Management of MRSA patients on the dental chair

Manjunath, Nandini; Banu, Faima; Chopra, Aditi; Kumar, Parimala; Nishana, Fathimath

doi:10.18203/2320-6012.ijrms20173595

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Namun, dewasa ini sering dijumpai resistensi antibiotik sehingga digunakan Chlorhexidine gluconate (CHX) sebagai penatalaksanaan infeksi bakteri S. aureus. 4,5 Dosis CHX pada sediaan topical maupun obat kumur yang umumnya digunakan dalam penatalaksanaan infeksi S. aureus adalah sebanyak 0.2%. CHX masih merupakan gold standar antibakteri yang memiliki mekanisme aksi bakteriostatik maupun bakteriosid.…”

Section: Pendahuluanunclassified

Perbandingan Daya Hambat Chlorhexidine Gluconate 0.2% dan Ekstrak Ethanol Bunga Kecicang (Etlingera elatior) terhadap Bakteri Staphylococcus aureus secara In Vitro

Henadi,

I Gusti Ayu Fienna Novianthi Sidiartha,

I Gusti Agung Sri Pradnyani

2021

BDJ

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Introduction: Staphylococcus aureus is part of the normal human flora in the oral cavity which is often found as a pathogen in multi-cases of dental and systemic diseases. Management infection of this bacteria, generally uses β-lactam antibiotics group. However, nowadays there were often cases of Staphylococcus aureus antibiotic resistance thus Chlorhexidine gluconate (CHX) 0.2% is used. CHX has extensive antibacterial power with relatively low toxicity. Furthermore, the latest research has shown that there are even present CHX-resistant Staphylococcus aureus strains. Kecicang (Etlingera elatior) is a plant that is often used as herbs and traditional medicine in Bali. Kecicang has been shown to contain antibacterial compounds, so it is expected to be an antibacterial alternative to avoid cases of antibiotic resistance. The aim of the study is to determine the ratio of 0.2% CHX inhibition and 10%, 20%, 30%, 40%, and 50% kecicang extracts. Method: Post Test Only Control Group Design study design is used in this study, comparing the inhibitory power of kecicang flower extract with 0.2% CHX against Staphylococcus aureus (ATCC 35923). The extract is made using the maceration method, using 96% ethanol solvent, 10%, 20%, 30%, 40%, and 50% concentration then analyzed using qualitative-phytochemical analysis. The bacterial test is using the Kirby-Bauer method in MHA and observed by two examiners. Vancomycin is used as positive control and distilled water is used as a negative control. Results: Kecicang extract then detected positive for saponins, triterpenoids, steroids, phenols, and flavonoids, while alkaloids were detected negatively. The mean CHX inhibition zone is 0.2% (13,875 mm). The mean inhibition zone is 10% (5.5 mm), 20% (6 mm), 30% (6.4 mm), 40% (7.125 mm), 50% (7.5 mm). There is an increase in the inhibition zone along with increasing concentrations of kecicang extract (p <0.05) Conclusion: Based on measurements by two examiners, the kecicang flower extract 10%, 20%, 30%, 40%, and 50% has smaller inhibitory power than the 0.2% CHX inhibition power (p <0.05). Latar Belakang: Staphylococcus aureus adalah normal flora rongga mulut yang sering menjadi pathogen kasus penyakit gigi dan sistemik. Penatalaksanaan umumnya menggunakan antibiotik golongan β-laktam. Namun, dewasa ini sering dijumpai kasus resistensi Staphylococcus aureus sehingga digunakan Chlorhexidine gluconate (CHX) 0.2%. CHX memiliki daya antibakteri luas dengan toksisitas relatif rendah. Namun, penelitian menunjukan bahkan terdapat strain Staphylococcus aureus resisten CHX. Kecicang (Etlingera elatior) adalah tumbuhan yang sering dimanfaatkan sebagai rempah serta obat tradisional di Bali. Kecicang terbukti mengandung komponen fitokimia-majemuk bersifat antibakteri, sehingga diharapkan menjadi alternatif antibakteri untuk menghindari kasus resistensi antibiotik. Tujuan penelitian: mengetahui perbandingan daya hambat CHX 0.2% dan ekstrak kecicang 10%, 20%, 30%, 40%, dan 50%. Metode: Penelitian menggunakan rancangan penelitian Post Test Only Control Group Design, membandingkan daya hambat ekstrak bunga kecicang dengan CHX 0.2% terhadap Staphylococcus aureus (ATCC 35923). Ekstrak dibuat dengan metode maserasi simplisia, pelarut ethanol 96%, variasi konsentrasi 10%,20%,30%,40%, dan 50% kemudian dilakukan analisis fitokimia-kualitatif. Pengujian bakteri menggunakan metode Kirby-Bauer pada MHA, diamati dua orang mata pengamat. Kontrol positif menggunakan Vancomycin dan kontrol negatif menggunakan aquades. Hasil: Ekstrak kecicang terdeteksi positif saponin, triterpenoid, steroid, fenol, dan flavonoid, sedangkan alkaloid terdeteksi negatif. Mean zona hambat CHX 0.2% (13.875 mm). Mean zona hambat kecicang 10% (5.5 mm), 20% (6 mm), 30% (6.4 mm), 40% (7.125 mm), 50% (7.5 mm). Terlihat peningkatan zona hambat seiring dengan peningkatan konsentrasi ekstrak bunga kecicang (p<0.05) Kesimpulan: Berdasarkan pengukuran oleh dua orang mata pengamat, ekstrak bunga kecicang konsentrasi 10%,20%,30%,40%, dan 50% memiliki daya hambat lebih kecil daripada daya hambat CHX 0.2% (p<0.05).

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Section: Pendahuluanunclassified

Perbandingan Daya Hambat Chlorhexidine Gluconate 0.2% dan Ekstrak Ethanol Bunga Kecicang (Etlingera elatior) terhadap Bakteri Staphylococcus aureus secara In Vitro

Henadi,

I Gusti Ayu Fienna Novianthi Sidiartha,

I Gusti Agung Sri Pradnyani

2021

BDJ

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“…Manjunath recently focused on the management of MRSA patients in the dental chair [57]. MRSA can be transmitted by a carrier state, often asymptomatic, in dental patients and dental healthcare personnel (DHCP) (by contaminated hands) or by spray and splash, contaminated items.…”

Section: Noncompliance Lapses and Errors During Infection Preventiomentioning

confidence: 99%

Infection Control in Dentistry and Drug-Resistant Infectious Agents: A Burning Issue. Part 2

Barenghi¹,

Barenghi²,

Blasio³

2020

Surgical Infections - Some Facts

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We showed that antibiotic-resistant bacterial infections inside of dental settings are relevant. Here, we have focused on the limited awareness on infection prevention guidelines, and the lapses and errors during infection prevention, which sustain the evidence of possible reservoirs of antibiotic-resistant bacterial infections in humans (dental staff and patients) and on dental items or in the environment. We chose Staphylococci and Enterobacteriaceae as markers since they are considered as prioritized bacteria according to antibiotic resistance pressure, and the data are available on their virulence factors and for dental settings. For better dental patient and healthcare personnel safety, we need to improve knowledge on bioburden and biofouling, based also on molecular biological methods, and education and training initiatives to limit the hazards in surgical dental settings and to sustain accreditation survey.

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“…11 Latex agglutination method detects mecA gene product i.e., PBP2a. 12 The genotypic methods confirm the presence or absence of mecA gene in methicillin resistant Staphylococcus aureus isolates by polymerase chain reaction. 13 MRSA is considered to be a potential "Super Bug" which is a major threat to hospital infection control.…”

Section: Introductionmentioning

confidence: 99%

Detection of mecA gene by latex agglutination and its molecular analysis by PCR in methicillin resistant staphylococcus aureus.

Khawaja

Javed

Mushtaq³

et al. 2020

TPMJ

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Antimicrobial resistance (AMR) is a devastating question that is threatening the health globally. The extensive and indiscriminative use of antibiotics has evolved a notorious resistance in Staphylococcus aureus. This resistance developed through possession of mecA gene, which codes for modified penicillin binding protein (PBP2a) and the emergent strain being labeled “methicillin resistant Staphylococcus aureus”. Conventional phenotypic techniques for detection of MRSA rely on standardization of cultural characteristics. The drawbacks of diagnostic error to report MRSA include: poor prognosis, expensive treatment, dissemination of multi-drug resistant strains and even treatment failure. Latex agglutination method can be adopted as a more accurate and quick strategy for rapid detection of methicillin resistance. Objectives: To compare detection of mecA gene in methicillin resistant isolates of Staphylococcus aureus by latex agglutination and PCR; by assessing the sensitivity and specificity of both methods. Study Design: Descriptive Cross-Sectional study. Setting: Pathology Department, Post Graduate Medical Institute, Lahore. Period: From January 2015 to December 2015; according to standard operating procedures at Microbiology laboratory. Material & Methods: A total 713 consecutive, non-duplicate isolates of Staphylococcus aureus were processed. Methicillin resistance was determined using cefoxitin (30mg) by Kirby-Bauer method using CLSI guideline (2016), latex agglutination method; and PCR for mecA gene. Results: The results showed that out of 713 Staphylococcus aureus isolates, 92 (12.90%) isolates were resistant to cefoxitin and were labelled as MRSA. majority MRSA isolates recovered from pus (44.57%) and wound swab (20.65%), followed by blood (13.04%), fluid (8.70%), CSF (4.35%), CVP (3.26%), HVS (3.26%) and tracheal secretion (2.17%). By latex agglutination method, 87 (94.50%) were positive for PBP2a; while on PCR mecA gene was detected only in 82 (89.10%) MRSA isolates. When assessed with PCR (gold standard) the sensitivity and diagnostic accuracy of latex agglutination was 100% and 94.57%, respectively. Conclusion: Latex agglutination test can be employed as rapid and reliable diagnostic technique in MRSA isolates for mecA gene detection, where resources for molecular methods are inadequate. This can effectually lessen the misdiagnosis of resistant strains, and over/ ill-use of antibiotics.

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Management of MRSA patients on the dental chair

Cited by 4 publications

References 16 publications

Perbandingan Daya Hambat Chlorhexidine Gluconate 0.2% dan Ekstrak Ethanol Bunga Kecicang (Etlingera elatior) terhadap Bakteri Staphylococcus aureus secara In Vitro

Perbandingan Daya Hambat Chlorhexidine Gluconate 0.2% dan Ekstrak Ethanol Bunga Kecicang (Etlingera elatior) terhadap Bakteri Staphylococcus aureus secara In Vitro

Infection Control in Dentistry and Drug-Resistant Infectious Agents: A Burning Issue. Part 2

Detection of mecA gene by latex agglutination and its molecular analysis by PCR in methicillin resistant staphylococcus aureus.

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