Staphylococcus aureus is the most common cause of peritonitis in patients undergoing peritoneal dialysis in Brazil. Using restriction endonuclease analysis of plasmid DNA, we investigated the importance of chronic carriage of S. aureus in the development of peritonitis in patients on continuous ambulatory peritoneal dialysis at the Division of Nephrology, Escola Paulista de Medicina, Sao Paulo, Brazil. A total of 117 isolates (30 patients) of S. aureus were available for typing, including 51 isolates (22 patients) from the nares, 58 isolates (27 patients) from pericatheter skin, and 8 isolates (6 patients) from peritoneal fluid, from patients with peritonitis. Restriction endonuclease subtyping showed that although most patients harbored more than one subtype of S. aureus, in the majority of patients nasal and/or pericatheter skin isolates with identical restriction endonuclease digest patterns were recovered on more than one occasion. Furthermore, 95% of patients with both nasal and pericatheter colonization were colonized with the same subtypes at both sites. All of the patients with peritonitis were infected with a subtype which colonized the nares, pericatheter skin, or both. These results demonstrate the importance of an endogenous source of S. aureus in the development of continuous ambulatory peritoneal dialysis-associated peritonitis.
Enterococci resistance to glycopeptides was evaluated em Brazilian poultry fed with feed supplemented with avoparcin as growth promoter. The susceptibility to the glycopeptides avoparcin, teicoplanin and vancomycin was determined for 217 enterococci isolated from cloacal swabs (one swab per bird) in tests and controls groups. Tests group comprised three groups (A, B and C) of Hubbard broiler-chickens 14, 21 and 35 days old, respectively. These birds were from one single farm, with a common feed source supplemented with avoparcin (10 mg/kg of feed). Controls groups (1 and 2) comprised 25 and 42 days old broilers, respectively, obtained from the Faculty of Veterinary Medicines aviary (University of São Paulo) where avoparcin was never used. No glycopeptide resistant enterococci strain was found, but an increase of Enterococcus faecium in faeces of chickens fed with avoparcin, independent of the age of the bird, was detected.
Lactobacillus spp. were identified in 100 broiler litter samples collected from different poultry-rearing regions in Brazil. Ten different Lactobacillus species were identified: L. viridenscens and L. amylophilus.
4mig/mL). A resistência cruzada para as fluoroquinolonas foi observada mesmo para drogas não disponíveis comercialmente. As fluoroquinolonas que permaneceram ativas contra amostras resistentes à ciprofloxacina (clinafloxacina e WIN-57.273) apresentaram MICs 8 a 64 vezes mais elevados que as amostras sensíveis à ciprofloxacina, sugerindo que, quando lançadas na prática clínica, esses MICs possam se elevar ainda mais, inviabilizando o uso clínico desses compostos. CONCLUSÃO. Os resultados do presente estudo mostraram uma alta taxa de resistência a antimicrobianos das amostras de S. aureus nos hospitais do Brasil, restando poucas opções para o tratamento de infecções causadas por ORSA.]]>
Central venous catheterization is a common technique to establish rapid and temporary access for hemodialysis. However, it is a known risk factor for Staphylococcus aureus infection and bacteremia. Mupirocin is a topical antibiotic with high in vitro anti-staphylococcal activity. A randomized prospective trial was conducted to assess the effectiveness of mupirocin ointment in the prevention of Staphylococcus aureus skin and catheter colonization, and episodes of bacteremia in 136 end-stage renal disease patients. Of these, 67 received skin disinfection at the venous catheter insertion site with povidone iodine (control group), and 69 received the same treatment followed by application of 2% mupirocin ointment at the cannula site after catheter placement and at the end of each dialysis session. Patients were followed until catheter removal and were monitored for the development of Staphylococcus aureus skin/catheter colonization and episodes of bacteremia. Median duration of catheter use was greater in the mupirocin than in the control group (37 versus 20 d, P < 0.01). Patients in the mupirocin group had a significantly lower rate of Staphylococcus aureus isolation from the pericatheter skin (1.76 per 1000 versus 14.27 per 1000 patient-days, P < 0.001) and from the catheter surface (3.17 per 1000 versus 14.27 per 1000 patient-days, P < 0.001). The proportion of patients with Staphylococcus aureus skin infection at the insertion site was lower in the mupirocin group (4.3% versus 23.9%, P = 0.001). Staphylococcus aureus-associated bacteremia was observed in 17 patients (two in the mupirocin group [0.71 episodes per 1000 patient-days] and 15 in the control group [8.92 per 1000 patient-days], P < 0.001). The hazard ratio of developing Staphylococcus aureus bacteremia was 7.2 (95% confidence interval, 1.6 to 31.6) times greater in patients not receiving mupirocin. Mupirocin applied to the insertion site significantly reduces the risk of Staphylococcus aureus skin and catheter colonization, exit-site infection, and Staphylococcus aureus bacteremia in hemodialysis patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.