Antibiotic surgical prophylaxis increases nasal carriage of antibiotic-resistant staphylococci

McMurray, Claire; Hardy, Katherine; Verlander, Neville Q.; Hawkey, Peter M.

doi:10.1099/jmm.0.000182

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…We observed a positive association between previous dispensation of any antibiotics and isolation of MRSA, but caution is needed as MRSA was only isolated in 1.3% of the individuals in our study. This is consistent with previous hospital studies where antibiotic surgical prophylaxis increases nasal carriage of antibiotic-resistant staphylococci [ 23 ]. Evidence seems to indicate that the endogenous microflora of the patient may be critical since clinical studies have found that S. aureus skin colonisation increases the risk of a subsequent infection by three-fold, and up to 80% of cases of staphylococcal bacteraemia are caused by strains identical to those in the patient’s nasal cavity [ 24 ].…”

Section: Discussionsupporting

confidence: 93%

Previous antibiotic exposure and antibiotic resistance of commensal Staphylococcus aureus in Spanish primary care

Boada

Pons‐Vigués

Real

et al. 2018

European Journal of General Practice

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Introduction: Commensal flora of healthy people is becoming an important reservoir of resistant bacteria.Objectives: To evaluate the relationship of previous antibiotic-dispensed and resistance pattern of strains of Staphylococcus aureus in primary care patients.Methods: A cross-sectional study was carried out in seven primary care centres in Catalonia, Spain, from October 2010 to May 2011, as part of the APRES (The appropriateness of prescribing antibiotics in primary care in Europe concerning antibiotic resistance) study. Outpatients aged 4 or more who did not present an infectious disease and had not taken antibiotic or had not been hospitalised in the previous 3 months were invited to participate. Nasal swabs were collected for S. aureus culture, and antimicrobial susceptibility testing was carried out. Antibiotics dispensed boxes in the previous 4 years were extracted from Information System for Research in Primary Care.Results: A total of 4,001 nasal swabs were collected, and 3,969 were tested for identification, 765 S. aureus were tested for resistance. Resistance rates to penicillin, azithromycin and methicillin were 87.1%, 11.6% and 1.3%, respectively, and a total of 10 MRSA strains were isolated (1.3%). Penicillin-resistant staphylococci were statistically significantly associated with the previous number of packages of penicillin dispensed (OR, 1.18; 95% CI, 1.04–1.35).Conclusion: Although no causal inference is possible, an association was observed between previous antibiotic dispensation and isolation of resistant organisms in community-dwelling individuals, mainly between packages of penicillin and penicillin-resistant staphylococci.

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Section: Discussionsupporting

confidence: 93%

Previous antibiotic exposure and antibiotic resistance of commensal Staphylococcus aureus in Spanish primary care

Boada

Pons‐Vigués

Real

et al. 2018

European Journal of General Practice

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“…Staphylococci were cultured on selective media and identified to species level as described previously [8]. In brief, S. aureus and coagulase negative staphylococci (CNS) isolates were preliminary identified by colony morphology from culture media.…”

Section: Methodsmentioning

confidence: 99%

“…Antibiotic surgical prophylaxis is administered to surgical patients to reduce the risk of postoperative infection. The only culture-dependent study of the impact of antibiotic surgical prophylaxis on the nasal microbiota [8] reported that antibiotics did impact on staphylococcal diversity but that the effect was patient specific. However, a major limitation of the study was the culture-based methodology.…”

Section: Introductionmentioning

confidence: 99%

Staphylococcal species heterogeneity in the nasal microbiome following antibiotic prophylaxis revealed by tuf gene deep sequencing

McMurray¹,

Hardy²,

Calus³

et al. 2016

Microbiome

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BackgroundStaphylococci are a major constituent of the nasal microbiome and a frequent cause of hospital-acquired infection. Antibiotic surgical prophylaxis is administered prior to surgery to reduce a patient’s risk of postoperative infection. The impact of surgical prophylaxis on the nasal staphylococcal microbiome is largely unknown. Here, we report the species present in the nasal staphylococcal microbiome and the impact of surgical prophylaxis revealed by a novel culture independent technique. Daily nasal samples from 18 hospitalised patients, six of whom received no antibiotics and 12 of whom received antibiotic surgical prophylaxis (flucloxacillin and gentamicin or teicoplanin +/− gentamicin), were analysed by tuf gene fragment amplicon sequencing.ResultsOn admission to hospital, the species diversity of the nasal staphylococcal microbiome varied from patient to patient ranging from 4 to 10 species. Administration of surgical prophylaxis did not substantially alter the diversity of the staphylococcal species present in the nose; however, surgical prophylaxis did impact on the relative abundance of the staphylococcal species present. The dominant staphylococcal species present in all patients on admission was Staphylococcus epidermidis, and antibiotic administration resulted in an increase in species relative abundance. Following surgical prophylaxis, a reduction in the abundance of Staphylococcus aureus was observed in carriers, but not a complete eradication.ConclusionsUtilising the tuf gene fragment has enabled a detailed study of the staphylococcal microbiome in the nose and highlights that although there is no change in the heterogeneity of species present, there are changes in abundance. The sensitivity of the methodology has revealed that the abundance of S. aureus is reduced to a low level by surgical prophylaxis and therefore reduces the potential risk of infection following surgery but also highlights that S. aureus does persist.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-016-0210-1) contains supplementary material, which is available to authorized users.

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“…In addition, the increasing occurrence of antibiotic resistance has been recognized to be a global problem. There is also some evidence for selecting antibiotic-resistant staphylococci in relation to wide-range antibiotic prophylaxis [48]. …”

Section: Rationale and Basic Concepts Of Pji Preventionmentioning

confidence: 99%

Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

et al. 2016

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Prosthetic joint infection (PJI) is a feared complication of total joint arthroplasty associated with increased morbidity and mortality. There is a growing body of evidence that bacterial colonization and biofilm formation are critical pathogenic events in PJI. Thus, the choice of biomaterials for implanted prostheses and their surface modifications may significantly influence the development of PJI. Currently, silver nanoparticle (AgNP) technology is receiving much interest in the field of orthopaedics for its antimicrobial properties and a strong anti-biofilm potential. The great advantage of AgNP surface modification is a minimal release of active substances into the surrounding tissue and a long period of effectiveness. As a result, a controlled release of AgNPs could ensure antibacterial protection throughout the life of the implant. Moreover, the antibacterial effect of AgNPs may be strengthened in combination with conventional antibiotics and other antimicrobial agents. Here, our main attention is devoted to general guidelines for the design of antibacterial biomaterials protected by AgNPs, its benefits, side effects and future perspectives in PJI prevention.

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Antibiotic surgical prophylaxis increases nasal carriage of antibiotic-resistant staphylococci

Cited by 7 publications

References 26 publications

Previous antibiotic exposure and antibiotic resistance of commensal Staphylococcus aureus in Spanish primary care

Previous antibiotic exposure and antibiotic resistance of commensal Staphylococcus aureus in Spanish primary care

Staphylococcal species heterogeneity in the nasal microbiome following antibiotic prophylaxis revealed by tuf gene deep sequencing

Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

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