Methicillin-Resistant Staphylococcus Aureus and Antimicrobial Use in Belgian Hospitals

Crowcroft, Natasha S.; Ronveaux, Olivier; Monnet, Dominique; Mertens, R

doi:10.1086/501555

Cited by 118 publications

(92 citation statements)

References 17 publications

(10 reference statements)

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“…Low colonization density or an intracellular reservoir may be responsible for negative results of intermittent screenings. 26 ' 27 Interestingly, infection during follow-up was more frequent among patients with intermittent carriage, a finding that, to our knowledge, has not been reported up to now. Eventually, negative results of intermittent screenings may lead to a premature suspension Log-rank test for decolonization treatment versus no decolonization treatment in patients with 4-7 risk factors (P = .03).…”

Section: Mrsa Infection During Follow-upmentioning

confidence: 62%

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Marschall

Mühlemann

2006

Infect. Control Hosp. Epidemiol.

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OBJECTIVE. To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens. DESIGN. Retrospective cohort study. SETTING. A 1,033-bed tertiary care university hospital in Bern, Switzerland, in which the prevalence of methicillin resistance among S. aureus isolates is less than 5%. . Failure of decolonization treatment was associated with the presence of risk factors at the time of treatment (P = .01). Intermittent screenings that were negative for MRSA were frequent (26% of patients), occurred early after first detection of MRSA (median, 31.5 days), and were associated with a lower probability of clearing colonization (HR, 0.34 [95% CI,) and an increased risk of MRSA infection during follow-up.CONCLUSIONS. Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.

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Section: Mrsa Infection During Follow-upmentioning

confidence: 62%

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Marschall

Mühlemann

2006

Infect. Control Hosp. Epidemiol.

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“…Much larger representative samples of epidemic and nonepidemic strains will have to be tested to document a possible correlation between intensive use of fluoroquinolones and selection of particularly invasive S. aureus isolates with a high potential of epidemic transmission. Interestingly, one recent study evaluating the relationship between the incidence of MRSA and the use of different classes of antimicrobials in Belgian hospitals found a correlation with increasing use of quinolones in a multivariate analysis (7). In another prospective randomized study, outbreaks of MRSA superinfections causing late-onset pneumonia were clearly associated with ciprofloxacin use in intensive care units (23).…”

Section: Discussionmentioning

confidence: 99%

Induction of Fibronectin-Binding Proteins and Increased Adhesion of Quinolone-ResistantStaphylococcus aureusby Subinhibitory Levels of Ciprofloxacin

Bisognano

Vaudaux

Rohner

et al. 2000

Antimicrob Agents Chemother

116

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We recently reported that strain EN1252a, a fluoroquinolone-resistant derivative of Staphylococcus aureus NCTC8325 with mutations in grlA and gyrA, expressed increased levels of fibronectin-binding proteins (FnBPs) and showed a significantly higher attachment to fibronectin-coated polymer surfaces after growth in the presence of subinhibitory concentrations of ciprofloxacin. The present study evaluated the occurrence and frequency of fluoroquinolone-induced FnBP-mediated adhesion in clinical isolates of fluoroquinolone-resistant methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA). Eight of ten MRSA isolates and four of six MSSA isolates with grlA and gyrA mutations exhibited significant increases in attachment to fibronectin-coated surfaces after growth in the presence of one-quarter the MIC of ciprofloxacin. Fluoroquinolone-induced FnBP-mediated adhesion of one clinical MRSA strain and the double mutant strain EN1252a also occurred on coverslips removed from the subcutaneous space of guinea pigs. For strain EN1252a, the regulation of fnb transcription by sub-MICs of ciprofloxacin was studied on reporter plasmids carrying fnb-luxAB fusions. One-quarter of the MIC of ciprofloxacin significantly increased fnbB, but not fnbA, promoter activity of the fluoroquinolone-resistant mutant but not its fluoroquinolone-susceptible parent ISP794. This response was abolished by pretreatment with rifampin, indicating an effect at the level of transcription. Activation of the fnbB promoter was not due to an indirect effect of ciprofloxacin on growth rate and still occurred in an agr mutant of strain EN1252a. These data suggest that sub-MIC levels of ciprofloxacin activate the fnbB promoter of some laboratory and clinical isolates, thus contributing to increased production of FnBP(s) and leading to higher levels of bacterial attachment to fibronectin-coated or subcutaneously implanted coverslips.

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“…10,11 Pseudomonas also showed a maximum sensitivity to penicillin derivatives (Piperacillin/Tazobactam) in our study as already reported in other International studies. 12,13 Third generation Cephalosporin (ceftazidime) and Aminoglycoside (gentamicin) has a potent anti-pseudomonas activity. 14,15 The antibiotic sensitivity of other isolates showed a variable pattern.…”

Section: Discussionmentioning

confidence: 99%

An Observational Study- Pattern of Pathogens and Their Sensitivity Isolated From Superficial Surgical Site Infections

Yashaswi¹,

Bhushan²,

Nupur³

et al. 2017

jemds

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BACKGROUNDInfection is an important cause of morbidity and mortality in post-operative patients. Frequently emerging multidrug resistance and difficulty in curing patients with medications necessitates such study. Surgical Site Infections (SSI) are defined as infections that occur at the incision site within thirty days after surgery.The objectives of the study were to determine the pattern of pathogens involved and their antibiotic sensitivity isolated from superficial surgical site infections. MATERIALS AND METHODSThis is an observational study that was conducted for 6 months. Pus culture and sensitivity reports were collected prospectively from hospitalised patients who developed postoperative wound infections. The patients who developed faecal/biliary/urinary fistula or operated for malignancies and with negative cultures were excluded from the study. Analysis was carried out using SPSS 10. RESULTSDuring the study period 60 patients were analysed, E. coli 36 (60%) is the most common isolate in our study followed by 12 (20%) Klebsiella. Staphylococcus epidermidis is the least commonly found isolate, 1 (1.7%). All isolates were sensitive to penicillin derivatives and carbapenem. Quinolones, Aminoglycosides and Monobactams were also showing some promise in our study. However, Cephalosporins were ineffective against most of the important isolates in our study. CONCLUSIONThere was compelling evidence that Cephalosporins were ineffective against the common pathogens causing SSI and it is time for surgeons to court 'new' antibiotics effective against today's pathogens for both prophylaxis and empirical therapy.

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Methicillin-Resistant Staphylococcus Aureus and Antimicrobial Use in Belgian Hospitals

Cited by 118 publications

References 17 publications

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Duration of Methicillin-Resistant Staphylococcus aureus Carriage, According to Risk Factors for Acquisition

Induction of Fibronectin-Binding Proteins and Increased Adhesion of Quinolone-ResistantStaphylococcus aureusby Subinhibitory Levels of Ciprofloxacin

An Observational Study- Pattern of Pathogens and Their Sensitivity Isolated From Superficial Surgical Site Infections

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