Nasal carriage of S. aureus increases the risk of surgical site infection after major heart surgery

Muñóz, Patricia; Hortal, Javier; Giannella, Maddalena; Barrio, José María; Rodríguez‐Créixems, Marta; Pérez, María Jesús; Rincón, Cristina; Bouza, Emilio

doi:10.1016/j.jhin.2007.08.010

Cited by 137 publications

(90 citation statements)

References 22 publications

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“…aureus nasal colonization is a significant risk factor for several infections, including bacteremia, postoperative infections, and diabetic foot ulcer infections, and contributes to the spread of this pathogen in hospital environments (50)(51)(52)(53). Many hospitals…”

Section: Discussionmentioning

confidence: 99%

Tannic Acid Inhibits Staphylococcus aureus Surface Colonization in an IsaA-Dependent Manner

et al. 2013

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Staphylococcus aureus is a human commensal and pathogen that is capable of forming biofilms on a variety of host tissues and implanted medical devices. Biofilm-associated infections resist antimicrobial chemotherapy and attack from the host immune system, making these infections particularly difficult to treat. In order to gain insight into environmental conditions that influence S. aureus biofilm development, we screened a library of small molecules for the ability to inhibit S. aureus biofilm formation. This led to the finding that the polyphenolic compound tannic acid inhibits S. aureus biofilm formation in multiple biofilm models without inhibiting bacterial growth. We present evidence that tannic acid inhibits S. aureus biofilm formation via a mechanism dependent upon the putative transglycosylase IsaA. Tannic acid did not inhibit biofilm formation of an isaA mutant. Overexpression of wild-type IsaA inhibited biofilm formation, whereas overexpression of a catalytically dead IsaA had no effect. Tannin-containing drinks like tea have been found to reduce methicillin-resistant S. aureus nasal colonization. We found that black tea inhibited S. aureus biofilm development and that an isaA mutant resisted this inhibition. Antibiofilm activity was eliminated from tea when milk was added to precipitate the tannic acid. Finally, we developed a rodent model for S. aureus throat colonization and found that tea consumption reduced S. aureus throat colonization via an isaA-dependent mechanism. These findings provide insight into a molecular mechanism by which commonly consumed polyphenolic compounds, such as tannins, influence S. aureus surface colonization.

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Section: Discussionmentioning

confidence: 99%

Tannic Acid Inhibits Staphylococcus aureus Surface Colonization in an IsaA-Dependent Manner

et al. 2013

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“…The quinoline-derived cationic antimicrobial HT61 [1] was initially developed to improve the success of nasal decolonisation interventions aimed at decreasing the risk of post-operative surgical site infections (SSI) posed by carriage of methicillin resistant Staphylococcus aureus (MRSA) [2,3] . However, more recently it has been proposed as a resistance breaker to be used in conjunction with other more established antimicrobials [4] .…”

Section: Introductionmentioning

confidence: 99%

“…In bilayers containing 25 mol% phosphatidylglycerol, neutron reflectometry data suggests that exposure to HT61 increases the level of solvent in the hydrophobic region of the membrane, which is indicative of gross structural damage. Increasing the proportion of PG elicits a concomitant level of membrane damage resulting in almost total destruction when 75 mol% phosphatidylglycerol is present.We therefore propose that HT61's primary action is directed towards the cytoplasmic membrane of Gram positive bacteria.The quinoline-derived cationic antimicrobial HT61 [1] was initially developed to improve the success of nasal decolonisation interventions aimed at decreasing the risk of post-operative surgical site infections (SSI) posed by carriage of methicillin resistant Staphylococcus aureus (MRSA) [2,3] . However, more recently it has been proposed as a resistance breaker to be used in conjunction with other more established antimicrobials [4] .…”

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confidence: 99%

Mechanism of Action of a Membrane-Active Quinoline-Based Antimicrobial on Natural and Model Bacterial Membranes

et al. 2017

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self-assembled monolayers; SLD, scattering length density; SMW, silicon matched water; SSI, surgical site infections; SRS, standard reaction solution; TMPA, 3-(trimethoxysilyl)propyl acrylate; TSA, tryptone soya agar. ABSTRACTHT61 is a quinoline-derived antimicrobial, which exhibits bactericidal potency against both multiplying and quiescent methicillin resistant and sensitive Staphylococcus aureus, and has been proposed as an adjunct for other antimicrobials in order to extend their usefulness in the face of increasing antimicrobial resistance. In this study we have examined HT61's effect on the permeability of Staphylococcus aureus membranes and whether this putative activity can be attributed to an interaction with lipid bilayers. Using membrane potential and ATP release assays, we have shown that HT61 disrupts the membrane enough to results in depolarisation of the membrane and release of intercellular constituents at concentrations above and below the minimum inhibitory concentration of the drug. Utilising both monolayer subphase injection and neutron reflectometry we have shown that increasing the anionic lipid content of the membrane leads to a more marked effect of the drug. In bilayers containing 25 mol% phosphatidylglycerol, neutron reflectometry data suggests that exposure to HT61 increases the level of solvent in the hydrophobic region of the membrane, which is indicative of gross structural damage. Increasing the proportion of PG elicits a concomitant level of membrane damage resulting in almost total destruction when 75 mol% phosphatidylglycerol is present.We therefore propose that HT61's primary action is directed towards the cytoplasmic membrane of Gram positive bacteria.The quinoline-derived cationic antimicrobial HT61 [1] was initially developed to improve the success of nasal decolonisation interventions aimed at decreasing the risk of post-operative surgical site infections (SSI) posed by carriage of methicillin resistant Staphylococcus aureus (MRSA) [2,3] . However, more recently it has been proposed as a resistance breaker to be used in conjunction with other more established antimicrobials [4] . Although the protein synthesis inhibitor mupirocin is currently widely used for anti-MRSA nasal decolonisation, it is not active against non-multiplying persister bacteria which constitute a reservoir for recolonisation [5] . In addition to this, an increased prevalence of mupirocin resistant MRSA [6] has led to the development of more effective alternatives, including the experimental antimicrobials LTX-109 [7] and XF-73 [8] in addition to HT61 [1] .The mode of action of HT61 has not hitherto been thoroughly investigated, however initial cell-based assays showed that HT61 is capable of depolarising the cytoplasmic membrane ofGram positives with further evidence from electron microscopy suggesting that HT61 causes lysis of either the membrane or cell wall [1,4] . The putative membrane-targeting of HT61 may provide some explanation for its potency against non-multiplying MRSA [9] , and suggests that...

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“…Colonization is well described, with up to 30% of the population thought to be carriers (7,16,18), and is associated with a higher risk of infection in the hospital setting (2,4,9,11,12,15,17,18). The anterior nares have been shown to be the most frequent site of carriage and therefore a single site for detection (9,10,18).…”

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confidence: 99%

Comparison of Flocked and Rayon Swabs for Detection of Nasal Carriage of Staphylococcus aureus among Pathology Staff Members

et al. 2010

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Comparison of flocked swabs (E-swabs; Copan) to the standard rayon swabs (Copan) was undertaken for detection of Staphylococcus aureus nasal carriage among staff at Dorevitch Pathology in Heidelberg, Melbourne, Australia. Among 100 volunteers, 36 were found to be colonized with S. aureus by one or both swab results. The prevalence detected by E-swabs was 35%, and the prevalence through rayon swabs was 34% (95% confidence interval [CI] for the difference in proportions, ؊12 to 14). Thirty-three volunteers tested positive with both types of swabs, while 2 were detected on E-swabs alone and another on rayon swab testing alone. There was no evidence of a significant difference in carriage detected by E-swabs or rayon swabs.Staphylococcus aureus is a common cause of infections in the community and a major cause of hospital-associated morbidity (18). Colonization is well described, with up to 30% of the population thought to be carriers (7,16,18), and is associated with a higher risk of infection in the hospital setting (2,4,9,11,12,15,17,18). The anterior nares have been shown to be the most frequent site of carriage and therefore a single site for detection (9,10,18). Nasal carriage is defined as "persistent" or "intermittent or noncarriage," with persistent carriers showing an increased risk of infection, compared with intermittent carriers who share the same low risk as noncarriers (13). Given the clinical relevance, it is imperative to use the best swab system which would provide the highest yield in detecting nasal carriage. Flocked swabs have been described as improving uptake of epithelial cells and, therefore, microorganisms and viruses (1,5,6,14), but are more expensive than standard rayon swabs, so it is therefore worth investigating whether there is evidence that E-swabs perform better in detecting nasal carriage.Aims. This study was designed to determine if there is a difference in the performance of E-swabs over standard rayon swabs in detecting nasal carriage of S. aureus among healthy adult staff volunteers at a pathology service in Melbourne, Australia.Ethics approval was gained from The University of Melbourne Human Research Ethics Committee (identification no. 0826852). Volunteers were recruited from staff based at Dorevitch Pathology in Melbourne.All volunteers were sequentially allocated a study identification number, and individual results remained anonymous. Each volunteer had sampling from each naris with both swabs (E-swab and Rayon swab; Copan). To ensure that equal numbers of participants were swabbed with each swab type, participants with odd study numbers were sampled with an E-swab first (right then left naris) followed by the rayon swab and those with even study numbers were swabbed in the reverse order. The swab sequence was therefore captured in the study identification number, allowing us to investigate whether swab sequence was important and to control for potential bias associated with swab sequence. Laboratory staff involved in isolating S. aureus were blinded to the swabbing seque...

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Nasal carriage of S. aureus increases the risk of surgical site infection after major heart surgery

Cited by 137 publications

References 22 publications

Tannic Acid Inhibits Staphylococcus aureus Surface Colonization in an IsaA-Dependent Manner

Tannic Acid Inhibits Staphylococcus aureus Surface Colonization in an IsaA-Dependent Manner

Mechanism of Action of a Membrane-Active Quinoline-Based Antimicrobial on Natural and Model Bacterial Membranes

Comparison of Flocked and Rayon Swabs for Detection of Nasal Carriage of Staphylococcus aureus among Pathology Staff Members

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