Treatment Of Staphylococcal Infections Research Articles

Nonconventional Therapeutics against Staphylococcus aureus.

Staphylococcus aureus is one of the most important human pathogens that is responsible for a variety of diseases ranging from skin and soft tissue infections to endocarditis and sepsis. In recent decades, the treatment of staphylococcal infections has become increasingly difficult as the prevalence of multi-drug resistant strains continues to rise. With increasing mortality rates and medical costs associated with drug resistant strains, there is an urgent need for alternative therapeutic options. Many innovative strategies for alternative drug development are being pursued, including disruption of biofilms, inhibition of virulence factor production, bacteriophage-derived antimicrobials, anti-staphylococcal vaccines, and light-based therapies. While many compounds and methods still need further study to determine their feasibility, some are quickly approaching clinical application and may be available in the near future.

Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with infection at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

BackgroundStaphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection. Development of resistance to commonly used antimicrobials limited treatment options against infections due to this pathogen. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with surgical site infection and ear infection and corresponding nasal swab was investigated in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia.MethodsWound and corresponding nasal swabs from patients with surgical site infection from general surgery ward (n = 14), orthopedic ward (n = 21) and those with otitis media (n = 59) from Ear Nose and Throat (ENT) ward were cultured for S. aureus isolation according to standard procedures from December 2013 to June 2014. Isolates were investigated for susceptibility to panel of 17 antimicrobials using Kirby Bauer disc diffusion assay. Susceptibility to methicillin was phenotypically determined based on sensitivity of isolates to cefoxitin and oxacillin.ResultsA total of 79 S. aureus isolates were recovered from 54(57.4%) of patients. The isolates were resistant to ampicillin (100%), oxacillin and cefoxitin (68.4%, each), clindamycin (63.3%), cephalothin (59.5%), tetracycline (57%), sulfamethoxazole + trimethoprim and bacitracin (53.2%, each), and erythromycin (51.9%). Resistance to two or more antimicrobials was recorded in 74 (95%) of the isolates, while resistance to 3 or more antimicrobials was detected in 65(82.3%) of the isolates. Fifty-four (68.4%) of the isolates were methicillin resistant S. aureus (MRSA). Rate of occurrence of MRSA was more common among isolates from surgical wards (p < 0.001) compared to those from ENT ward. High level of multi-drug resistance (MDR) was detected more commonly among isolates from orthopedic ward than those from general surgical ward and patients with ear infection (p < 0.001). One of the isolate cultured from wound swab of a patient with surgical site infection from orthopedic ward was resistant to all of the 17 antimicrobials tested.ConclusionS. aureus isolates from patients in TASH exhibited resistance to majority of antimicrobials commonly employed for the treatment of staphylococcal infections which calls for urgent need of prudent use of antimicrobials and the need for implementation of effective infection control practices to hamper spread of MDR S. aureus.

Zawartość polifenoli w ekstraktach z podagrycznika pospolitego (Aegopodium podagraria L.) oraz ich aktywność przeciwgronkowcowa

Introduction. Various plant secondary metabolites produce valuable pharmacological effects, demonstrating antibacterial, antiviral and antifungal properties. Goutweed, as very widespread plant, for a very long time was used to treat of burns, wounds and different inflammations. According data of literature raw materials obtained from Aegopodium podagraria L. growing in different geographical origin have antibacterial activity. Aim. The aim of the study was to evaluate the overall content of polyphenols in plant materials from goutweed depending on the temperature of extraction and to check their antistaphylococcal properties. Material and methods. Leaves, flowers, seeds and rhizomes of goutweed were purified, frozen and lyophilized. Plant material was subjected to extraction for 3 hours at 80°C and 25°C in a water-bath. For the microbiological tests the reference and clinical strain of S. aureus were used. Susceptibility testing to antibiotics and chemotherapeutics for bacteria was carried out using disc-diffusion method. The minimal inhibitory concentration (MIC) values for gentamicin were detected by use of E-test. MIC for the ethanolic extracts was established by the microdilution broth method with use of resazurin. Results. The results of experiments showed that the overall content of polyphenols in the ethanolic extracts from different organs of Aegopodium podagraria L. depends on the temperature of extraction. Research found that all tested extracts show inhibiting activity against reference and clinical strain of S. aureus with MIC value 64 mg/ml. Conclusions. Our investigations draw attention on the impact of the conditions of extraction and also in the relation to the literature, to the geographical conditions on the content of plant metabolites – polyphenols in the different raw materials from goutweed. Ethanolic extracts from Aegopodium podagraria L. because of the inhibiting activity can be helpful as addition to preparations used in the treatment of staphylococcal infections.

Staphylococcus aureus biofilm and the role of bacteriophages in its eradication

The ability to form biofilm is an important virulence factor of many microorganisms. Infections involving biofilms account for approx. 65% of all human infections. Biofilms may develop on intravascular catheters or implanted devices such as prosthetic heart valves. Implanted devices are covered by biofilm and become reservoirs of microorganisms which can be a cause of persistent infections (endocarditis, deep tissue abscesses, septic arthritis, and osteomyelitis). Treatment of infections caused by biofilm-growing cells is linked to a high risk of failure due to an extreme resistance to antimicrobial agents and increased capacity to evade the immune responses. A large number of biofilm-associated infections involve Staphylococcus aureus. Treatment of staphylococcal infections is a great challenge for clinicians because of the presence of various mechanisms of resistance to antibiotics in S. aureus, for example methicillin resistance and biofilm production. Therapeutic difficulties related with antibiotic-resistant bacteria and limitations in research on new antimicrobials were the reasons that nearly 100 years after discovery, bacteriophages caught the attention of scientists around the world as a new therapeutic option for bacterial infections. Numerous in vitro studies on S. aureus strains showed that phages can both prevent biofilm formation and contribute to the elimination of bacteria from the mature biofilm structure. The major role in biofilm eradication play depolymerases produced by some phages which facilitate their penetration into the inner layers of biofilm by disturbing the biofilm structure. This leads to the conclusion that bacteriophages treatment might become a new strategy in the prevention and eradication of infectious bacterial biofilms, including these formed by S. aureus.

Molecular and phenotypic characterization of the vancomycin-resistant gene in bacterial isolates acquired from catheter tips.

Gram-positive bacteria, particularly Staphylococcus aureus is a significant pathogen, not only in the hospital setting but the community also. S. aureus is a major cause of serious hospital and community-acquired infections, particularly in the colonized individuals. The emergence of vancomycin-resistant S. aureus (VRSA) strains has led to global concerns about treatments for staphylococcal infections. Until now, few strains of VRSA have been reported worldwide. The conventional disk diffusion method for determination of vancomycin sensitivity often misclassifies intermediately susceptible isolates to fully sensitive. However, non-automated minimum inhibitory concentration (MIC) detection methods are the gold standards. Hence there is a dire need of some advanced methods for rapid detection of VRSA strains. In the present study, Gram-positive clinical isolates were collected from different wards of K.G.M.U. Hospital, among them, 12 bacterial isolates were identified as Staphylococcus aureus and 18 isolates as Klebsiella spp. Genomic DNA of S. aureus was isolated and used as template in PCR for detection of the presence of van A and van X gene based on a given protocol. Nosocomial infections have an impact on morbidity and probably on mortality as well, and pose a significant economic burden. Rapid molecular identification of antibiotic-resistant strains undoubtedly helps to prevent the hospital-induced infections.

Molecular and phenotypic characterization of the vancomycin-resistant gene in bacterial isolates acquired from catheter tips

Gram-positive bacteria, particularly Staphylococcus aureus is a significant pathogen, not only in the hospital setting but the community also. S. aureus is a major cause of serious hospital and community-acquired infections, particularly in the colonized individuals. The emergence of vancomycin-resistant S. aureus (VRSA) strains has led to global concerns about treatments for staphylococcal infections. Until now, few strains of VRSA have been reported worldwide. The conventional disk diffusion method for determination of vancomycin sensitivity often misclassifies intermediately susceptible isolates to fully sensitive. However, non-automated minimum inhibitory concentration (MIC) detection methods are the gold standards. Hence there is a dire need of some advanced methods for rapid detection of VRSA strains. In the present study, Gram-positive clinical isolates were collected from different wards of K.G.M.U. Hospital, among them, 12 bacterial isolates were identified as Staphylococcus aureus and 18 isolates as Klebsiella spp. Genomic DNA of S. aureus was isolated and used as template in PCR for detection of the presence of van A and van X gene based on a given protocol. Nosocomial infections have an impact on morbidity and probably on mortality as well, and pose a significant economic burden. Rapid molecular identification of antibiotic-resistant strains undoubtedly helps to prevent the hospital-induced infections.

Multidrug and vancomycin resistance among clinical isolates of Staphylococcus aureus from different teaching hospitals in Nigeria.

Staphylococcus aureus has emerged as a major public health concern because of the occurrence of multi-drug resistant strains. This study aimed at investigating the multi-drug and vancomycin resistance profile of S. aureus from different infection sites in some teaching hospitals in Nigeria. Swabs were collected from different infection sites from out-patients in three teaching hospitals from October 2015 to May, 2016. The antibiotic-susceptibility test was carried out with selected antibiotics usually administered anti-microbials in the treatment of infections in these hospitals. The prevalence of multi-drug and vancomycin resistance strains of S. aureus from clinical samples was determined using disk diffusion and agar dilution methods respectively. The result showed (165)82.5% of the isolates were resistant to ≥3 antibiotics tested. They were highly resistant to ceftazidime 180(90%), cloxacillin 171(85.6%) and augmentin 167(83.3%), but susceptible to ofloxacin 150(75%), gentamicin 142(71.7%), erythromycin 122(61.1%), ceftriaxone 111(55.6%) and cefuroxime 103(51.7%). All the isolates from the HVS were all multidrug resistant strains. While (56)90.16% were multidrug resistant (MDR) in urine samples, followed by (8)88.89% MDR strains in sputum, (37)88.81% MDR strains in semen, (49)71.64% MDR strains in wounds and (6)60% MDR strains in ear swabs samples. Although (147)73.5% of the isolates were vancomycin susceptible S. aureus (VSSA), (30)15% were vancomycin intermediate resistant S. aureus (VISA) and (89)44.5% of the isolates were considered vancomycin resistant S. aureus (VRSA). The high percentage of the VRSA could have resulted from compromising treatment options and inadequate antimicrobial therapy. The implication, infections caused by VRSA would be difficult to treat with vancomycin and other effective antibiotics of clinical importance. Ensuring proper monitoring of drug administration will, therefore, enhance the legitimate role of vancomycin as an empiric choice for both prophylaxis against and treatment of staphylococcal infections.

Inducible clindamycin and methicillin resistant Staphylococcus aureus in a tertiary care hospital, Kathmandu, Nepal

BackgroundStaphylococcus aureus, an important nosocomial pathogen, is frequently associated with infections in human. The management of the infections by it especially methicillin resistant ones is often difficult because methicillin resistant S. aureus is usually resistant to multiple antibiotics. Macrolide-lincosamide streptogramin B family of antibiotics is commonly used to treat such infections as an alternative to vancomycin.MethodsThis study was conducted over the period of one and half year from November 2013–April 2015 in Microbiology laboratory of Nepal Medical College and Teaching Hospital, Kathmandu, Nepal to find the incidence of different phenotypes of MLSB resistance among S. aureus from clinical samples and their association with methicillin resistance. Two hundred seventy isolates of S. aureus were included in the study. Methicillin resistance was detected by cefoxitin disc diffusion method and inducible clindamycin resistance by erythromycin and clindamycin disc approximation test (D-test).ResultsOf the 270 clinical isolates of S. aureus, 25.1% (68/270) were MRSA. Erythromycin and clindamycin resistance was seen in 54.4% (147/270) and 41.8% (113/270) isolates respectively. Resistance to erythromycin and clindamycin were higher in MRSA as compared to MSSA (erythromycin-resistance: 88.2% Vs 39.1% and clindamycin-resistance: 79.4% Vs 41.8%). The overall prevalence of iMLSB and cMLSB phenotype was 11.48% (31/270) and 29.25% (79/270) respectively. Both iMLSB and cMLSB phenotypes predominated in MRSA strains.ConclusionsDetection rate of MRSA in our study shows the necessity to improve in healthcare practices and to formulate new policy for the control of MRSA infections. Clindamycin resistance in the form of iMLSB and cMLSB especially among MRSA emphasizes the need of D-test to be performed routinely in our set up while using clindamycin as an alternative choice to anti-staphylococcal antibiotics like vancomycin and linezolid in the treatment of staphylococcal infections.

Mupirocin in the Treatment of Staphylococcal Infections in Chronic Rhinosinusitis: A Meta-Analysis.

BackgroundSaline irrigation of the nasal cavity is a classic and effective treatment for acute or chronic rhinosinusitis. Topical antibiotics such as mupirocin have been widely used for recalcitrant chronic rhinosinusitis. Therefore, the purpose of this study was to evaluate the effect of saline irrigation using mupirocin.MethodsA systematic literature review and meta-analysis of mupirocin saline irrigation were performed using EMBASE, MEDLINE, and Cochrane library through December 2015. Data were analyzed with R 3.2.2 software. A random effects model was used because of the diversity of included studies. Sensitivity analysis of particular tested groups and single proportion tests were also performed. The main outcome measure was residual staphylococcal infection, as confirmed by culture or PCR.ResultsTwo RCTs, two prospective studies and two retrospective studies were included. A random effects model meta-analysis of the pooled data identified a relative risk of residual infection of 0.13 (95% CI: 0.06–0.26, p<0.05) with low heterogeneity (I2 = 0%). The proportion of residual staphylococcal infections after 1 month was 0.08 (95% CI: 0.04–0.16). However, this proportion increased to 0.53 at 6 months (95% CI: 0.27–0.78).ConclusionsThe short-term use of mupirocin has a strongly reductive effect on staphylococcal infection in chronic rhinosinusitis. Although there is currently a lack of clear evidence, future studies with well-designed inclusion criteria and randomized controlled trials are needed to examine mupirocin’s long-term effect on chronic rhinosinusitis.

The evolutionary pathway of the staphylococcal cassette chromosome element

AbstractThe staphylococcal cassette chromosome (SCC) element can carry resistance genes to antibiotics, disinfectants, and heavy metals, contributing to the survival of strains in the environment and causing difficulties in the treatment of staphylococcal infections. Methicillin resistance in staphylococci, which is of particular clinical significance, is encoded by staphylococcal cassette chromosome

Characterization of Teicoplanin Nonsusceptible Staphylococcus epidermidis Clinical Isolates Belonging Predominantly to ST267.

Staphylococcus epidermidis is the main cause of bacteremia and infections of indwelling catheters, glycopeptide antibiotics are often considered as the choice of empirical drugs for the treatment of staphylococcal infections. In the present study, 12 teicoplanin nonsusceptible S. epidermidis isolates were collected between January and October 2013. All strains carried the mecA gene, displayed multiple drug resistance, and showed heterogeneous resistance to vancomycin using the population analysis profiling/area under the curve method. Multilocus sequence typing revealed four different sequence types among these isolates; eight isolates belonged to the same ST type (ST267). Pulsed-field gel electrophoresis (PFGE) with SmaI endonuclease showed four distinct pulsotypes. Six isolates that belonged to ST267 shared the same PFGE bands, indicating that they were clonally related. In addition, cell wall thickening and decreased autolysis were found in these isolates. Our study demonstrated that ST267 was the most epidemic clone among teicoplanin nonsusceptible S. epidermidis and identified a potential endemic clone in this region, which was believed to be the first report that the ST267 clone has spread in China. Our findings revealed that strengthened monitoring of S. epidermidis for drug resistance to glycopeptide antibiotics is urgently needed, and heightened measures should be taken to control the further spread of the ST267 clone.

VanA-Type MRSA (VRSA) Emerged in Surface Waters.

Due to the widespread occurrence of mecA-encoded methicillin resistance in Staphylococcus aureus (MRSA), treatment of staphylococcal infections is shifted to glycopeptide antibiotics like vancomycin and teicoplanin. The selective pressure of glycopeptides has eventually led to the emergence of staphylococci with increased resistance. Of great concern is vanA-encoded high level vancomycin and teicoplanin resistance in MRSA (VRSA). Therefore, this study aimed at investigating the occurrence of VRSA in surface waters. Out of 290, two staphylococcal isolates identified as MRSA Al11, Ba01, and one as MRS Co11 through 16S rRNA sequencing, also displayed high level resistance towards vancomycin and teicoplanin. These staphylococcal isolates were found to harbor vanA gene with sequence similarities of 99%-100% to the vanA gene extracted from vancomycin- and teicoplanin-resistant enterococcal (VRE) surface water isolates of Enterococcus faecalis Cr07, E07, Pb06 and E. faecium E330. High level glycopeptide resistance rendering protein encoded by the vanA gene, D-alanine-D-lactate ligase found in VRE, was also shown to be present in all vanA-type staphylococcal isolates through western blot. Current study elucidated that surface waters provide high potential for enterococcal vanA gene being transferred to MRSA, so called VRSA, and require special scientific consideration.

Safety, tolerability and pharmacokinetics of multiple oral doses of AFN-1252 administered as immediate release (IR) tablets in healthy subjects

Background: AFN-1252 is a novel inhibitor of FabI, which is essential in Staphylococcus spp. This study evaluated the safety, tolerability and pharmacokinetics of multiple oral doses of AFN-1252 immediate-release tablets.Methods: Part I evaluated AFN-1252 as a single 200 mg dose in fed versus fasted subjects. Part II evaluated 200, 300 and 400 mg doses of AFN-1252 administered once-daily for 10 days.Results: Pharmacokinetics indicated good absorption with a median Tmax of 2–3 hours, and a mean t1/2 of 7–10 hours, for all doses. Cmax and AUC responses were non-linear. A high-fat meal reduced AUC0–t and Cmax values by 62% and 48%, respectively, and delayed Tmax by 2.5 hours. All adverse events, including possibly drug-related headache and nausea, were mild or moderate.Conclusions: Multiple ascending doses of AFN-1252 were safe and well tolerated. AFN-1252 has potential for once- or twice-daily dosing in the treatment of staphylococcal infections.

تحدید الجین vanA المشفر لمقاومة الفانکومایسین على الدنا الکروموسومی والبلازمیدات فی المکورات العنقودیة الذهبیة المعزولة من خمج الجروج.

Staphylococcus aureus is one of the common causes of hospital and community acquired infections and treatment of Staphylococcal infections is complication because ability of this bacteria species to resistant to antibiotics .In this study vancomycin resistant Staphylococcus aureus were grew on Muller hintone agar contain vancomycin (6µg / ml) with percentage 25% (24/96) , Genomic DNA and plasmids isolated from isolates using standard producers. VanA gene amplification using PCR and suitable primers. The amplification gene was produced 1032bp at agarose gel electrophoresis .VanA gene was detected in 50% (12/24) on chromosomal DNA and in 20.8% (5/25) on plasmid of vancomycin resistant Staphylococcus aureus.

Nasal Carriage of Staphylococcus aureus among Paramedical Students in Alexandria and Evaluation of Dry Spot Staphytect Latex Kit as a Rapid Screening Method for Staphylococcus aureus

Background: Staphylococcus aureus ( S. aureus) is a common cause of nosocomial and community acquired infections worldwide. Nasal carriage of S. aureus acts as an endogenous reservoir for clinical infections in the colonized individual and also as a source of cross-colonization for community spread. Infections caused by S. aureus range clinically from minor skin infections to severe life threatening infections; with mortality rates ranging from 6 to 40 %.Treatment of staphylococcal infections has now become more challenging with emergence of methicillin resistant S. aureus (MRSA) strains; which are often also multidrug-resistant. Objectives: The present study was conducted to screen for the prevalence rate of nasal carriage of S. aureus among paramedical students studying at the Faculty of Allied Medical Sciences, Pharos University, Alexandria, Egypt. The study also aimed at studying the validity of Dry Spot Staphytect Latex Kit as a rapid screening test for identification of S. aureus. Methods: Nasal swabs were collected from 100 volunteer students over a period of three months (February-April 2015). Swabs were cultured both on blood agar and mannitol salt agar and all isolates that were confirmed microscopically and biochemically as S. aureus were tested for antibiotic sensitivity using modified Kirby Bauer technique. Dry Spot Staphytect Latex Kit was evaluated as a rapid method for identification of S. aureus, setting the positive result of tube coagulase test as a gold standard. Results: The nasal carriage rate of S. aureus detected was 34%, 18 % of which were MRSA strains. The highest level of sensitivity to antibiotics among S. aureus isolates was recorded for vancomycin and mupirocin, (97.1%) each. Regarding MRSA strains, 100% were sensitive to mupirocin and 100% were resistant to oxacillin. Dry Spot Staphytect Latex Kit had a sensitivity of 97.06 %, a specificity of 96.97 %, a positive predictive value of 94.29 %, a negative predictive value of 98.46 % and an accuracy of 97 % in rapid identification of S. aureus. Conclusion: Paramedical university students are a high risk group for nasal carriage of S. aureus and MRSA. Dry Spot Staphytect latex test is recommended for use as an efficient rapid, sensitive, specific and accurate screening test for S. aureus and MRSA. Key words: S. aureus , MRSA, nasal carriage, paramedical students, Dry Spot Staphytect Latex Kit

Epidemiological and Inducible Resistance in Coagulase Negative Staphylococci.

Background and Objectives:Coagulase negative staphylococci (CNS) are potential pathogens with the increased use of implants in hospitals. Macrolide, lincosamide and streptogramin B (MLSB) are used in the treatment of staphylococcal infections. The aim of this study was to molecular detection of inducible clindamycin resistance and genetic pattern in CNS isolates and their transmission between hospitals.Materials and Methods:110 CNS strains, isolated from hospitalized patients in the intensive care unit and infectious wards of Besat and Toohid hospitals, Sanandaj. Methicillin resistance was done by agar screen test and the resistance inducible Clindamycin by the D-Test. Multiplex PCR was performed, using primers specific for erm (A, B, C, and TR) genes. Diversity of strains was determined by ERIC–PCR technique based on the similarities between DNA fingerprints by using Jaccards coefficient in the SAHN program of the NTSYS-pc software.Results:Of the 110 isolates, 64(58.2%) were methicillin -resistant CNS (MRCNS), 48(43.6%) were resistant to erythromycin (ERCNS). Out of 48 Erythromycin-resistant strains 5 (10.4%) were iMLSB phenotypes that 4 isolates showed genes erm by Multiplex PCR. The ERIC–PCR profiles allowed typing of the 110 isolates into 90 ERIC-types which were grouped into fourteen main clusters (C1–C14).Conclusion:The results of this study also showed that most of CNS isolated produced different genomic fingerprint patterns, therefore, source of infection is differen t.

Small Scale Plastic Anaerobic Biogas Digester Disinfects Ciprofloxacin Resistant Staphylococcus aureus (CRSA) from Hospital Wastewater in Cameroon: A Preliminary Report

Disposal of untreated medical and pharmaceutical wastewaters containing antibiotic resistant bugs is frequently discharged onto the environment. Antibiotic resistance is fast becoming one of the most important health problems in both the developing as well as the developed world. The need to embark on this study has been motivated by a number of empirical observations: a retrospective study from January 2012 to April 2014 indicated a growing resistance by Staphylococcus aureus from abscesses, urinary tract and vaginal tract to ciprofloxacin in some hospital and clinics in Cameroon using 500 patients folders which were randomly selected and observed that ciprofloxacin antibiotic resistance was up to 65% with multidrug resistance also observed. Nosocomial Staphylococcal infections are also highly prevalent amongst patients with prolonged hospital stay in Cameroon. Hospital wastewater sampled from 10 health care units in the North West Region of Cameroon was cultured at the Phyto-Biotechnology research laboratory, on Manitol Salt agar and Nutrient agar. Staphylococcus aureus was recovered as the most prevalent bacteria. An antibiotic sensitivity test was carried out using the most frequently prescribed antibiotics in Cameroon for the treatment of staphylococcal infections. We hypothesize that such untreated water used in small-scale agricultural practices in SSA potentially carry antibiotic resistant fluoroquinolones and B-lactams are also being used in human chemotherapeutics. This potentially disseminates resistant microbial strains into humans and thus limits the range of effective antibiotics or human use. Ciprofloxacin resistant Staphylococcus aureus isolates (10,000CFU/ml) from hospital wastewater was re-suspended in peptone water and fed onto a 5 litre plastic digester using poultry and cow manure slurries as starter cultures. After 6 weeks Hydraulic retention time, samples drawn from the digester and cultured yielded no growth for staphylococcus aureus as against control in a round bottom flasks containing CRSA left on bench. Methane gas was collected at the 5 th week in a plastic tube for cooking. It was concluded that plastic digesters can potentially disinfects antibiotic resistant Staphylococcus aureus from hospital wastewater while producing biogas for cooking and sterile slurry for gardening.

The prevalence of aminoglycoside-modifying enzymes among coagulase negative staphylococci in Iranian pediatric patients.

In spite of widespread emergence of aminoglycoside resistance, these drugs are still used in the treatment of staphylococcal infections. This study aimed to investigate the distribution of aminoglycoside resistance and genes encoding aminoglycoside - modifying enzymes (AMEs) as well as Staphylococcal Cassette Chromosome mec (SCCmec) type in coagulase negative staphylococci (CoNS) in pediatric patients. Totally, 93 CoNS isolates were examined for susceptibility to aminoglycosides using disk diffusion and/or E-test methods. AMEs genes and SCCmec types were detected using multiplex PCR. Strain typing was performed using repetitive extragenic palindromic (REP) - PCR assay. The non-susceptibility rates to kanamycin, tobramycin, gentamicin, amikacin and netilmicin were 73%, 59%, 49.5%, 16% and 7.5%, respectively. aac(6')-Ie-aph(2″)-Ia, ant(4')-Ia and aph(3')-IIIa were encountered in 56 (60.2%), 38 (40.8%) and 18 (19.3%) isolates, respectively. In aac(6')-Ie-aph(2″)-Ia- positive isolates, the non- susceptibility rates to kanamycin, gentamicin, tobramycin, amikacin and netilmicin were 83%, 74%, 73%, 49% and 43%, respectively. SCCmec types included type IV (n = 31), I (n = 17), II (n = 5), III (n = 4), and V (n = 2). Three isolates had two types; I + III (n = 2) and III + IV (n = 1) whereas 11 isolates were non-typeable. AMEs genes carriers were distributed frequently into type IV. We found diverse fingerprint patterns among our isolates. In conclusion, there was a strong correlation between alarming rate of aminoglycoside resistance and methicillin resistance. Discordances between phenotypic and genotypic detection of aminoglycoside resistance were discernible. AMEs genes might be related to SCCmec types.

Prevalence of inducible clindamycin resistance among community-associated staphylococcal isolates in central Serbia

The emergence of resistance to most antimicrobial agents in staphylococci indicates the need for new effective agents in the treatment of staphylococcal infections. Clindamycin is considered to be one safe, effective and less costly agent. We analysed 482 staphylococcal isolates. Detection of inducible clindamycin resistance was performed by the D-test, while the presence of methylases genes: erm (A), erm (B) and erm (C), as well as, macrolide efflux gene mef was determined by polymerase chain reaction. Inducible clindamycin resistance phenotype was significantly higher in Staphylococcus aureus (S. aureus) strains then in coagulase-negative staphylococci (CNS). Among analysed S. aureus isolates, the predominance of the erm (C) gene, followed by the erm (A) gene were detected. These results indicate that the D-test should be routinely performed on each staphylococcal isolates.

Surveillance of Methicillin-resistant Staphylococcus aureus Causing Nosocomial Infections in Five Medical Centers of Monterrey, Nuevo León, México from 2005–2009

Staphylococcus aureus is a principal cause of human bacterial infection worldwide. The dissemination of antibiotic resistance among S. aureus strains is very import in the treatment of Staphylococcal infections. We undertook this study to identify methicillin-resistant Staphylococcus aureus (MRSA) clones responsible for nosocomial infection in five medical centers in Monterrey, Nuevo León (N.L.), México from 2005-2009. One hundred ninety MRSA strains collected from 2005-2009 from five hospitals affiliated with the Instituto Mexicano del Seguro Social (IMSS) in Monterrey, N.L., México were characterized by antimicrobial susceptibility, pulsed field gel electrophoresis (PFGE) and Staphylococcal Cassette Chromosome mec (SCCmec) typing. Only one clone was present in the five hospitals (clone C); this clone is strongly associated with the New York-Japan clone (SCCmec II) with a broad resistance profile. This study clearly documented the high ability for dissemination and the persistence of the New York-Japan clone in these centers.