitive Staphylococcus aureus from two eyes, and Streptococcus pneumoniae from one eye. All detected bacteria were resistant to levofloxacin (LVFX). Five of the seven cases, especially four of the five severe cases with hypopyon, had a history of atopic dermatitis. All cases were observed after 2015.ConclusionsInfectious keratitis after CXL caused by microbes resistant to LVFX is increasing. In addition to careful postoperative observation of the cornea, preoperative evaluation of bacteria within the conjunctival sac evident on nasal swab cultures may be useful to identify potentially problematic microbes and inform the selection of appropriate antibiotics.

Nasal Carriage of Staphylococci among Health Care Workers and Impact of Conventional Decolonisation Methods

Introduction Staphylococci are one of the most common causes of nosocomial infections. The principal route of transmission of Staphylococci is the contaminated hands of health care workers (HCWs). Staphylococci can also be found as part of the nasal microbiota without causing overt disease. So we undertake the present study to estimate the prevalence of asymptomatic nasal carriage of Staphylococci among HCWs and impact of conventional decolonisation methods in a tertiary care hospital in West Bengal. Materials and Methods Nasal swabs were collected from anterior nares of HCWs for culture and antibiotic sensitivity test on day one. HCWs who were found to be carriers of Staphylococci were advised to apply mupirocin ointment to anterior nares twice daily along with chlorhexidinegluconate bath once daily for five days. All HCWs were also advised to practice standard hygiene protocol. All of them were re-tested for nasal swab culture and antibiotic sensitivity on day seven and day twenty eight. Results Nasal carriage of Staphylococci in the first, second and third culture report was found to be 64.28%, 7.14% and 24.49% respectively. Cefotaxime, cotrimoxazole and erythromycin were least effective against Staphylococci. There was variable sensitivity to clindamycin, gentamycin and ciprofloxacin. All strains of Staphylococci were highly sensitive to linezolid. All strains of Staphylococci except MRSA were highly sensitive to vancomycin. Conclusion The present study re-establishes the fact that HCWs carry Staphylococci in their nose in significantly high proportion. So different measures should be undertaken to minimise Staphylococci related nosocomial infections.

Prevalence of Staphylococcus aureus nasal carriage and surgical site infection rate among patients undergoing elective cardiac surgery

BackgroundNasal carriers of Staphylococcus aureus are at increased risk of postoperative surgical site infection. Nasal decolonization with mupirocin is recommended in patients undergoing cardiac surgery to reduce surgical site infection. These data are still lacking in Thailand. Therefore, the aim of this study was to determine the prevalence of S. aureus nasal carriage in Thai patients undergoing elective cardiac surgery. The association of surgical site infection and S. aureus nasal carriage was also examined. MethodsThis was a prospective cohort study of 352 patients who planned to undergo elective cardiac surgery. Nasal swab culture was performed in all patients preoperatively. ResultsOf 352 patients, 46 (13.1%) had a positive nasal swab culture for methicillin-sensitive S. aureus (MSSA) and one patient (0.3%) harbored a methicillin-resistant S. aureus (MRSA) strain. The incidence of superficial and deep surgical site infection was 1.3% and 0.3%, respectively. After multivariate analysis, S. aureus nasal carriage was independently associated with superficial surgical site infection (odds ratio 13.04, 95% confidence interval 1.28–133.27; P=0.03). ConclusionsThe prevalence of MSSA and MRSA nasal carriage in Thai patients undergoing elective cardiac surgery was low. The incidence of surgical site infection was also very low in the population studied. Nevertheless, it was found that S. aureus nasal carriage increased the risk of superficial surgical site infection.

Can preoperative screening for methicillin-resistant staphylococcus aureus effectively predict surgical site infections in spine surgeries?

Introduction: Hospital care-associated infections prolong hospital stay and thus increased financial burden, causes long-term disability and mortality in patients and can increase resistance of microorganisms to antimicrobials. Surgical site infections (SSIs) are the most frequent type of hospital care-associated infections in the developing countries. Staphylococcus is the most commonly isolated organism with methicillin-resistant Staphylococcus aureus (MRSA) posing a great threat. The most common human reservoir for S. aureus is the nares. We propose a study to evaluate the efficacy of preoperative screening of MRSA by nasal and throat culture by correlating it with postoperative SSI. Study Design: Prospective study. Purpose of the Study: 1. To determine the prevalence of MRSA colonization in a population of patients scheduled for elective spine surgery. 2. To determine whether preoperative nasal and throat swab cultures for MRSA are predictive of postoperative SSI in patients undergoing spine surgery. Materials and Methods: Two hundred and forty-eight patients who underwent spine surgery at Baby Memorial Hospital, Calicut, from December 2018 onward are included in this study. Patients who had spine surgeries for infections were excluded from the study. Patients who developed postoperative SSIs were cross-checked with preoperative data and analyzed whether the infecting organism is same as in the preoperative nasal and throat swab culture (if it is present). The significance of the correlation between preoperative nasal and throat swab culture and postoperative SSI are assessed statistically with Chi-square test. Discussion: Among the 248 patients in this study, preoperative nasal and throat swab culture yielded MRSA in 27 patients (nasal – 24, throat – 2, and both – 1). Out of 248 patients, 6 patients developed SSIs with MRSA, but none of them had MRSA in preoperative nasal or throat swab culture. Conclusion: Preoperative MRSA screening by throat and nasal swab is not routinely needed in spine surgery as it appears to carry no positive predictive value in postoperative SSIs.

Prevalence of nasal carriage of Staphylococcus aureus in allergic rhinitis patients and healthy controls in Thailand

Staphylococcus aureus has been proposed as a disease modifier of allergic rhinitis (AR) severity. Although several studies have investigated the prevalence of nasal carriage of S. aureus in healthy controls and AR patients, data from Thailand is scarce. The aim of this study was to determine the prevalence of nasal carriage of S. aureus in AR patients compared with healthy controls in Thailand. This prospective study enrolled non-AR healthy controls and confirmed AR aged 18-60 years who attended the Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during June 2013 and December 2013. To detect nasal carriage of S. aureus, nasal swab was used for specimen collection from the nasal vestibule. S. aureus prevalence was compared between groups. All AR patients were assessed for disease severity and quality of life. The 200 enrolled participants were evenly divided between the AR and healthy control groups. Nasal swab cultures were positive for S. aureus in 20 of 100 subjects in the healthy control group, and in 21 of 100 subjects in the AR group (p = 0.86). Nasal carriage of S. aureus was significantly more prevalent in males than in females (p = 0.01). None of the investigated factors were found to be significantly associated with AR severity among S. aureus-positive AR subjects. The 20% prevalence of S. aureus in AR patients is not different from that of healthy controls in Thailand, and is similar to other reported rates. No significant associations with AR severity were identified.

Nasal carriage of Staphylococcus aureus by medical students: Assessment of antibiotic susceptibility and risk factors

Objective: Staphylococcus aureus (S. aureus) is the leading vector for both hospital-sourced and population-sourced infections globally and nasal carriage may be responsible for these serious infections. The aim of this study was to assess the nasal S. aureus carriage rates, antibiotic susceptibility and risk factors among preclinical period medical students.Method: A total of 183 preclinical period students from Ahi Evran University Faculty of Medicine voluntarily participated in our study. They were requested to complete a survey form containing questions about demographic information, hygiene habits and medical history and possible risk factors were recorded. S. aureus isolates proliferating from nasal swab culture samples were studied with antibiotic susceptibility tests.Results: Of the total of 183 students, 39 (21.4%) had S. aureus proliferation identified from nasal swab samples. None of these isolates were methicillin-resistant S. aureus (MRSA). Antibiotic susceptibility tests found highest resistance against penicillin (85%). There were negative correlations between nasal spray use and allergy history with nasal S. aureus carriage.Conclusions: Medical students may each be mobile sources of bacteria in hospitals, especially as MRSA carriers. According to our results, it is necessary to note the importance of training and standard infection control precautions to prevent the increase in MRSA carriage rates in the clinical period as none of our preclinical period students carried MRSA. Advanced studies are important to monitor carriage rates.

Discussion: Preoperative Nasal Swab Culture: Is It Beneficial in Preventing Postoperative Infection in Complicated Septorhinoplasty?

Discussion: Preoperative Nasal Swab Culture: Is It Beneficial in Preventing Postoperative Infection in Complicated Septorhinoplasty?