Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-Resistant<i>Staphylococcus aureus?</i>

Richet, Hervé; Benbachir, M.; Brown, Derek E J; Giamarellou, Helen; Gould, Ian M.; Gubina, Marija; Heczko, Piotr B; Kalenić, Smilja; Pană, Marina; Pittet, Didier; Redjeb, S. Ben; Schindler, Jiří; Starling, Carlos Ernesto Ferreira; Struelens, Marc; Witte, Wolfgang; Jarvis, William R.

doi:10.1086/502216

Cited by 35 publications

(25 citation statements)

References 28 publications

(12 reference statements)

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“…Less than 20 years after the discovery of penicillin, the organism acquired the ␤-lactamase gene. In addition, methicillin resistance has been spreading rapidly in recent years (17), and the first fully vancomycin-resistant isolates have recently appeared (1,3,4). To complicate matters further, most strains of S. aureus are capable of assuming the biofilm mode of growth, and when bacteria are growing in a biofilm state, they are resistant to antibiotic levels 10-to 1,000-fold higher than genetically identical planktonic bacteria.…”

mentioning

confidence: 99%

Use of Confocal Microscopy To Analyze the Rate of Vancomycin Penetration through Staphylococcus aureus Biofilms

Jefferson

Goldmann

Pier

2005

Antimicrob Agents Chemother

271

178

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When bacteria assume the biofilm mode of growth, they can tolerate levels of antimicrobial agents 10 to 1,000 times higher than the MICs of genetically equivalent planktonic bacteria. The properties of biofilms that give rise to antibiotic resistance are only partially understood. Inhibition of antibiotic penetration into the biofilm may play a role, but this has not been proven directly. In this report, penetration of the glycopeptide antibiotic vancomycin into viable Staphylococcus aureus biofilms was analyzed by confocal scanning laser microscopy using a fluorescently labeled derivative of the drug. We found that while vancomycin bound to free-floating bacteria in water within 5 min, it took more than 1 h to bind to cells within the deepest layers of a biofilm. These results indicate that the antibiotic is transported through the depth of the biofilm but that the rate is significantly reduced with respect to its transport through flowing water. This suggests that, whereas planktonic bacteria were rapidly exposed to a full bolus of vancomycin, the bacteria in the deeper layers of the biofilm were exposed to a gradually increasing dose of the drug due to its reduced rate of penetration. This gradual exposure may allow the biofilm bacteria to undergo stressinduced metabolic or transcriptional changes that increase resistance to the antibiotic. We also investigated the role of poly-N-acetylglucosamine, an important component of the S. aureus biofilm matrix, and found that its production was not involved in the observed decrease in the rate of vancomycin penetration.

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mentioning

confidence: 99%

Use of Confocal Microscopy To Analyze the Rate of Vancomycin Penetration through Staphylococcus aureus Biofilms

Jefferson

Goldmann

Pier

2005

Antimicrob Agents Chemother

271

178

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“…15 Of the isolated cases of S. aureus, 67% were identified as MRSA, and there was an incidence of MRSA infection of 0.5 per 1,000 patient-days of hospitalization. Only 4/6 centres (67%) had an active MRSA surveillance program, with a mean proportion of one infection control nurse for every 191 hospital beds (range from 1:80 to 1:324).…”

Section: The Status Of Prevention and Control Of Mrsa In Hospitals Inmentioning

confidence: 99%

Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

Labarca¹,

Salles²

2010

Braz J Infect Dis

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After the first reports of the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the 1970s, numerous measures intended to prevent its transmission were initiated in hospitals. However, in most cases, large-scale measures failed to be implemented and the transmission of MRSA has since led to a global pandemic. Presently, doubts still remain about the best approach to prevent and control MRSA and more often than not, control measures are not implemented. Therefore, we review here the current situation in Latin America with respect to existing policies for control of MRSA, and evaluate the evidence for control measures in hospitals and the community. We look at the risk factors for infection and transmission of MRSA between hospital patients and within specific populations in the community, and at the effect of antibiotic usage on the spread of MRSA in these settings. Finally, we summarize recommendations for the prevention and control of MRSA, which can be applied to the Latin American hospital environment and community setting.

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“…Support strengthening of infection control capacities within health-care settings (II). 1026,1030,1031 C. Promote hand hygiene at the community level to strengthen both self-protection and the protection of others (II). …”

Section: For National Governmentsmentioning

confidence: 99%

Hand Hygiene

Longtin¹,

Sax²,

Allegranzi³

et al. 2011

N Engl J Med

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107

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Are There Regional Variations in the Diagnosis, Surveillance, and Control of Methicillin-ResistantStaphylococcus aureus?

Cited by 35 publications

References 28 publications

Use of Confocal Microscopy To Analyze the Rate of Vancomycin Penetration through Staphylococcus aureus Biofilms

Use of Confocal Microscopy To Analyze the Rate of Vancomycin Penetration through Staphylococcus aureus Biofilms

Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

Hand Hygiene

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