Purpose To compare the efficacy of systemic treatment with linezolid (LNZ) versus vancomycin (VAN) on methicillin-resistant Staphylococcus aureus (MRSA) burden and eradication in endotracheal tube (ETT) biofilm and ETT cuff from orotracheally intubated patients with MRSA respiratory infection. Methods Prospective observational clinical study was carried out at four European tertiary hospitals. Plasma and endotracheal aspirate (ETA) levels of LNZ and VAN were determined 72 h after treatment initiation through high-performance liquid chromatography or bioassay. LNZ or VAN concentration in the ETT biofilm and MRSA burden and eradication was determined upon extubation. The minimum inhibitory concentration (MIC) for LNZ and VAN was assessed by E-test strips (Biomerieux®). Scanning electron microscopy images were obtained, and ETT biofilm thickness was compared between groups. Results Twenty-five patients, 15 treated with LNZ and 10 with VAN, were included in the study. LNZ presented a significantly higher concentration (μg/mL) than VAN in ETT biofilm (72.8 [1.3–127.1] vs 0.4 [0.4–1.3], p < 0.001), although both drugs achieved therapeutic plasma levels 72 h after treatment initiation. Systemic treatment with LNZ achieved lower ETT cuff MRSA burdens than systemic treatment with VAN. Indeed, LNZ increased the MRSA eradication rate in ETT cuff compared with VAN (LNZ 75%, VAN 20%, p = 0.031). Conclusions In ICU patients with MRSA respiratory infection intubated for long periods, systemic treatment with LNZ obtains a greater beneficial effect than VAN in limiting MRSA burden in ETT cuff. Electronic supplementary material The online version of this article (10.1186/s13054-019-2523-5) contains supplementary material, which is available to authorized users.
Artículos de investigación clínica o experimental Prevalencia de Staphylococcus aureus que coloniza el personal de salud de un hospital de la ciudad de Cali Prevalence of Staphylococcus Aureus Colonizing the Health Care Personnel of a Hospital in the City of Cali Prevalência de Staphylococcus aureus que coloniza o pessoal de saúde de um hospital da cidade de Cali
Cerclage wiring may be used for fracture fixation or osteotomy stabilization in revision arthroplasty. There is a lack of evidence regarding the potential risk of bacterial colonization for the different types of cerclages. The objective of our research is to study the adhesion and biofilm formation of S. epidermidis, S. aureus, and P. aeruginosa on two different cerclage cable models, comparing a polymer cable and a stainless steel metal cable. A two-cm cerclage piece of each material was submerged in 2 mL of tryptic soy broth (TSB) inoculated with 10 μL of a 0.5 McFarland bacterial culture, and incubated at 37°C during 2 h for adhesion and 48 h for biofilm formation. The cerclages were washed with 1xPBS and sonicated in a new culture medium. Aliquots of several dilutions of each sonicated culture were spread in TSB agar and incubated at 37°C for 24 h. The number of colonies was counted. The colony-forming units per ml (CFU/mL) and the percentage of reduction were calculated. Experiments were triplicated. For P. aeruginosa, a statistically significant reduction in biofilm formation was found on the polymer cerclage cable, compared to the metal cerclage cable. Reductions of 59% and 88%, after 2 h and 48 h, respectively, were observed. For S. epidermis and S. aureus, there was a trend towards lower bacterial adhesion and biofilm formation for the polymer cerclage cable. In summary, these results demonstrate that the braided polymer cerclage cable may be less prone to bacterial adherence and biofilm formation compared to the braided metal cerclage cable.
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