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Sample records for eczema herpeticum mrsa

  1. [Eczema herpeticum in a patient with atopic dermatitis, carrying r501x and 2282del4 filaggrin null mutations].

    PubMed

    Valdés-Rodríguez, Rodrigo; Saavedra-Alanís, Víctor M; Islas-Aguilar, Mario A; Torres-Álvarez, Bertha

    2015-01-01

    Eczema herpeticum is an acute dermatoses caused by herpes simplex virus type 1 in atopic dermatitis patients, and is considered a dermatology emergency. Eczema herpeticum occurs in less than 3% of atopic patients. We report a patient with a history of atopic dermatitis who presented to an emergency department with eczema herpeticum. He was admitted and treated with antiviral medications with good outcome. We investigated filaggrin null mutations in the patient and his family and correlate them with the severity of the disease. We present the first Mexican patient with eczema herpeticum, atopic dermatitis and the presence of R501 X and 2282del4 filaggrin null mutations. PMID:25946536

  2. Close association of predominant genotype of herpes simplex virus type 1 with eczema herpeticum analyzed using restriction fragment length polymorphism of polymerase chain reaction.

    PubMed

    Yoshida, Masami; Umene, Kenichi

    2003-04-01

    Herpes simplex virus type 1 (HSV-1) strains belonging to the same genotype can possibly share biological properties and clinical manifestations common to the genotype. We classified previously 66 HSV-1 strains into 35 genotypes (F1-F35) using restriction fragment length polymorphism (RFLP) and F1 and F35 genotypes were revealed to be predominant [Arch. Virol. 13 (1993) 29]. It was found later that the F35 genotype seemed to be closely associated with eczema herpeticum [J. Med. Virol. 49 (1996) 329]. In the present study, a convenient method was developed for classification of two predominant genotypes by RFLP of polymerase chain reaction (RFLP-PCR). Using this method, genotypes of 21 strains isolated from eczema herpeticum were analyzed; seven of 21 strains (33.3%) were of F1 and five of 21 (23.8%) were of F35. Genotypes of 19 strains isolated from facial herpes other than eczema herpeticum were as follows; six of 19 (31.6%) strains were of F1 and one of 19 (5.3%) were of F35. Thus, strains belonging to F35 were appear to have been isolated more frequently from eczema herpeticum (5/21) than from facial herpes (1/19). These ratios showed a statistically significant difference. These results support the hypothesis that F35 strains is clearly associated with eczema herpeticum, in agreement with previous study. This is the first report of PCR-based approach for classification of HSV-1 strains into genotypes seeking an association of a genotype with clinical manifestation. PMID:12668262

  3. Eczema

    MedlinePLUS

    Eczema is a term for several different types of skin swelling. Eczema is also called dermatitis. It is not dangerous, but most types cause ... swollen and itchy skin. Factors that can cause eczema include other diseases, irritating substances, allergies and your ...

  4. Eczema

    MedlinePLUS

    ... If you think you have eczema, your best bet is to visit your doctor, who may refer ... your skin. Soft cotton clothes are a better bet. Moisturize! A fragrance-free moisturizer such as petroleum ...

  5. Eczema

    PubMed Central

    Krafchik, Bernice R

    2000-01-01

    Eczema is a term used to describe a variety of conditions which primarily include atopic dermatitis, seborrheic dermatitis, contact dermatitis, both irritant and allergic, scabies, tinea infections and immunodeficiencies. Some physicians use the term solely to describe atopic dermatitis. The article reviews clinical findings, etiology, diagnosis, prognosis, treatment, complications and new therapies for atopic dermatitis. PMID:20177504

  6. Psoriasis Herpeticum due to Varicella Zoster Virus: A Kaposi's Varicelliform Eruption in Erythrodermic Psoriasis.

    PubMed

    Garg, Geeta; Thami, Gurvinder P

    2012-05-01

    Kaposi's varicelliform eruption (KVE) or eczema herpeticum is characterized by disseminated papulovesicular eruption caused by a number of viruses like Herpes simplex virus I and II, Coxsackie virus, and Vaccinia and Small pox viruses in patients with pre-existing skin disease. The occurrence of KVE with psoriasis has been reported recently as a new entity psoriasis herpeticum. The rare causation of psoriasis herpeticum due to Varicella zoster virus in a patient with underlying psoriasis is being reported for the first time. PMID:22707775

  7. MRSA

    MedlinePLUS

    Methicillin-resistant Staphylococcus aureus; Hospital-acquired MRSA (HA-MRSA) ... Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus (MRSA) infections. Treating MRSA skin and soft ...

  8. MRSA

    MedlinePLUS

    ... Disorder Dealing With Anger Meningitis Writing a Paper MRSA KidsHealth > Teens > Infections > Bacterial & Viral Infections > MRSA Print ... and how can you protect yourself? What Is MRSA? MRSA stands for methicillin-resistant Staphylococcus aureus . Staphylococcus ...

  9. MRSA

    MedlinePLUS

    MRSA stands for methicillin-resistant Staphylococcus aureus. It causes a staph infection (pronounced "staff infection") that is resistant to several common antibiotics. There are two types of infection. ...

  10. Types of Eczema (Dermatitis)

    MedlinePLUS

    ... Diseases and treatments E - H Eczema Types of eczema Also called dermatitis What is eczema? Eczema is a general term. Dermatologists use it ... eczema” and ones often called “dermatitis. Often called eczema Atopic dermatitis Children, especially babies, are most likely ...

  11. Hand Eczema

    PubMed Central

    Agarwal, Uma Shankar; Besarwal, Raj Kumar; Gupta, Rahul; Agarwal, Puneet; Napalia, Sheetal

    2014-01-01

    Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients. PMID:24891648

  12. Eczema: Bleach Bath Therapy

    MedlinePLUS

    ... treatment Tips Eczema: Bleach bath therapy Share your child's eczema story Basal cell carcinoma Bedbugs Botulinum toxin Chemical peel Contact dermatitis Dry skin Dermatofibrosarcoma protuberans Dyshidrotic eczema E - H I - L M - P Q - T U - W Health and beauty For ...

  13. MRSA Screening

    MedlinePLUS

    ... Was this page helpful? Formal name: Methicillin resistant Staphylococcus aureus Screening Related tests: Wound Culture At a ... know? How is it used? A methicillin resistant Staphylococcus aureus (MRSA) screen is a test that looks ...

  14. MRSA (For Parents)

    MedlinePLUS

    ... A With Robert Irvine Pregnant? What to Expect MRSA KidsHealth > Parents > Infections > Bacterial & Viral Infections > MRSA Print ... and most infections can be treated easily. About MRSA MRSA stands for methicillin-resistant Staphylococcus aureus, a ...

  15. Stopping MRSA

    ERIC Educational Resources Information Center

    Vogel, Carl

    2008-01-01

    Last fall, a fever gripped the nation--an overheating of news stories about the so-called super bug: methicillin-resistant Staphylococcus aureus, "staph," or simply "MRSA." The bacteria are not airborne contaminants, but when they enter a person's body through cuts, abrasions, or other breaks in the skin, they can cause infections, which can…

  16. Eczema (Atopic Dermatitis) Causes

    MedlinePLUS

    ... Read more information on enabling JavaScript. Skip Content Marketing Share this: Main Content Area Eczema (Atopic Dermatitis) Causes A combination of genetic and environmental factors appears to be involved in the development of eczema. The condition often is associated with ...

  17. Eek! It's Eczema!

    MedlinePLUS

    ... Puberty Video: Am I Normal? (Girls and Puberty) Movie: Digestive System How the Body Works Main Page ... some kind of scaly creature from a monster movie. No need to worry. It's just eczema. What ...

  18. Types of Eczema (Dermatitis)

    MedlinePLUS

    ... rings, use lukewarm water, and wash with a fragrance-free cleanser. Dyshidrotic eczema: Tips for managing Making ... time can help prevent flares. Wash with mild, fragrance-free cleansers : Skip the antibacterial soaps, waterless hand ...

  19. Eczema (Atopic Dermatitis) Symptoms

    MedlinePLUS

    ... from atopic dermatitis by volunteering for NIAID clinical studies on ClinicalTrials.gov . Related Links Allergic Diseases Asthma Food Allergy Immune System Methicillin-Resistant Staphylococcus Aureus (MRSA) National ...

  20. Eczema (Atopic Dermatitis) Diagnosis

    MedlinePLUS

    ... from atopic dermatitis by volunteering for NIAID clinical studies on ClinicalTrials.gov . Related Links Allergic Diseases Asthma Food Allergy Immune System Methicillin-Resistant Staphylococcus Aureus (MRSA) National ...

  1. MRSA and the Workplace

    MedlinePLUS

    ... Tweet Share Compartir Source: CDC MRSA photos Overview Staphylococcus aureus , often referred to simply as â??staph, ... wound infections, bloodstream infections, and pneumonia). Methicillin-resistant Staphylococcus aureus (MRSA) refers to types of staph that ...

  2. Recreational Water Illness (RWI): MRSA

    MedlinePLUS

    ... MRSA website. Can MRSA be spread at recreational water facilities? MRSA does not survive long in recreational ... myself, my family, and others when visiting recreational water facilities? Take action! There are steps you can ...

  3. MRSA in Schools

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a form of Staphylococcus aureus, a common bacterium that has developed resistance to several forms of antibiotics. MRSA has been around for many years, mostly in health care settings but has moved into the community in recent years. Infections can be seen anywhere but are mostly seen in…

  4. Eczema (Atopic Dermatitis)Treatment

    MedlinePLUS

    ... Read more information on enabling JavaScript. Skip Content Marketing Share this: Main Content Area Eczema (Atopic Dermatitis)Treatment On this page Skin Care at Home New Treatment Under Development: Wet Wrap Therapy Skin Care at Home You ...

  5. Making Headway Toward Causes of Eczema

    MedlinePLUS

    ... All rights reserved. More Health News on: Eczema Genes and Gene Therapy Recent Health News Related MedlinePlus Health Topics Eczema Genes and Gene Therapy About MedlinePlus Site Map FAQs Contact Us Get ...

  6. Oil on troubled waters: emollients and eczema.

    PubMed

    Voegeli, Dr David

    While most of us will have suffered from episodes of dry skin (xerosis) at some stage in our lives, this is usually confined to the occasional mildly annoying episode. However, for others, particularly those with eczema, this forms part of a chronic, very distressing situation that often has a significant impact on their quality of life. Despite the fact that many children and adults have eczema, it is still often considered to be a minor skin condition that children will 'grow out of'. However, an increased research focus towards examining the impact of eczema on the individual has shown that eczema is anything but a minor problem. PMID:20966858

  7. General Information about MRSA in the Community

    MedlinePLUS

    ... visit this page: About CDC.gov . Methicillin-resistant Staphylococcus aureus (MRSA) Infections Share Compartir General Information About MRSA in the Community MRSA is methicillin-resistant Staphylococcus aureus , a type of staph bacteria that is ...

  8. Eczema in north west of libya.

    PubMed

    Arshah, Tm; Shambesh, Mk; Grera, Am; Albaccush, M

    2008-01-01

    The life style and demographic structure of Libyan society is changing, and this could affect the epidemiology of certain diseases, including eczema. The aim of this study was to assess the burden of eczema among a selected patient population in the Zliten area in the northwest of Libya. We conducted a retrospective study by reviewing case notes and records in public and private dermatology practices in the Zliten area. The frequency of eczema among patients attending dermatology clinics in the Zliten area was 12.8%, and the male to female ratio was almost 1:1. The most affected age group among patients was 20-29 years. Eczema represented a larger proportion of dermatologic conditions during spring and summer. Of all cases of eczema, 72.6% were endogenous and 24.9% were exogenous (p<0.001). The most common type of eczema was contact dermatitis (22.7% of all cases), followed by atopic dermatitis (19.7%) and pityriasis alba (10.5%). In conclusion, eczema is a public health problem in Zliten-Libya, and this necessitates prospective studies to determine its incidence and prevalence. PMID:21499454

  9. Eczema

    MedlinePLUS

    ... All Around Family Life Family Life Family Life Health Management - Medical Home Family Dynamics Media Work & Play Getting Involved in Your Community Health Issues Health Issues Health Issues Conditions Injuries & Emergencies ...

  10. Eczema - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... XYZ List of All Topics All Eczema - Multiple Languages To use the sharing features on this page, please enable JavaScript. Korean (???) Spanish (español) Vietnamese (Tiê?ng Viê?t) Korean (???) ...

  11. General Information about MRSA in Healthcare Settings

    MedlinePLUS

    ... visit this page: About CDC.gov . Methicillin-resistant Staphylococcus aureus (MRSA) Infections Share Compartir General Information About ... and surgical site infections. MRSA is methicillin-resistant Staphylococcus aureus , a type of staph bacteria that is ...

  12. NARES CULTURE FOR MRSA SCREENING I. INTRODUCTION

    E-print Network

    Kay, Mark A.

    NARES CULTURE FOR MRSA SCREENING I. INTRODUCTION Active Surveillance Testing (AST) to detect newly admitted patients who are nasally colonized with MRSA is required in 2009 to comply with California Health an anterior nares specimen for MRSA screening. III. SUPPLIES 1. For children, adolescents and adults: BD BBL

  13. MRSA as a rare cause of vaginitis.

    PubMed

    de Bree, L C J; van Rijen, M M L; Coertjens, H P M; van Wijngaarden, P

    2015-12-01

    We describe a 26-year-old otherwise healthy woman with MRSA vaginitis. Traditional MRSA risk factors were absent and additional screening sites were negative. Patient was treated successfully with oral antibiotics combined with topical lactic acid emulsion. Because her partner appeared to have solitary MRSA carriage on the glans, a suggestion of sexual transmission was made. He was treated successfully with topical mupirocin ointment. Although solitary vaginal MRSA carriage and infection seems to be rare and its clinical impact is yet undefined, clinicians should consider adding the genitourinary tract to traditional screening sites in case of recurrent MRSA infections. PMID:25764306

  14. CA-MRSA. The new sports pathogen.

    PubMed

    Kurkowski, Christina

    2007-01-01

    Skin infections in athletes caused by community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) have been observed within many cities throughout the United States and within many countries throughout the world (Centers for Disease Control and Prevention [CDC], 2003). As the incidence rises in the athletic population, clinicians must learn to identify risk factors for CA-MRSA, diagnosis and treat infections with judicious use of antimicrobial agents and facilitate strategies to limit transmission. Recently, a new consensus guideline for handling CA-MRSA outbreaks in sports has been released by the CDC (Gorwitz et al., 2006). This article includes a review of the evolution of MRSA; distinguishes between healthcare associated Methicillin-resistant Staphylococcus aureus (HA-MRSA) and CA-MRSA; and reviews the diagnosis, management, and prevention strategies to limit transmission of CA-MRSA. PMID:17921891

  15. MRSA surveillance in a UK district hospital: measuring clinical isolates with MRSA is more useful than measuring MRSA bacteraemias.

    PubMed

    Enoch, D A; Cargill, J S; Sismey, A; Karas, J A

    2011-12-01

    The introduction of mandatory surveillance of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemias and targets in England has led to reductions in most hospitals. However, reductions were difficult to demonstrate at Peterborough & Stamford Hospitals NHS Foundation Trust as MRSA bacteraemia was already an uncommon event. The authors questioned the efficacy of monitoring bacteraemias in a low-prevalence hospital, and this study sought to determine the accuracy of measuring bacteraemias compared with all clinical isolates (excluding bacteraemias; e.g. wound, sputa, urine) to assess the effectiveness of interventions. Over the six-year study period, a significant reduction was seen in MRSA in clinical specimens and new MRSA carriers identified by screening, whereas the MRSA bacteraemia rate remained at low levels. The measurement of clinical isolates may be more useful for assessment of the effectiveness of interventions now that MRSA bacteraemia rates have fallen to low levels almost universally across the UK. PMID:21978609

  16. Swine MRSA isolates form robust biofilms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization of livestock animals is common and prevalence rates for pigs have been reported to be as high as 49%. Measures to prevent, control, or eliminate MRSA in swine is of considerable public health concern. Bacterial colonization ...

  17. Swine MRSA isolates form robust biofilms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methicillin-resistant Staphylococcus aureus (MRSA) colonization of livestock animals is common and prevalence rates for pigs have been reported to be as high as 49%. Measures to prevent, control, or eliminate MRSA in swine is of considerable public health concern. Bacterial colonization of both biol...

  18. MRSA

    MedlinePLUS

    ... causing abscesses are Staphylococcus aureus and Streptococcus . These bacteria… About Us | Terms of Use | Contact Us © 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site ...

  19. Vitamin D and the Development of Atopic Eczema

    PubMed Central

    Palmer, Debra J.

    2015-01-01

    A “vitamin D hypothesis” has been proposed to explain the increased prevalence of eczema in regions with higher latitude. This review focuses on the current available evidence with regard to the possible effect of vitamin D on the development of atopic eczema. Observational studies have indicated a link between vitamin D status and eczema outcomes, including lower serum vitamin D levels associated with increased incidence and severity of eczema symptoms. Vitamin D is known to have a regulatory influence on both the immune system and skin barrier function, both critical in the pathogenesis of eczema. However heterogeneous results have been found in studies to date investigating the effect of vitamin D status during pregnancy and infancy on the prevention of eczema outcomes. Well-designed, adequately powered, randomised controlled trials are needed. The study design of any new intervention trials should measure vitamin D levels at multiple time points during the intervention, ultraviolet (UV) radiation exposure via the use of individual UV dosimeters, and investigate the role of individual genetic polymorphisms. In conclusion, the current available evidence does not allow firm conclusions to be made on whether vitamin D status affects the development of atopic eczema. PMID:26239464

  20. Laboratory evaluation of the BD MAX MRSA assay.

    PubMed

    Widen, Raymond; Healer, Vicki; Silbert, Suzane

    2014-07-01

    A comparison between the BD MAX MRSA and Xpert MRSA assays was performed using 239 nares samples. A 97.9% overall agreement between the two molecular assays was observed. The BD MAX MRSA assay proved to be a reliable alternative for a highly automated system to detect methicillin-resistant Staphylococcus aureus (MRSA) in patient nares samples. PMID:24829235

  1. An overview of atopic eczema in children: a significant disease.

    PubMed

    Gill, Steve

    Atopic eczema is a significant disease, being the most common skin disorder in children, affecting 12-15% of all school-age children (Emerson et al, 1998). It is an inflammatory skin condition, which is genetic in origin but is triggered by many factors, such as detergents, emotional distress or dust mites (Buxton, 1998) and often starts in the first year of life. It is characterised by dry and itchy skin. This often breaks down and becomes infected, partly as a result of the close relationship of atopic eczema and the organism Staphylococcus aureus, which is found on the skin of most children with atopic eczema (Goodyear, 1993). PMID:16723923

  2. Hand eczema: the atopic subject and work.

    PubMed

    Adams, R M

    1993-11-01

    Of the large number of young persons entering the work force each year, few choose their work with more than cursory consideration of their physical ability to perform it. This is especially true of atopic persons. When the first manifestation of the disease is hand eczema triggered by the first work experience, often after the subject has undergone many months of training, the answer becomes very difficult. It often requires a job change, with accompanying economic and personal loss. When the work is responsible for aggravation or activation of the condition, the entire gamut of social services comes into play, including medical, legal, rehabilitation, and workers compensation. These lead, after months and often years, to job changes that may or may not alleviate or ameliorate the condition. For these reasons dermatologists need to have greater awareness of the position of the atopic subject in the workplace. PMID:8299386

  3. Methicillin-Resistant Staphylococcus aureus (MRSA) Diagnosis

    MedlinePLUS

    ... Main Content Area Methicillin-Resistant Staphylococcus aureus (MRSA) Diagnosis To diagnose S. aureus , a sample is obtained from ... for a patient more quickly, after an official diagnosis has been made. In the hospital, you might ...

  4. Environmental Cleaning and Disinfecting for MRSA

    MedlinePLUS

    ... visit this page: About CDC.gov . Methicillin-resistant Staphylococcus aureus (MRSA) Infections Share Compartir Environmental Cleaning & Disinfecting ... that tell you important facts. Disinfectants effective against Staphylococcus aureus or staph are most likely also effective ...

  5. Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment

    MedlinePLUS

    ... antibiotics, your provider will consider the potential for antibiotic resistance. Thus, if MRSA is suspected, your provider will avoid treating you with beta-lactam antibiotics, a class of antibiotic observed not to be ...

  6. Can I Tell You About Eczema? Collier Julie Can I Tell You About Eczema? 48pp £8.99 Jessica Kingsley Publishers 9781849055642 1849055645 [Formula: see text].

    PubMed

    2015-11-12

    HERE'S THE story of Helen and her life with eczema. She invites the reader to learn about her experience and the challenges of living with eczema. This book is an easy read and takes the reader through the eczema journey that many young people live through, showing how children can be helped and supported to live their lives with the condition. PMID:26558979

  7. A specific molecular signature for psoriasis and eczema

    PubMed Central

    Santos-Silva, Alice

    2015-01-01

    Psoriasis and eczema seem to present a specific distinctive gene expression pattern. In the Science Translation Medicine (Sci Transl Med), Quaranta et al. reported a specific molecular signature of psoriasis and eczema. By using an intraindividual genome expression analysis in patients affected by both diseases, the authors identified genes and signaling pathways that are regulated in common and that are exclusive for each disease. PMID:25992375

  8. MRSA CC398 in the pig production chain.

    PubMed

    Broens, E M; Graat, E A M; van der Wolf, P J; van de Giessen, A W; van Duijkeren, E; Wagenaar, J A; van Nes, A; Mevius, D J; de Jong, M C M

    2011-02-01

    In 2005, a distinct clone of methicillin resistant Staphylococcus aureus (MRSA CC398) was found in pigs and people in contact with pigs. The structure of the pig production chain in high technology pig husbandry enables pathogens to spread during animal trading, with an increasing prevalence in herds further down the chain. The objective of this study was to quantify the effect of the MRSA status of the supplying herd on the MRSA status of the receiving herd in order to gain more insight into the role of animal trading as a transmission route for MRSA CC398. Nasal samples (60-80 pigs per herd) were collected from 38 herds; in 20 herds, environmental samples were collected as well. Ten MRSA-positive herds (based on the results of nasal swabs of 10 individual pigs per herd) from a prior study were included in the data analysis. Herds were classified as MRSA positive if at least one sample tested positive. The 48 herds were part of 14 complete (40 herds) and 4 incomplete (8 herds) pig production chains. Fifty-six percent of the herds were classified as MRSA positive. MRSA-positive herds were observed at the start (breeding herds), middle (farrowing herds) and the end (finishing herds) of the pig production chain. All of the herds in 8 chains tested MRSA positive;, all of the herds in 5 chains tested MRSA negative and in the remaining 5 chains, MRSA-positive and MRSA-negative herds were detected. Seven spa types were found, which were all previously confirmed to belong to CC398. All of the isolates were susceptible to mupirocin, linezolid, rifampicin, fusidic acid and cotrimoxazole. Resistance against tetracycline, erythromycin and clindamycin was found in 100, 74 and 76% of the isolates, respectively. Seventy-nine percent of herds with a MRSA-positive supplier of pigs were MRSA positive, whereas 23% of herds with a MRSA-negative supplier were MRSA positive (OR=10.8; 95% CI: 1.5-110.1; P=0.011). The presence of entirely MRSA-positive and MRSA-negative chains and the strong association between the MRSA status of herds and their suppliers illustrates a large risk associated with purchasing pigs from MRSA-positive herds; a top-down strategy for future control programs is, therefore, a basic requirement. However, 23% of herds with a MRSA-negative supplier were MRSA positive and furthermore, 46% of the herds at the top of the pig production chain without a supplier tested MRSA positive. This underlined the need for the identification of additional risk factors for MRSA. PMID:21075466

  9. Impact of hand eczema severity on quality of life

    PubMed Central

    Charan, Ujwala Priya; Peter, C. V. Dincy; Pulimood, Susanne A.

    2013-01-01

    Background: Hand eczema is a common disease seen in dermatological practice comprising of a spectrum ranging from mild disease to a severe distressing and chronic course with a negative impact on the quality of life. Aim: To assess the impact of hand eczema severity on quality of life. Materials and Methods: Patients with hand eczema were enrolled in a prospective study. Disease severity was assessed by hand eczema severity index (HECSI) score and quality of life by dermatology life quality index (DLQI) questionnaire. Results: Forty-six patients participated of which 22 (47.8%) were males and 24 (52.2%) females. The commonest age group affected among men and women was 50-59 years (31.8%) and 40-49 years (41.7%) respectively. History of atopy was found in 23.9% and 63% had persistent disease. In 28 (60.9%), the trigger was washing soaps and detergents of which 21 (87.5%) were housewives. Of those employed, 27.7% reported loss of work days. The mean HECSI score was 14.46 (S.D = 20.98) and mean DLQI score was 9.54 (S.D = 5.62). Gender, age, occupation and duration of disease did not significantly affect the quality of life or disease severity. Increased episodes of eczema (>4 episodes/year) showed a statistically significant correlation with DLQI (P value = 0.021). There was no significant correlation between HECSI score and DLQI in this study. Conclusion: Majority of the patients with hand eczema had a significant impairment of their quality of life. The impairment of quality of life in this study was mainly dependent on increased frequency of the eruptions and not on hand eczema severity. PMID:23741665

  10. Novel unconventional therapeutic approaches to atopic eczema.

    PubMed

    Worm, M; Henz, B M

    2000-01-01

    Atopic eczema is a chronic, recurrent, multifactorial skin disease, and, accordingly, there are numerous therapeutic options for its symptomatic treatment. Conventional medications are however often unsatisfactory for many patients because of adverse effects on long-term use. For this reason, patients often readily welcome unconventional therapeutic approaches. We present here a selected number of such treatment modalities, namely gamma-linolenic acid, Chinese herbal tea, diets eliminating allergens, pseudoallergens, metal salts and sodium, and bioresonance. When stringent scientific criteria are applied in the evaluation of such study results, none of the reviewed alternative treatments provides unequivocal, convincing evidence of its efficacy, even when double-blind, placebo-controlled studies are available. With Chinese herbal tea, potentially serious adverse effects should be considered as well. Any new type of unconventional therapy should thus be thoroughly evaluated and shown to be equal or superior to conventional treatments with regard to both efficacy and tolerability before it is recommended for use in clinical practice. PMID:11096188

  11. Antimicrobial (Drug) Resistance: Methicillin-Resistant Staphylococcus aureus (MRSA)

    MedlinePLUS

    ... Marketing Share this: Main Content Area Methicillin-Resistant Staphylococcus aureus (MRSA) During the past four decades, methicillin-resistant Staphylococcus aureus , or MRSA, has evolved from a controllable ...

  12. Biopsychosocial Factors Associated with Prurigo Nodularis in Endogenous Eczema

    PubMed Central

    Oh, Choon Chiat; Li, Huihua; Lee, Wellington; Tey, Hong Liang

    2015-01-01

    Background: Prurigo nodularis is a dermatological manifestation secondary to chronic scratching or picking on focal areas of the skin. Its pathogenesis remains poorly understood, and limited data has indicated its association with psychological factors. Aim: To determine the biological, psychological and social factors associated with the occurrence of prurigo nodularis in patients with underlying endogenous eczema. Methods: A prospective case-control questionnaire –based study on patients with endogenous eczema, with and without prurigo nodules, was performed. The Impact of Skin Disease on Daily Life questionnaire was used to assess dimensions of physical functioning, including extent and severity of skin disease, itch, pain, fatigue and scratching, as well as dimensions of psychological and social functioning, including mood, illness cognition, disease-related impact, stigmatization and social support. Results: Thirty-six cases and 47 controls were recruited. Patients with endogenous eczema and prurigo nodules indicated a higher itch score on the visual analog scale over the previous 4 weeks compared to those without prurigo nodules (p=0.0292). There were no significant differences between the 2 groups in the scores reflecting the other parameters of physical, psychological and social functioning. Conclusion: In patients with endogenous eczema, those with prurigo nodules experience a greater itch intensity compared to those without prurigo nodules. There were no other physical, psychological and social factors that were found to be associated with the occurrence of prurigo nodules in endogenous eczema. PMID:26538749

  13. Predicting phenotypes of asthma and eczema with machine learning

    PubMed Central

    2014-01-01

    Background There is increasing recognition that asthma and eczema are heterogeneous diseases. We investigated the predictive ability of a spectrum of machine learning methods to disambiguate clinical sub-groups of asthma, wheeze and eczema, using a large heterogeneous set of attributes in an unselected population. The aim was to identify to what extent such heterogeneous information can be combined to reveal specific clinical manifestations. Methods The study population comprised a cross-sectional sample of adults, and included representatives of the general population enriched by subjects with asthma. Linear and non-linear machine learning methods, from logistic regression to random forests, were fit on a large attribute set including demographic, clinical and laboratory features, genetic profiles and environmental exposures. Outcome of interest were asthma, wheeze and eczema encoded by different operational definitions. Model validation was performed via bootstrapping. Results The study population included 554 adults, 42% male, 38% previous or current smokers. Proportion of asthma, wheeze, and eczema diagnoses was 16.7%, 12.3%, and 21.7%, respectively. Models were fit on 223 non-genetic variables plus 215 single nucleotide polymorphisms. In general, non-linear models achieved higher sensitivity and specificity than other methods, especially for asthma and wheeze, less for eczema, with areas under receiver operating characteristic curve of 84%, 76% and 64%, respectively. Our findings confirm that allergen sensitisation and lung function characterise asthma better in combination than separately. The predictive ability of genetic markers alone is limited. For eczema, new predictors such as bio-impedance were discovered. Conclusions More usefully-complex modelling is the key to a better understanding of disease mechanisms and personalised healthcare: further advances are likely with the incorporation of more factors/attributes and longitudinal measures. PMID:25077568

  14. Probiotics in the prevention of eczema: a randomised controlled trial

    PubMed Central

    Allen, Stephen J; Jordan, Sue; Storey, Melanie; Thornton, Catherine A; Gravenor, Michael B; Garaiova, Iveta; Plummer, Susan F; Wang, Duolao; Morgan, Gareth

    2014-01-01

    Objective To evaluate a multistrain, high-dose probiotic in the prevention of eczema. Design A randomised, double-blind, placebo-controlled, parallel group trial. Settings Antenatal clinics, research clinic, children at home. Patients Pregnant women and their infants. Interventions Women from 36?weeks gestation and their infants to age 6?months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20; total of 1010 organisms/day) or matching placebo. Main outcome measure Diagnosed eczema at age 2?years. Infants were followed up by questionnaire. Clinical examination and skin prick tests to common allergens were done at 6?months and 2?years. Results The cumulative frequency of diagnosed eczema at 2?years was similar in the probiotic (73/214, 34.1%) and placebo arms (72/222, 32.4%; OR 1.07, 95% CI 0.72 to 1.6). Among the secondary outcomes, the cumulative frequency of skin prick sensitivity at 2?years was reduced in the probiotic (18/171; 10.5%) compared with the placebo arm (32/173; 18.5%; OR 0.52, 95% CI 0.28 to 0.98). The statistically significant differences between the arms were mainly in sensitisation to cow's milk and hen's egg proteins at 6?months. Atopic eczema occurred in 9/171 (5.3%) children in the probiotic arm and 21/173 (12.1%) in the placebo arm (OR 0.40, 95% CI 0.18 to 0.91). Conclusions The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity. However, the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood. Trial registration Number ISRCTN26287422. PMID:24947281

  15. Control of MRSA infection and colonisation in an intensive care unit by GeneOhm MRSA assay and culture methods

    PubMed Central

    2009-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major nosocomial pathogens. Due to the diffusion of MRSA strains in both hospital and community settings, prevention and control strategies are receiving increased attention. Approximately 25% to 30% of the population is colonised with S. aureus and 0.2% to 7% with MRSA. The BD GeneOhm MRSA real-time PCR assay offers quicker identification of MRSA-colonised patients than do culture methods. Methods Ninety-five patients admitted to the Intensive Care Unit of IRCCS Policlinico San Matteo of Pavia (Italy) for a period > 24 h were screened for MRSA colonisation with both the culture method and the GeneOhm assay. Results Of the 246 nasal swabs collected from 95 patients, 36 samples were found to be positive by both methods (true-positive). 30% of colonised patients had developed the MRSA infection. Conclusion Our results show that the GeneOhm MRSA assay is a valuable diagnostic tool for detecting MRSA quickly in nasal swabs. This study confirms that colonisation represents a high risk factor for MRSA infection, and that good MRSA surveillance in an Intensive Care Unit is therefore an excellent way to prevent MRSA infection. PMID:19703294

  16. The impact of zoonotic MRSA colonization and infection in Germany.

    PubMed

    Köck, Robin; Ballhausen, Britta; Bischoff, Markus; Cuny, Christiane; Eckmanns, Tim; Fetsch, Alexandra; Harmsen, Dag; Goerge, Tobias; Oberheitmann, Boris; Schwarz, Stefan; Selhorst, Thomas; Tenhagen, Bernd-Alois; Walther, Birgit; Witte, Wolfgang; Ziebuhr, Wilma; Becker, Karsten

    2014-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) causes colonization and infection both in animals and humans. In Germany, cases of MRSA colonization among humans, w+hich affect 0.5-1.5% of the general population and 1.0-2.5% of patients at hospital admission, are still mostly associated with previous healthcare contact and defined epidemic clonal lineages. However, MRSA is also distributed in livestock production in Germany, mostly without causing infections in the animals. These MRSA predominantly belong to the clonal complex (CC) 398, but also to CC9 and CC97. Zoonotic transmission of MRSA CC398 from livestock to humans occurs predominantly in people with occupational livestock contact. Spread of MRSA CC398 to household members of these persons is also frequently observed, but dissemination in the general population is limited so far However, especially in areas with intensive livestock husbandry, about 20-38% of MRSA CC398 cases among humans cannot be epidemiologically linked to direct livestock contact, indicating other transmission pathways. MRSA CC398 currently causes about 2% of all human MRSA infections (wound infections, pneumonia, sepsis) in Germany, but up to 10% in regions characterized by a high density of livestock-farming. The burden of MRSA in companion animals was demonstrated to range between 3.6-9.4% within wound samples obtained from dogs, cats and horses, respectively. In contrast to livestock and horses, MRSA distributed in pet animals are mostly associated with MRSA clonal lineages that are also prevalent in human healthcare facilities. Overall, zoonotic exchange of MRSA between humans and animals has relevant impact on the epidemiology of MRSA in Germany. PMID:25868166

  17. Immunomodulating effect of laser therapy in patients with microbial eczema

    NASA Astrophysics Data System (ADS)

    Dudchenko, Mycola O.; Denisenko, Olga I.

    1999-11-01

    While examining 90 patients suffering the microbial eczema (ME), we revealed disorders of the immune system in the majority of them (3/4). It was established that the inclusion of percutaneous laser irradiation of the blood in a course of multimodality treatment of patients with ME caused an immunomodulating action which resulted in an improved ME course in these patients.

  18. Protective effect of probiotics in the treatment of infantile eczema

    PubMed Central

    LIN, RONG-JUN; QIU, LI-HUA; GUAN, REN-ZHENG; HU, SU-JUAN; LIU, YING-YING; WANG, GUANG-JUN

    2015-01-01

    The aim of the present study was to provide evidence for the application of probiotics in the prevention and treatment of infantile eczema by exploring changes in the intestinal Bifidobacteria levels and the Scoring Atopic Dermatitis (SCORAD) index prior and subsequent to treatment with probiotics in infants with eczema. A total of 40 infants with eczema were randomly divided into treatment and control groups. Prior and subsequent to the treatment, the SCORAD index was evaluated and the content of Bifidobacterium bifidum in the stool of each infant in the two groups was quantified using 16S rRNA/DNA quantitative polymerase chain reaction analysis. After four weeks of treatment with B. bifidum triple viable capsules, the levels of B. bifidum increased sharply (P<0.05) and the SCORAD index was notably reduced (P<0.05) as compared with the values prior to treatment. By contrast, neither the content of B. bifidum nor the SCORAD index changed significantly in the control group after four weeks (P>0.05). Following treatment, the levels of B. bifidum in the stools of the treatment group were significantly higher than those in the stools of the control group (P<0.05), and the SCORAD index was significantly lower than that of the control group (P<0.05). In conclusion, probiotic supplementation has a positive effect on the prevention and treatment of infantile eczema. PMID:26136864

  19. MRSA: status and prospects for therapy? An evaluation of key papers on the topic of MRSA and antibiotic resistance.

    PubMed

    Barrett, John F

    2004-12-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a serious nosocomial pathogen, and a related community-sourced MRSA is emerging. MRSA has evolved to become the major S. aureus phenotype in the hospital, emerging from just 30 to over 60% of the S. aureus population over the past 15 years. Together with its beta-lactam resistance, MRSA possesses multi-drug resistance genotype, including quinolones, macrolides and sulfonamides. MRSA has now emerged as the predominant nosocomial Gram-positive pathogen, and it has a high rate of mortality. Action must be taken to contain and eradicate MRSA through a combination of infection control and the development of novel anti-MRSA agents and vaccines. PMID:15584858

  20. Contact Eczema Caused by True Teak (Tectona Grandis)

    PubMed Central

    Krogh, H. K.

    1962-01-01

    An epidemiological study of occupational contact eczema in a furniture factory is presented. The localization, distribution, and clinical features of the skin lesions were characteristic of contact eczema caused by a sensitizing or irritating dust. True teak—Tectona grandis—was the cause of the skin condition. That teak is a fairly potent sensitizer and also contains primary irritants is fully confirmed by the present study. About half the employees who were heavily exposed to teak dust suffered from eczema and/or severe itching. Only 8% of those with slight exposure to teak dust experienced skin symptoms. Patch tests with native teak dust moistened with water were applied on 10 “controls” and 112 workers who were exposed to teak in various working procedures. Moistened teak dust produced toxic reactions in 20·5%, while native teak dust did not have primary irritant effects and was, therefore, considered to be the substance of choice for patch testing; 18·7% of the workers showed an allergic skin reaction to native teak dust. The diagnosis of allergic contact eczema was made in 12·5%, and 6·2% were considered to have latent allergy. Primary irritant (contact) eczema was considered to be present in four individuals who had experienced acute, transitory, eczematous eruptions during the hot part of the summer when they perspired freely. In these cases the patch test to native teak dust was negative. Desensitization or “hardening” was observed in four workers. In most cases the skin lesions were not severe enough to cause sickness absence. The cause of the relatively high percentage of sensitization to teak among the workers in the factory is discussed. The importance of suitable prophylactic measures is stressed. PMID:14459786

  1. Methicillin resistant Staphylococcus aureus (MRSA) in the intensive care unit

    PubMed Central

    Haddadin, A; Fappiano, S; Lipsett, P

    2002-01-01

    Methicillin resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality worldwide. MRSA strains are endemic in many American and European hospitals and account for 29%–35% of all clinical isolates. Recent studies have documented the increased costs associated with MRSA infection, as well as the importance of colonisation pressure. Surveillance strategies have been proposed especially in high risk areas such as the intensive care unit. Pneumonia and bacteraemia account for the majority of MRSA serious clinical infections, but intra-abdominal infections, osteomyelitis, toxic shock syndrome, food poisoning, and deep tissue infections are also important clinical diseases. The traditional antibiotic therapy for MRSA is a glycopeptide, vancomycin. New antibiotics have been recently released that add to the armamentarium for therapy against MRSA and include linezolid, and quinupristin/dalfopristin, but cost, side effects, and resistance may limit their long term usefulness. PMID:12151652

  2. MRSA prevalence in european healthcare settings: a review

    PubMed Central

    2011-01-01

    Background During the past two decades, methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly common as a source of nosocomial infections. Most studies of MRSA surveillance were performed during outbreaks, so that results are not applicable to settings in which MRSA is endemic. This paper gives an overview of MRSA prevalence in hospitals and other healthcare institutions in non-outbreak situations in Western Europe. Methods A keyword search was conducted in the Medline database (2000 through June 2010). Titles and abstracts were screened to identify studies on MRSA prevalence in patients in non-outbreak situations in European healthcare facilities. Each study was assessed using seven quality criteria (outcome definition, time unit, target population, participants, observer bias, screening procedure, swabbing sites) and categorized as 'good', 'fair', or 'poor'. Results 31 observational studies were included in the review. Four of the studies were of good quality. Surveillance screening of MRSA was performed in long-term care (11 studies) and acute care (20 studies). Prevalence rates varied over a wide range, from less than 1% to greater than 20%. Prevalence in the acute care and long-term care settings was comparable. The prevalence of MRSA was expressed in various ways - the percentage of MRSA among patients (range between 1% and 24%), the percentage of MRSA among S. aureus isolates (range between 5% and 54%), and as the prevalence density (range between 0.4 and 4 MRSA cases per 1,000 patient days). The screening policy differed with respect to time points (on admission or during hospital stay), selection criteria (all admissions or patients at high risk for MRSA) and anatomical sampling sites. Conclusions This review underlines the methodological differences between studies of MRSA surveillance. For comparisons between different healthcare settings, surveillance methods and outcome calculations should be standardized. PMID:21599908

  3. Contact Eczema Caused by True Teak (Tectona grandis)

    PubMed Central

    Krogh, H. K.

    1964-01-01

    A follow-up study of a previous epidemiological investigation in a furniture factory concerning allergic contact eczema caused by true teak (Tectona grandis) clearly shows that a good educational campaign associated with specific and general prophylactic measures are able to control occupational dermatoses. At the first investigation 20·5% of the workers had allergic contact eczema and/or severe itching whereas only 8·3% suffered from the same complaints on re-examination. The different prophylactic measures previously recommended had been taken. Patch tests with various teak extracts were made on 13 workers sensitized to teak; these showed that lapachol (a derivative of naphthoquinone) is one of the sensitizing agents in teak wood. Furthermore, allergic reactions were obtained in seven of these workers when Jacaranda wood dust containing lapachol was used as the test substance. PMID:14106137

  4. Bath additives for the treatment of childhood eczema (BATHE): protocol for multicentre parallel group randomised trial

    PubMed Central

    Santer, Miriam; Rumsby, Kate; Ridd, Matthew J; Francis, Nick A; Stuart, Beth; Chorozoglou, Maria; Wood, Wendy; Roberts, Amanda; Thomas, Kim S; Williams, Hywel C; Little, Paul

    2015-01-01

    Introduction Bath emollients are widely prescribed for childhood eczema, yet evidence of their benefits over direct application of emollients is lacking. Objectives To determine the clinical and cost-effectiveness of adding bath emollient to the standard management of eczema in children Methods and analysis Design: Pragmatic open 2-armed parallel group randomised controlled trial. Setting: General practitioner (GP) practices in England and Wales. Participants: Children aged over 12?months and less than 12?years with eczema, excluding inactive or very mild eczema (5 or less on Nottingham Eczema Severity Scale). Interventions: Children will be randomised to either bath emollients plus standard eczema care or standard eczema care only. Outcome measures: Primary outcome is long-term eczema severity, measured by the Patient-Oriented Eczema Measure (POEM) repeated weekly for 16?weeks. Secondary outcomes include: number of eczema exacerbations resulting in healthcare consultations over 1?year; eczema severity over 1?year; disease-specific and generic quality of life; medication use and healthcare resource use; cost-effectiveness. Aiming to detect a mean difference between groups of 2.0 (SD 7.0) in weekly POEM scores over 16?weeks (significance 0.05, power 0.9), allowing for 20% loss to follow-up, gives a total sample size of 423 children. We will use repeated measures analysis of covariance, or a mixed model, to analyse weekly POEM scores. We will control for possible confounders, including baseline eczema severity and child's age. Cost-effectiveness analysis will be carried out from a National Health Service (NHS) perspective. Ethics and dissemination This protocol was approved by Newcastle and North Tyneside 1 NRES committee 14/NE/0098. Follow-up will be completed in 2017. Findings will be disseminated to participants and carers, the public, dermatology and primary care journals, guideline developers and decision-makers. Trial registration number ISRCTN84102309. PMID:26525422

  5. Emollient treatment for childhood eczema: involving children and parents.

    PubMed

    Carr, Julie D

    2006-01-01

    Emollients are the mainstay of managing eczema but many children find them tedious and unpleasant to apply and they are thought to be under-prescribed and underused. This paper discusses the advantages of involving children and parents in treatment, and of giving them a choice of emollients and the chance to try out different ones at different times of day and at night. The author suggests practical ways of making emollient therapy more fun for children, for example by decorating tubs and other containers and applying creams to dolls and other suitable toys. Children, as well as adults, can become"expert patients" and any good ideas that they have can be shared with other children with eczema. Experience suggests that getting them more involved will improve concordance with treatment. It should be acknowledged that managing chronic eczema in children and young people is hard and it is important to praise and encourage the efforts that children and their parents are making. PMID:17002267

  6. Comparative Evaluation of Two PCR-Based Methods for Detection of Methicillin-Resistant Staphylococcus aureus (MRSA): Xpert MRSA Gen 3 and BD-Max MRSA XT.

    PubMed

    Lepainteur, Margaux; Delattre, Sandrine; Cozza, Sophie; Lawrence, Christine; Roux, Anne-Laure; Rottman, Martin

    2015-06-01

    We compared two walk-away molecular diagnostic assays, the GeneXpert MRSA Gen 3 assay and the BD-Max MRSA XT assay. A total of 119 prospective swabs and 36 culture-positive samples were tested. Xpert MRSA Gen 3 had sensitivity of 95.7% and specificity of 100% versus 87.5% and 97.1% for BD-Max. The difference in agreement with the enriched culture results was significantly in favor of the Xpert assay (P < 0.02, McNemar nonparametric text). PMID:25878336

  7. Risk of MRSA Infection in Patients with Intermittent versus Persistent MRSA Nares Colonization.

    PubMed

    Vigil, Daniel I; Harden, Wesley D; Hines, Anne E; Hosokawa, Patrick W; Henderson, William G; Bessesen, Mary T

    2015-11-01

    OBJECTIVE To determine the relative risk of invasive methicillin-resistant Staphylococcus aureus (MRSA) infection among non-colonized (NC) patients, intermittently colonized (IC) patients, and persistently colonized (PC) patients. DESIGN Observational cohort study of patient data collected longitudinally over a 41-month period. SETTING Department of Veterans Affairs Eastern Colorado Healthcare System, a tertiary care medical center. PATIENTS Any patient who received ?5 MRSA nasal swab tests between February 20, 2010, and July 26, 2013. In total, 3,872 patients met these criteria, 0 were excluded, 95% were male, 71% were white, and the mean age was 62.9 years on the date of study entry. METHODS Patients were divided into cohorts based on MRSA colonization status. Physicians reviewed medical records to identify invasive infection and were blinded to colonization status. Cox and Kaplan-Meier analyses were used to assess the relationship between colonization status and invasive infection. RESULTS In total, 102 patients developed invasive MRSA infections, 16.3% of these were PC patients, 11.2% of these were IC patients, and 0.5% of these were NC patients. PC patients were at higher risk of invasive infection than NC patients (hazard ratio [HR] 36.8; 95% CI, 18.4-73.6; P<.001). IC patients were also at higher risk than NC patients (HR, 22.8; 95% CI, 13.3-39.3; P<.001). The difference in risk between PC and IC patients was not statistically significant (HR, 1.61; 95% CI, 0.94-2.78, P=.084). Alternate analysis methods confirmed these results. CONCLUSIONS The risk of invasive MRSA infection is much higher among PC and IC patients, supporting routine clinical testing for colonization. However, this risk is similar among PC and IC patients, suggesting that distinguishing between the 2 colonization states may not be clinically important. Infect. Control Hosp. Epidemiol. 2015;36(11):1292-1297. PMID:26289065

  8. The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.

    PubMed

    Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

    2014-10-01

    The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. PMID:25282560

  9. Engineering MRSA antimicrobials that are refractory to resistance development

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methicillin resistant Staphylococcus aureus (MRSA) is one of the most costly multi-drug resistant pathogens to both human animal health, with billions of dollars are spent annually to treat human infections. MRSA is also appearing in livestock (bovine, porcine, poultry) as well as companion animal...

  10. [The effectiveness of hand hygiene products on MRSA colonization of health care workers by using CHROMagar MRSA].

    PubMed

    Koçak Tufan, Zeliha; Irmak, Hasan; Bulut, Cemal; Cesur, Salih; K?n?kl?, Sami; Demiröz, Ali Pekcan

    2012-04-01

    The aims of this study were; to investigate the hand hygiene compliance of the health care workers (HCWs) during their routine patient care, to determine the methicillin-resistant Staphylococcus aureus (MRSA) hand colonization of the HCWs, to investigate the effect of different hand hygiene products on MRSA colonization and to evaluate the effectiveness of chromogenic agar for detecting MRSA. HCWs were investigated during their routine patient care and hand cultures were taken before and after hand wash/hygiene. Two different techniques were used to obtain the hand cultures: fingertip method (CHROMagar MRSA containing HygiSlide); and direct swab method and then inoculation to CHROMagar MRSA media. MRSA strains grown on those cultures were confirmed with conventional methods. A total of 100 HCWs (of them 61 were female; mean age: 32.7 ± 5.2 years; age range: 25-51 years) involving physicians (n= 33), nurses (n= 38) and health care assistants (n= 29), were included in the study. MRSA was detected in 39% and 11% before hand hygiene and in 13% and 6% after hand hygiene, with HygiSlide CHROMagar media and with CHROMagar in plate media, respectively. No difference were found regarding clinics, occupations, or the type of patient handling in those HCWs who were positive (n= 13) for MRSA colonization following hand hygiene, and those who were negative (n= 26). However, the type of the hand hygiene product used exhibited a statistical difference. None of the seven HCWs who used alcohol based hand rub revealed growth in the second culture while 10 of 19 (53%) HCWs who used soap and three of 13 (23%) HCWs who used chlorhexidine were still colonized with MRSA. In terms of reduction in the MRSA counts, the most effective one was the alcohol based hand rub while the soap was the least, since seven of 19 (37%) HCWs who used soap showed no reduction at all in the MRSA counts. A high ratio of hand colonization with MRSA was detected in our hospital staff (39%). It was shown that the colonization could be reduced significantly (with a rate of 66%) with hand hygiene. Alcohol based hand rub was found to be the most effective method in hand hygiene. The fingertip technique was found to be superior to inoculation to plate media for obtaining hand cultures and CHROMagar MRSA media was found to be rapid, effective and practical for detecting the MRSA hand colonization. PMID:22639312

  11. Comparison of Methicillin Resistant Staphylococcus Aureus in Healthy Community Hospital Visitors [CA-MRSA] and Hospital Staff [HA-MRSA

    PubMed Central

    Pathare, Nirmal A; Tejani, Sara; Asogan, Harshini; Al Mahruqi, Gaitha; Al Fakhri, Salma; Zafarulla, Roshna; Pathare, Anil V.

    2015-01-01

    Background The prevalence of community-associated methicillin-resistant Staphylococcus aureus [CA-MRSA] is unknown in Oman. Methods Nasal and cell phones swabs were collected from hospital visitors and health-care workers on sterile polyester swabs and directly inoculated onto a mannitol salt agar containing oxacillin, allowing growth of methicillin-resistant microorganisms. Antibiotic susceptibility tests were performed using Kirby Bauer’s disc diffusion method on the isolates. Minimum inhibitory concentration (MIC) was determined for vancomycin and teicoplanin against the resistant isolates of MRSA by the Epsilometer [E] test. A brief survey questionnaire was requested be filled to ascertain the exposure to known risk factors for CA-MRSA carriage. Results Overall, nasal colonization with CA-MRSA was seen in 34 individuals (18%, 95% confidence interval [CI] =12.5%–23.5%), whereas, CA-MRSA was additionally isolated from the cell phone surface in 12 participants (6.3%, 95% CI =5.6%–6.98%). Nasal colonization prevalence with hospital-acquired [HA] MRSA was seen in 16 individuals (13.8%, 95% confidence interval [CI] =7.5%–20.06%), whereas, HA-MRSA was additionally isolated from the cell phone surface in 3 participants (2.6%, 95% CI =1.7–4.54). Antibiotic sensitivity was 100% to linezolid and rifampicin in the CA-MRSA isolates. Antibiotic resistance to vancomycin and clindamycin varied between 9–11 % in the CA-MRSA isolates. Mean MIC for vancomycin amongst CA- and HA-MRSA were 6.3 and 9.3 ?g/ml, whereas for teicoplanin they were 13 and 14 ?g/ml respectively by the E-test. There was no statistically significant correlation between CA-MRSA nasal carriage and the risk factors (P>0.05, Chi-square test). Conclusions The prevalence of CA-MRSA in the healthy community hospital visitors was 18 % (95% CI, 12.5% to 23.5%) as compared to 13.8% HA-MRSA in the hospital health-care staff. Despite a significant prevalence of CA-MRSA, these strains were mostly sensitive. Recommendation: The universal techniques of hand washing, personal hygiene and sanitation are thus warranted. PMID:26543522

  12. Eczema/Atopic Dermatitis Approved by the UHS Patient Education Committee

    E-print Network

    Maroncelli, Mark

    Eczema/Atopic Dermatitis Approved by the UHS Patient Education Committee Revised 5/18/10 Page 1 of 1 Eczema, or atopic dermatitis, is a common allergic skin reaction often affecting the face, elbows. Identifying the cause of the itch is essential in relieving the dermatitis. Common triggers include allergens

  13. Assessing United States Patient and Dermatologist Experiences with Severe Chronic Hand Eczema

    PubMed Central

    Baranowski, Eileen; Zelt, Susan; Reynolds, Maria; Sherrill, Beth

    2015-01-01

    Objective: Patients with severe chronic hand eczema often have persistent symptoms that interfere with daily activities, social functioning, and employment. Many patients are refractory to topical corticosteroids. This survey-based study was performed to characterize treatment experiences, impact on productivity, and quality of life of patients with severe chronic hand eczema; understand dermatologists’ severe chronic hand eczema treatment patterns. Design: A web-based survey in the United States queried pre-identified patients with severe chronic hand eczema regarding symptoms, treatment history, quality of life, work productivity, treatment satisfaction, and healthcare utilization. In a separate survey, dermatologists were asked about treatment patterns and satisfaction with currently available therapies. Results: The most commonly reported symptoms currently experienced by patients (n=163) were dryness/flaking (81%), itchiness (75%), and cracking/tearing of the skin (71%). Over the last three months, 84 percent of patients with severe chronic hand eczema self-reported using topical steroids, and 30 percent used systemic corticosteroids or retinoids. Approximately 30 percent reported impairment while working and productivity loss. Patient quality of life was negatively impacted. Dermatologists (n=125) reported most often treating severe chronic hand eczema with topical corticosteroids (99%), followed by topical immunomodulators (71%) and systemic treatments (70%). Only two percent were very satisfied with currently available products. Conclusion: Patients with severe chronic hand eczema experience symptoms that negatively impact work productivity and quality of life. Few dermatologists are very satisfied with currently available severe chronic hand eczema treatment options. PMID:26705436

  14. Therapeutic management of anal eczema: an evidence-based review

    PubMed Central

    Havlickova, B; Weyandt, G H

    2014-01-01

    Aim To conduct a systematic review of treatments for anal eczema (AE). Methods We conducted a Medline search for clinical trial data for the treatment of perianal diseases including AE, including papers not published in the English language. We assessed the study reports using the system recommended by the Oxford Centre for Evidence-based Medicine. No meta-analysis was attempted. Results The evidence base for topical treatments used to treat AE is very poor: there are very few studies and many of those that exist are of poor quality. The best evidence was found for medications that are yet to be licensed for AE. Among products with existing licences for the treatment of eczema, our assessment found some evidence to support the continued use of mild-to-moderate corticosteroids first line in most patients. Discussion Features of the perianal region, and the fact that it is almost always occluded, mean that not all medications recommended in the general treatment guidelines for eczema are appropriate for AE. However, there are no specific treatment guidelines for these patients. This may in part be because of the lack of high-quality evidence-based medicine in this therapy area. Many frequently prescribed medications were developed and licensed many years ago, in an era when clinical trial design was not expected to be as rigorous as it is today. Conclusion This review highlights the need to conduct more high-quality clinical trials in patients with AE in order that specific guidelines for the management of this difficult proctological condition can be prepared. PMID:24898365

  15. Synergistic, collaterally sensitive ?-lactam combinations suppress resistance in MRSA.

    PubMed

    Gonzales, Patrick R; Pesesky, Mitchell W; Bouley, Renee; Ballard, Anna; Biddy, Brent A; Suckow, Mark A; Wolter, William R; Schroeder, Valerie A; Burnham, Carey-Ann D; Mobashery, Shahriar; Chang, Mayland; Dantas, Gautam

    2015-11-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent multidrug-resistant pathogens worldwide, exhibiting increasing resistance to the latest antibiotic therapies. Here we show that the triple ?-lactam combination meropenem-piperacillin-tazobactam (ME/PI/TZ) acts synergistically and is bactericidal against MRSA subspecies N315 and 72 other clinical MRSA isolates in vitro and clears MRSA N315 infection in a mouse model. ME/PI/TZ suppresses evolution of resistance in MRSA via reciprocal collateral sensitivity of its constituents. We demonstrate that these activities also extend to other carbapenem-penicillin-?-lactamase inhibitor combinations. ME/PI/TZ circumvents the tight regulation of the mec and bla operons in MRSA, the basis for inducible resistance to ?-lactam antibiotics. Furthermore, ME/PI/TZ subverts the function of penicillin-binding protein-2a (PBP2a) via allostery, which we propose as the mechanism for both synergy and collateral sensitivity. Showing in vivo activity similar to that of linezolid, ME/PI/TZ demonstrates that combinations of older ?-lactam antibiotics could be effective against MRSA infections in humans. PMID:26368589

  16. Clinical inquiries. Do nonmedicated topicals relieve childhood eczema?

    PubMed

    Yates, Jennifer E; Phifer, Jennifer B; Flake, Donna

    2009-05-01

    Emollients are effective first-line treatment to decrease symptoms of eczema and reduce the need to use steroids in children. Tar preparations work, but compliance may be limited. Gamma-linoleic acid preparations, borage oil, and evening primrose oil show efficacy in small studies. MAS063DP cream (Atopiclair) is effective. Chamomile and bathing in acidic hot spring water may be effective, but these treatments have not been adequately evaluated. Wet wrap dressings may be effective but increase the risk of skin infections. Hamamelis distillate creams and massage with essential oils/aromatherapy are ineffective. PMID:19442393

  17. Diverging prevalences and different risk factors for childhood asthma and eczema: a cross-sectional study

    PubMed Central

    Barnish, Maxwell S; Tagiyeva, Nara; Devereux, Graham; Aucott, Lorna; Turner, Steve

    2015-01-01

    Objective To compare the prevalences of and risk factors for asthma, wheeze, hay fever and eczema in primary schoolchildren in Aberdeen in 2014. Design Cross-sectional survey. Setting Primary schools in Aberdeen, North-East Scotland. Participants Children in Scottish school years primary 1–7 were handed a questionnaire by their class teacher to be completed by their parents and returned to the researchers by post or online. Main outcome measures Lifetime history of asthma, eczema and hay fever, and recent history of wheeze. Results 41 schools agreed to participate (87%). 11?249 questionnaires were distributed and 3935 returned (35%). A parent-reported lifetime history of asthma, eczema and hay fever was present in 14%, 30% and 24% of children, respectively. The odds of lifetime asthma increased with age (OR 1.1 per year, 95% CI 1.1 to 1.2), male sex (OR 1.89, 95% CI 1.4 to 2.3), parental smoking (OR 1.7, 95% CI 1.2 to 2.3) and eczema (OR 6.6, 95% CI 5.2 to 8.4). Prevalence of recent wheeze was also reported to be 14% and was positively associated with male sex, parental smoking and eczema. In contrast, parental eczema was the only identified predictor of childhood eczema risk. Conclusions The lifetime prevalence of asthma in primary schoolchildren was 14% in this survey, approximately half the prevalence of eczema. We report diverging prevalences in relation to previous studies in our locality, and different risk factors for asthma and eczema. These findings suggest that asthma and eczema are unlikely to have a common origin. PMID:26059525

  18. Trends in the epidemiology and prescribing of medication for eczema in England

    PubMed Central

    Simpson, Colin R; Newton, John; Hippisley-Cox, Julia; Sheikh, Aziz

    2009-01-01

    Summary Background The prevalence of eczema, particularly in younger children, increased substantially over the second half of the 20th century. Analysis of primary healthcare data-sets offers the possibility to advance understanding about the changing epidemiology of eczema. Aim To investigate recent trends in the recorded incidence, lifetime prevalence, prescribing and consulting behaviour of patients with eczema in England. Methods QRESEARCH is one of the world’s largest national aggregated health databases containing the records of over nine million patients. We extracted data on all patients with a recorded diagnosis of eczema and calculated annual age–sex standardized incidence and lifetime period prevalence rates for each year from 2001–2005. We also analysed the consulting behaviour of these patients when compared with the rest of the QRESEARCH database population. The number of eczema prescriptions issued to people in England was also estimated. Results The age–sex standardized incidence of eczema was 9.58 per 1000 person-years in 2001 and increased to 13.58 per 1000 patients in 2005 (p<0.001). By 2005, eczema affected an estimated 5,773,700 (95% confidence intervals [CI] 5,754,100–5,793,400) individuals in England, who, on average, consulted a general practitioner 4.02 (95% CI 4.01–4.03) times a year. During the study period, the number of eczema related prescriptions increased by 56.6% (95% CI 56.6–56.7), so by 2005 an estimated 13,690,300 (95% CI 13,643,200–13,737,600) prescriptions were issued. Conclusions Recorded incidence and lifetime prevalence of eczema in England continue to increase. Similar increases have also been observed in the estimated number of eczema prescriptions issued to the English population. PMID:19297652

  19. Warm, Humid, and High Sun Exposure Climates are Associated with Poorly Controlled Eczema: PEER (Pediatric Eczema Elective Registry) Cohort, 2004–2012

    PubMed Central

    Sargen, Michael R.; Hoffstad, Ole; Margolis, David J.

    2013-01-01

    Anecdotal reports of children experiencing eczema flares during winter and summer months along with global variation in eczema prevalence has fueled speculation that climate may modulate disease activity. The aim of this study was to determine if long-term weather patterns affect the severity and persistence of eczema symptoms in children. We performed a prospective cohort study of U.S. children (N=5,595) enrolled in PEER (Pediatric Eczema Elective Registry) between 2004 and 2012 to evaluate the effect of climate (daily temperature, daily sun exposure, daily humidity) on the severity of eczema symptoms. Odds ratios were calculated for the patient evaluated outcome of disease control. Multivariate logistic regression modeling adjusting for gender, race, income, and topical medication use demonstrated that higher temperature (OR=0·90, 95% CI: 0·87–0·93, p<0·001) and increased sun exposure (OR=0·93, 95% CI: 0·89–0·98, p=0·009) were associated with poorly controlled eczema. Higher humidity (OR=0·90, 95% CI: 0·812–0.997, p=0·04) was also associated with poorly controlled disease, but the statistical significance of this association was lost in our multivariate analysis (p=0.44). PMID:23774527

  20. New patterns of methicillin-resistant Staphylococcus aureus (MRSA) clones, community-associated MRSA genotypes behave like healthcare-associated MRSA genotypes within hospitals, Argentina.

    PubMed

    Egea, Ana L; Gagetti, Paula; Lamberghini, Ricardo; Faccone, Diego; Lucero, Celeste; Vindel, Ana; Tosoroni, Dario; Garnero, Analía; Saka, Hector A; Galas, Marcelo; Bocco, José L; Corso, Alejandra; Sola, Claudia

    2014-11-01

    Methicillin-resistant Staphylococcus aureus (MRSA) burden is increasing worldwide in hospitals [healthcare-associated (HA)-MRSA] and in communities [community-associated (CA)-MRSA]. However, the impact of CA-MRSA within hospitals remains limited, particularly in Latin America. A countrywide representative survey of S. aureus infections was performed in Argentina by analyzing 591 clinical isolates from 66 hospitals in a prospective cross-sectional, multicenter study (Nov-2009). This work involved healthcare-onset infections-(HAHO, >48 hospitalization hours) and community-onset (CO) infections [including both, infections (HACO) in patients with healthcare-associated risk-factors (HRFs) and infections (CACO) in those without HRFs]. MRSA strains were genetically typed as CA-MRSA and HA-MRSA genotypes (CA-MRSAG and HA-MRSAG) by SCCmec- and spa-typing, PFGE, MLST and virulence genes profile by PCR. Considering all isolates, 63% were from CO-infections and 55% were MRSA [39% CA-MRSAG and 16% HA-MRSAG]. A significantly higher MRSA proportion among CO- than HAHO-S. aureus infections was detected (58% vs 49%); mainly in children (62% vs 43%). The CA-MRSAG/HA-MRSAG have accounted for 16%/33% of HAHO-, 39%/13% of HACO- and 60.5%/0% of CACO-infections. Regarding the epidemiological associations identified in multivariate models for patients with healthcare-onset CA-MRSAG infections, CA-MRSAG behave like HA-MRSAG within hospitals but children were the highest risk group for healthcare-onset CA-MRSAG infections. Most CA-MRSAG belonged to two major clones: PFGE-type N-ST30-SCCmecIVc-t019-PVL(+) and PFGE-type I-ST5-IV-SCCmecIVa-t311-PVL(+) (45% each). The ST5-IV-PVL(+)/ST30-IV-PVL(+) clones have caused 31%/33% of all infections, 20%/4% of HAHO-, 43%/23% of HACO- and 35%/60% of CACO- infections, with significant differences by age groups (children/adults) and geographical regions. Importantly, an isolate belonging to USA300-0114-(ST8-SCCmecIVa-spat008-PVL(+)-ACME(+)) was detected for the first time in Argentina. Most of HA-MRSAG (66%) were related to the Cordobes/Chilean clone-(PFGE-type A-ST5-SCCmecI-t149) causing 18% of all infections (47% of HAHO- and 13% of HACO-infections). Results strongly suggest that the CA-MRSA clone ST5-IV-PVL(+) has begun to spread within hospitals, replacing the traditional Cordobes/Chilean-HA-MRSA clone ST5-I-PVL(-), mainly in children. Importantly, a growing MRSA reservoir in the community was associated with spreading of two CA-MRSA clones: ST5-IV-PVL(+), mainly in children with HRFs, and ST30-IV-PVL(+) in adults without HRFs. This is the first nationwide study in Argentina providing information about the molecular and clinical epidemiology of CA-MRSA, particularly within hospitals, which is essential for designing effective control measures in this country and worldwide. PMID:25240872

  1. First outbreak of community-acquired MRSA USA300 in France: failure to suppress prolonged MRSA carriage despite decontamination procedures.

    PubMed

    Baud, O; Giron, S; Aumeran, C; Mouly, D; Bardon, G; Besson, M; Delmas, J; Coignard, B; Tristan, A; Vandenesch, F; Illes, G; Lesens, O

    2014-10-01

    The first French outbreak of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) USA300 clone was investigated. After outbreak investigation, hygiene measures were implemented in all family households and childminders' homes. Several decontamination procedures were performed, which used a combination of topical mupirocin, total body application of chlorhexidine, chlorhexidine gargle (if >6 years old) and a course of antibiotic therapy in cases of infection or decontamination failure. Patients were followed up for MRSA skin and soft tissue infections (SSTIs) and carriage. Strains were characterised by antimicrobial drug resistance profile, pulsed-field gel electrophoresis (PFGE) and DNA microarrays. Between June 2011 and June 2012, six children and six adults among the ten corresponding relatives developed 28 SSTIs. None of the family members, including the index case, had any contact with foreigners or individuals known to have SSTIs. After infection control measures and prolonged decontamination have been implemented with a high adherence, six patients remained sustained CA-MRSA USA300 carriers, including one who developed mupirocin resistance and six who experienced minor CA-MRSA-related SSTIs. A baby was identified as an MRSA carrier 2 months after delivery. CA-MRSA decontamination using mupirocin and chlorhexidine in the community setting may also be a questionable strategy, associated with failure and resistance to both agents. Close monitoring of CA-MRSA SSTIs is required in France and in other European countries where MRSA USA300 has recently emerged. We showed that a closed management based on hygiene measures reinforcement, decolonisation and extended screening may fail to suppress CA-MRSA carriage and subsequent infections. PMID:24816900

  2. Pattern of contact sensitivity in Indian patients with hand eczema.

    PubMed

    Suman, Mansi; Reddy, Belum Siva Nagi

    2003-09-01

    One hundred consecutive patients with hand eczema were patch tested with the Indian Standard Series and indigenous antigens after a detailed history and clinical examination. Both sexes were involved and the majority of them were in the age group between 20-39 years (56%). Their occupational profile varied in order of frequency from household work (37%), to masons (14%), students (11%), factory workers (7%), and others (31%). Itching was the most common presenting complaint (93%). A history of atopy was found in 36% of the patients. The predominant sites involved were the palms (43%), followed by fingers (32%), dorsum (17%), and the entire hand (8%). Dry, scaly skin was the most common morphological picture, followed by hyperpigmentation, fissuring, and lichenification. Based on history, clinical examination and patch test results, the diagnosis was made as allergic contact dermatitis in 67% of cases and irritant contact dermatitis in 15% of cases. Positive patch tests with one or more allergens were noted in 67% of the patients. Vegetables (21%) were found to be the most common sensitizers, followed by nickel sulphate (20%), potassium dichromate (18%), and others. Wet work, soaps, and detergents were found to be the most offending irritants. The present study confirmed the fact that hand eczema is a multifactorial disease caused by both irritants and allergens. PMID:14578554

  3. Suicidal ideation, mental health problems, and social function in adolescents with eczema: a population-based study.

    PubMed

    Halvorsen, Jon A; Lien, Lars; Dalgard, Florence; Bjertness, Espen; Stern, Robert S

    2014-07-01

    There are few studies on psychosocial problems in adolescents with eczema. We performed a cross-sectional, questionnaire-based study to explore the relationship of suicidal ideation, mental health problems, and social functioning with eczema. A total of 4,744 adolescents (18-19 years) were invited for the study, of whom 3,775 (80%) participated. The overall prevalence of current eczema was 9.7%. Among those with current eczema, 15.5% reported suicidal ideation compared with 9.1% among those without eczema, significantly associated in a multivariate model (odds ratio 1.87, 95% confidence interval 1.31-2.68). In a subgroup analyses, the prevalence of suicidal ideation in those with both eczema and itch was 23.8%, and was significantly associated, compared with those without eczema (3.57, 2.46-5.67). Eczema was associated with mental health problems assessed by the Strength and Difficulties Questionnaire (1.72, 1.21-2.45) and the Hopkins Symptom Checklist 10 (1.63, 1.23-2.16). Five questions assessed social function: feeling attached to family and friends; thriving at school; experiencing bullying; and romantic relationships. Boys with current eczema were less likely to have had romantic relationships (1.93, 1.21-3.08). Eczema in late adolescence is associated with suicidal ideation and mental health problems but rarely with social problems. Our findings point to the importance of addressing mental health issues in adolescents with eczema. PMID:24496238

  4. Patients and Loved Ones: Information about MRSA in Healthcare Settings

    MedlinePLUS

    ... visit this page: About CDC.gov . Methicillin-resistant Staphylococcus aureus (MRSA) Infections Share Compartir Patients and Loved ... text [PDF - 232 KB] En español: Preguntas frecuentes " Staphylococcus aureus resistente a la meticilina" [PDF - 237 KB] “ ...

  5. Blue Light Phototherapy Kills Methycillin Resistant Staphylococcus Aureus (MRSA)

    NASA Astrophysics Data System (ADS)

    Enwemeka, Chukuka S.; Williams, Debora; Enwemeka, Sombiri K.; Hollosi, Steve; Yens, David

    2010-05-01

    Background: Methycillin resistant staphylococcus aureus (MRSA) bacteria continue to defy most available antibiotics. As a result infections with MRSA remain a growing public health concern. As a paradigm shift and a significant departure from the on-going trend to develop stronger drug-based therapies, we studied the effect of 405 nm and 470 nm wavelengths of blue light on two strains of MRSA—US-300 strain of CA-MRSA and the IS853 strain of HA-MRSA—in vitro. Methods: We cultured and plated each strain, following which bacteria colonies were irradiated with 0, 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 25, 30, 35, 40, 45, 50, 55, or 60 Jcm-2 energy densities—just once. Specimens were incubated at 35° C for 24 h. Then, digital images obtained were quantified to obtain colony counts and the aggregate area occupied by bacteria colonies. Results: Each wavelength produced a statistically significant dose-dependent reduction in both the number and the aggregate area of colonies formed by each bacteria strain (P<0.001). Maximum eradication of the US-300 (92.1%) and the IS-853 colonies (93.5%) was achieved within 10 minutes of irradiation with each wavelength. The longer the irradiation the more bacteria were eradicated. However, the effect was non-linear as increases of energy densities between 1.0 and 15 J cm-2 resulted in more bacteria death than similar increases between 15 J cm-2 and 60 J cm-2. Conclusion: At low doses, blue light photo-destroys HA-MRSA and CA-MRSA in vitro; raising the prospect that phototherapy may be an effective clinical tool in the on-going effort to stem MRSA infections.

  6. Within-host diversity of MRSA antimicrobial resistances

    PubMed Central

    Stanczak-Mrozek, Kinga I.; Manne, Anusha; Knight, Gwenan M.; Gould, Katherine; Witney, Adam A.; Lindsay, Jodi A.

    2015-01-01

    Objectives MRSA is a major antimicrobial resistance (AMR) pathogen. The reservoir of infecting isolates is colonization, which is the site of evolutionary selection. The aim was to identify if AMRs in colonizing MRSA populations diversified and potential mechanisms of resistance gene transfer in vivo. Methods Nasal swabs from 38 MRSA carriers admitted to hospital were plated and 20 individual colonies from each patient tested for phenotypic antibiotic susceptibility and genetically for lineage, carriage of four prophages and three plasmid families. Free bacteriophages were detected in swabs as well as their capacity for transducing resistance genes. Results Nine (24%) patients carried phenotypic AMR variants and 24 (63%) carried prophage and plasmid variants. If a single colony was selected for testing, the probability of detecting all AMR in that patient was 87%. Sixty-four different AMR and mobile genetic element (MGE) profiles were detected, mostly in the MRSA CC22 background (where CC stands for clonal complex), with up to 8 profiles per patient. Nearly half of the patients carried detectable free bacteriophages and phages successfully transduced resistance genes between laboratory and patient isolates in vitro. WGS showed MRSA core genomes were stable, while AMR and MGEs varied. Conclusions ‘Clouds’ of MRSA variants that have acquired or lost AMR and MGEs are common in nasal colonizing populations and bacteriophages may play an important role in gene transfer. Accurate estimation of AMR and genetic variability has implications for diagnostics, epidemiology, antimicrobial stewardship and understanding the evolutionary selection of AMR in colonizing populations. PMID:25957384

  7. MRSA--what is it, and how do we deal with the problem?

    PubMed

    Barrett, John F

    2005-04-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become a serious nosocomial pathogen, and more recent reports in the scientific literature underscore the potential issues with emerging community-MRSA. MRSA is reported to be involved in > 50% of hospital S. aureus infections, more in the intensive care unit (ICU) than the non-ICU, and increases in multi-drug resistant MRSA and increasingly virulent MRSA have been reported. Together with its broad-based beta-lactam resistance, MRSA often possesses a multi-drug resistance genotype, including cephalosporins, aminoglycosides, fluoroquinolones, and macrolide resistances. MRSA has now emerged as the predominant nosocomial Gram-positive pathogen, and it has a high rate of morbidity and mortality. Action must be taken to contain and eradicate MRSA through a combination of infection control, the development of novel anti-MRSA agents, development of vaccines and other non-traditional approaches of intervention. PMID:15934914

  8. Dyshidrotic eczema associated with the use of IVIg

    PubMed Central

    Kotan, Dilcan; Erdem, Teoman; Acar, Bilgehan Atilgan; Boluk, Ayhan

    2013-01-01

    Intravenous immunoglobulin (IVIg) treatment is highly effective for autoimmune diseases including myasthenia gravis. Recovery is observed at approximately. 75% of myasthenia gravis patients through IVIg treatment. As a result of many clinical studies, the recommended dose is determined as 0.4?g/kg for 5?days (maximum total dose at 2?g/kg body weight). If an additional immunomodulatory treatment is not administered, IVIg maintenance treatment is needed mostly. However, some side effects may inhibit long-term treatment. For this reason, it is important to know the effect profile well and when the treatment should be discontinued. A female myasthenia gravis patient case is presented here, where dyshidrotic eczema has occurred after the second dose of  intravenous Ig medication and whose treatment is despite further IVIg therapy. PMID:23417935

  9. Knowledge, instruction and behavioural change: building a framework for effective eczema education in clinical practice

    PubMed Central

    Thompson, Deryn Lee; Thompson, Murray John

    2014-01-01

    Aims A discussion on the reasons educational interventions about eczema, by nurses, are successful, with the subsequent development of a theoretical framework to guide nurses to become effective patient educators. Background Effective child and parent education is the key to successful self-management of eczema. When diagnosed, children and parents should learn to understand the condition through clear explanations, seeing treatment demonstrations and have ongoing support to learn practical skills to control eczema. Dermatology nurses provide these services, but no one has proposed a framework of the concepts underpinning their successful eczema educational interventions. Design A discussion paper. Data Sources A literature search of online databases was undertaken utilizing terms ‘eczema OR atopic dermatitis’, ‘education’, ‘parent’, ‘nurs*’, ‘framework’, ‘knowledge’, motivation’, in Scopus, CINAHL, Web of Science, Medline and Pubmed. Limits were English language and 2003–2013. Implications for Nursing The framework can inform discussion on child and parent education, provide a scaffold for future research and guide non-specialist nurses, internationally, in providing consistent patient education about eczema. Conclusion Founded on an understanding of knowledge, the framework utilizes essential elements of cognitive psychology and social cognitive theory leading to successful self-management of eczema. This framework may prove useful as a basis for future research in child and parent education, globally, in the healthcare community. A framework has been created to help nurses understand the essential elements of the learning processes at the foundation of effective child and parent education. The framework serves to explain the improved outcomes reported in previous nurse-led eczema educational interventions. PMID:25312442

  10. Nummular Eczema of Breast: A Potential Dermatologic Complication after Mastectomy and Subsequent Breast Reconstruction

    PubMed Central

    Iwahira, Yoshiko; Nagasao, Tomohisa; Shimizu, Yusuke; Kuwata, Kumiko; Tanaka, Yoshio

    2015-01-01

    Purposes. The present paper reports clinical cases where nummular eczema developed during the course of breast reconstruction by means of implantation and evaluates the occurrence patterns and ratios of this complication. Methods. 1662 patients undergoing breast reconstruction were reviewed. Patients who developed nummular eczema during the treatment were selected, and a survey was conducted on these patients regarding three items: (1) the stage of the treatment at which nummular eczema developed; (2) time required for the lesion to heal; (3) location of the lesion on the reconstructed breast(s). Furthermore, histopathological examination was conducted to elucidate the etiology of the lesion. Results. 48 patients (2.89%) developed nummular eczema. The timing of onset varied among these patients, with lesions developing after the placement of tissue expanders for 22 patients (45.8%); after the tissue expanders were replaced with silicone implants for 12 patients (25%); and after nipple-areola complex reconstruction for 14 patients (29.2%). Nummular eczema developed both in periwound regions (20 cases: 41.7%) and in nonperiwound regions (32 cases: 66.7%). Histopathological examination showed epidermal acanthosis, psoriasiform patterns, and reduction of sebaceous glands. Conclusions. Surgeons should recognize that nummular eczema is a potential complication of breast reconstruction with tissue expanders and silicone implants. PMID:26380109

  11. Hand eczema and use of snus (moist snuff) - a population-based study.

    PubMed

    Wrangsjö, Karin; Alderling, Magnus; Lindahl, Gunborg; Meding, Birgitta

    2015-03-01

    A possible association between use of snus (Swedish moist snuff) and hand eczema was studied. 27,466 individuals responded to questions regarding hand eczema, tobacco use and other life style factors in a Swedish Public Health Survey in 2006, response rate 58%. Of these persons, 12.2% reported daily snus use (men 22.0%, women 4.3%), 15.5% daily smoking (men 14.4%, women 16.5%). Of snus users 7.5 % reported hand eczema (men 6.5%, women 11.8%), of smokers 11.7% (men 8.6%, women 13.6%) and of non-tobacco-users 9.7% (men 7.9%, women 11.0%). In multivariate analysis hand eczema was significantly less common in snus users, in total prevalence proportion ratio (PPR)?=??0.813, in men PPR =??0.820, but significantly more common in smoking women, PPR?=?1.238. Physical exercise was a confounder; gender an effect modifier. No positive association was demonstrated between snus use and hand eczema in contrast to the positive association found between smoking and hand eczema in women. PMID:24854399

  12. Probiotic supplementation influences faecal short chain fatty acids in infants at high risk for eczema.

    PubMed

    Kim, H K; Rutten, N B M M; Besseling-van der Vaart, I; Niers, L E M; Choi, Y H; Rijkers, G T; van Hemert, S

    2015-12-01

    The composition of the gut microbiota plays a role in the development of allergies. Based on the immunomodulating capacities of bacteria, various studies have investigated the potential role for probiotics in the prevention of childhood eczema. In a previous study we have shown that significantly less children developed eczema after probiotic supplementation (Bifidobacterium bifidum W23, Bifidobacterium animalis subsp. lactis W52 and Lactococcus lactis W58, Ecologic(®)Panda) at three months of age as compared to controls. Here, metabolites in faecal samples of these 3-month old children were measured by (1)H-nuclear magnetic resonance to investigate possible gut metabolic alterations. Lower amounts of short-chain fatty acids (SCFAs), succinate, phenylalanine and alanine were found in faecal samples of children later developing eczema, whereas the amounts of glucose, galactose, lactate and lactose were higher compared to the children not developing eczema. Although these differences were already present at the age of 3 months, eczema did not develop in the majority of children before the age of 1 year. Supplementation of multispecies probiotics seems to induce higher levels of lactate and SCFAs, and lower levels of lactose and succinate when compared with the placebo group. This might explain the temporary preventive effect of probiotics on the development of eczema. These results highlight the role bacterial metabolites may play in development of the immune system, even before clinical manifestations of allergic disease arise. PMID:26565082

  13. What's new in atopic eczema? An analysis of systematic reviews published in 2007 and 2008. Part 1. Definitions, causes and consequences of eczema.

    PubMed

    Williams, H C; Grindlay, D J C

    2010-01-01

    This review summarizes clinically important findings from nine systematic reviews indexed in bibliographical databases between August 2007 and August 2008, dealing with the definitions, causes and consequences of atopic eczema (AE). One review of diagnostic criteria found that out of 10 sets of criteria, only the UK refinement of the Hanifin and Rajka criteria have been adequately tested (in 19 studies). Another review of 20 named outcome measures found that only three [SCORing Atopic Dermatitis (SCORAD), the Eczema Area and Severity Index (EASI) and the Patient Oriented Eczema Measure (POEM)] had been tested and found to perform adequately. In terms of risk factors for developing disease, a review found that birth by caesarean section increased the risk of asthma and hay fever but not eczema in offspring. A review of cohort studies also found evidence that adverse psychological factors in early life predispose to more atopic disease and a worse prognosis. Another review found that filaggrin gene mutations were a consistently strong risk factor for AE, with a person carrying one of these mutations being over three times more likely to exhibit eczema. It has been suggested that eczema might protect against some forms of cancer, and a detailed systematic review of brain cancers that included 53,233 participants from eight case-control and cohort studies found that having atopic disease was associated with a 39% reduction in glioma risk, a finding that was also present for just those with AE (odds ratio 0.69, 95% CI 0.58-0.82). A further review of case-control and cohort studies failed to find any association between keeping furry pets at birth and subsequent risk of eczema, although pet fur might still exacerbate established disease. In terms of disease consequences, a review found that eczema was the commonest cause of chronic sleep loss in young people, affected the whole family. A review of four economic studies from the US found that the annual cost of AE in the States was as high as $3.8 billion when indirect costs are included. PMID:19874343

  14. Contamination of public buses with MRSA in Lisbon, Portugal: a possible transmission route of major MRSA clones within the community.

    PubMed

    Conceição, Teresa; Diamantino, Fernanda; Coelho, Céline; de Lencastre, Hermínia; Aires-de-Sousa, Marta

    2013-01-01

    In a previous study we have shown that public buses in Oporto, the second largest city in Portugal, were highly contaminated with MRSA. Here we describe the results of a similar study performed in another urban area of Portugal-Lisbon, the capital. Between May 2011 and May 2012, hand touched surfaces of 199 public buses in Lisbon were screened for MRSA contamination. Subsequently, the hands of 575 passengers who frequently use these bus lines were also screened. All hand carriers of MRSA were further screened for nasal carriage. The isolates were characterized by PFGE, staphylococcal cassette chromosome (SCC) mec typing, spa typing, MLST and were tested for the presence of mecA, Panton-Valentine leukocidin and arginine catabolic mobile element genes. MRSA contamination was shown in 72 buses (36.2%). The majority of the isolates belonged to three major clones: Clone A was identified as EMRSA-15 defined by pattern PFGE A, spa types t2357/t747/t025/t379/t910, ST22, and SCCmec IVh (n = 21; 29%). Clone B was the New York/Japan clone characterized by PFGE B-t002/t10682-ST5-II (n = 15; 21%). Clone C included isolates with characteristics of the international community-acquired USA300 or related clones, PFGE C-t008-ST8-IVa/IVc/IVg/IVnt/VI (n = 19; 26%). The first two clones are currently the two major lineages circulating in Portuguese hospitals. The hands of 15 individuals were contaminated with MRSA belonging to the nosocomial clones A or B. Eleven of these individuals were not nasal carriers of MRSA and all but one had travelled by public transportation, namely by bus, prior to sampling. In conclusion, public buses in two major cities in Portugal are often contaminated with MRSA representing clones dominant in hospitals in the particular geographic area. MRSA contamination of public transport and the transfer of the bacteria to the hands of passengers may represent a route through which hospital-acquired MRSA clones may spread to the community. PMID:24223124

  15. Prevalence of childhood eczema and food sensitization in the First Nations reserve of Natuashish, Labrador, Canada

    PubMed Central

    2014-01-01

    Background The Mushua Innu of Natuashish, Labrador, Canada seem to have a high rate of childhood eczema. Anecdotally this problem seems to be more common now than 20 years ago. There has been speculation that this could be related to food sensitization that may have arisen coincident with a move away from a traditional Innu diet. We undertook to assess the prevalence and severity of pediatric eczema in Natuashish (population 792), and investigate the level of sensitization to common food antigens. Methods Over a three-month period we performed a population survey of all children in the community from the ages of 2–12 inclusive. The one-year prevalence of eczema was assessed using the United Kingdom Working Party’s diagnostic criteria, and graded on the Nottingham Severity Scale. All children with eczema and twice as many age/sex matched controls were offered complete blood counts, total IgE, and food specific IgE levels for egg white, cow’s milk protein and wheat. Results One hundred and eighty two (95% of the eligible children) were assessed. Of the 182 children examined eczema was diagnosed in 30 (16.5%) - 22 females and 8 males. The majority of children with eczema (20/30) were classified as being in the moderate and severe category. Of the 22 with eczema and 40 controls who consented to venipuncture all but 3 had IgE levels above the lab's reference range. Food specific antibody assays showed that 32, 23, and 5 percent of children with eczema were sensitized to egg, milk, and wheat respectively. None of the controls were sensitized. Conclusions The children of Natuashish, Labrador have a high rate of eczema, much of it graded as moderate or severe. IgE levels were markedly elevated in children with and without eczema, with average values at least ten-fold higher than other populations. There is no evidence of an unusual amount of sensitization to egg, milk or wheat. PMID:24649812

  16. Structure-activity relationship of indoloquinoline analogs anti-MRSA.

    PubMed

    Zhao, Min; Kamada, Tomonori; Takeuchi, Aya; Nishioka, Hiromi; Kuroda, Teruo; Takeuchi, Yasuo

    2015-12-01

    Indolo[3,2-b]quinoline analogs (3a-3s), 4-(acridin-9-ylamino) phenol hydrochloride (4), benzofuro[3,2-b]quinoline (3t), indeno[1,2-b]quinolines (3u and 3v) have been synthesized. Those compounds were found to exhibit anti-bacterial activity towards Methicillin-resistant Staphylococcus aureus (anti-MRSA activity). Structure-activity relationship studies were conducted that indoloquinoline ring, benzofuroquinoline ring and 4-aminophenol group are essential structure for anti-MRSA activity. PMID:26522949

  17. Efficacy of Listerine antiseptic against MRSA, Candida albicans and HIV.

    PubMed

    Yamanaka, A; Hirai, K; Kato, T; Naito, Y; Okuda, K; Toda, S; Okuda, K

    1994-02-01

    The antiseptic activity of Listerine and Cool Mint Listerine against methicillin-resistant Staphylococcus aureus (MRSA), Candida albicans, human immuno deficiency virus (HIV) and oral bacteria was examined in this study. Exposure for 30 seconds to Listerine killed MRSA completely. Exposure for 30 seconds significantly decreased viable cells of C. albicans. More than 60% of HIV was inactivated by a 30 second exposure to 50% Listerine. Listerine exhibited a potent bactericidal effect against cariogenic and periodontopathic bacteria. Cool Mint Listerine had almost the same antiseptic effect against tested microorganisms. Listerine appears to be effective for killing etiologic microorganisms of opportunistic infection in the oral cavity. PMID:7923507

  18. First Outbreak with MRSA in a Danish Neonatal Intensive Care Unit: Risk Factors and Control Procedures

    PubMed Central

    Ramsing, Benedicte Grenness Utke; Arpi, Magnus; Andersen, Erik Arthur; Knabe, Niels; Mogensen, Dorthe; Buhl, Dorte; Westh, Henrik; Østergaard, Christian

    2013-01-01

    Introduction The purpose of the study was to describe demographic and clinical characteristics and outbreak handling of a large methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a neonatal intensive care unit (NICU) in Denmark June 25th–August 8th 2008, and to identify risk factors for MRSA transmission. Methods Data were collected retrospectively from medical records and the Danish Neobase database. All MRSA isolates obtained from neonates, relatives and NICU health care workers (HCW) as well as environmental cultures were typed. Results During the 46 day outbreak period, 102 neonates were admitted to the two neonatal wards. Ninety-nine neonates were subsequently sampled, and 32 neonates (32%) from 25 families were colonized with MRSA (spa-type t127, SCCmec V, PVL negative). Thirteen family members from 11 of those families (44%) and two of 161 HCWs (1%) were colonized with the same MRSA. No one was infected. Five environmental cultures were MRSA positive. In a multiple logistic regression analysis, nasal Continuous Positive Airway Pressure (nCPAP) treatment (p?=?0.006) and Caesarean section (p?=?0.016) were independent risk factors for MRSA acquisition, whereas days of exposure to MRSA was a risk factors in the unadjusted analysis (p?=?0.04). Conclusions MRSA transmission occurs with high frequency in the NICU during hospitalization with unidentified MRSA neonates. Caesarean section and nCPAP treatment were identified as risk factors for MRSA colonization. The MRSA outbreak was controlled through infection control procedures. PMID:23825581

  19. The structureactivity relationships of mansonone F, a potent anti-MRSA sesquiterpenoid quinone: SAR studies

    E-print Network

    Suh, Young-Ger

    The structure­activity relationships of mansonone F, a potent anti-MRSA sesquiterpenoid quinone on mansonone F, a series of C6 and C9 analogs of mansonone F have been synthesized and their anti-MRSA activities were evaluated. Most of the analogs exhibited good or excellent anti-MRSA activities

  20. Matching Queries to Frequently Asked Questions: Search Functionality for the MRSA Web-Portal

    E-print Network

    Theune, Mariët

    Matching Queries to Frequently Asked Questions: Search Functionality for the MRSA Web-Portal Almer As part of the long-term EUREGIO MRSA-net project a system was developed which enables health care workers and the general public to quickly find answers to their questions regarding the MRSA pathogen. This paper focuses

  1. Complementary and alternative medicines and childhood eczema: a US population-based study.

    PubMed

    Silverberg, Jonathan I; Lee-Wong, Mary; Silverberg, Nanette B

    2014-01-01

    The prevalence of complementary and alternative medicine (CAM) use in US children with eczema is unknown. Furthermore, it is unknown whether CAM use in the United States is associated with higher eczema prevalence. We sought to determine the eczema prevalence in association with CAM usage. We analyzed data from the 2007 National Health Interview Survey that included a nationally representative sample of 9417 children ages 0 to 17 years. Overall, 46.9% (95% confidence interval, 45.6%-48.2%) of children in the United States used 1 or more CAM, of which 0.99% (0.28%-1.71%) used CAM specifically to treat their eczema, including herbal therapy (0.46%), vitamins (0.33%), Ayurveda (0.28%), naturopathy (0.24%), homeopathy (0.20%), and traditional healing (0.12%). Several CAMs used for other purposes were associated with increased eczema prevalence, including herbal therapy (survey logistic regression; adjusted odds ratio [95% confidence interval], 2.07 [1.40-3.06]), vitamins (1.45 [1.21-1.74]), homeopathic therapy (2.94 [1.43-6.00]), movement techniques (3.66 [1.62-8.30]), and diet (2.24 [1.10-4.58]), particularly vegan diet (2.53 [1.17-5.51]). In conclusion, multiple CAMs are commonly used for the treatment of eczema in US children. However, some CAMs may actually be harmful to the skin and be associated with higher eczema prevalence in the United States. PMID:25207686

  2. Combating CA-MRSA in Physical Education, Sports, and Dance

    ERIC Educational Resources Information Center

    Andrews, Amanda K.; Howard-Shaughnessy, Candice; Adams, Jon E.

    2007-01-01

    By now most people have heard about the deadly bacteria that can fester in locker rooms, on sports equipment, and in dance facilities, among other places. This article was written to help PERD professionals become better informed about these bacteria, called community-acquired methicillin-resistant "Staphylococcus aureus" (CA-MRSA). Readers will…

  3. Hand Sanitizers Carry Unproven Claims to Prevent MRSA Infections

    MedlinePLUS

    ... hand sanitizing lotion prevents infection from the bacterium E. coli and the H1N1 flu virus. And another firm ... any products claiming to prevent infection from MRSA, E. coli , Salmonella , or H1N1 flu, which a consumer can ...

  4. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema.

    PubMed

    Lewis-Jones, S

    2006-08-01

    The misery of living with atopic eczema (syn. dermatitis, AD) cannot be overstated for it may have a profoundly negative effect on the health-related quality of life (HRQoL) of children and their family unit in many cases. As it is one of the commonest chronic relapsing childhood dermatosis (UK lifetime prevalence 16-20% by 20 years), with increasing worldwide prevalence, this has major social and financial implications for individuals, healthcare providers and society as a whole. This review explores the impact of AD on the lives of children and their family units and the use of some of the recently developed HRQoL measures, which have enabled investigation and categorisation of the physical, psychological and psycho-social effects of childhood eczema across all aspects of life. These effects include symptoms of itching and soreness, which cause sleeplessness in over 60%. Sleep deprivation leads to tiredness, mood changes and impaired psychosocial functioning of the child and family, particularly at school and work. Embarrassment, comments, teasing and bullying frequently cause social isolation and may lead to depression or school avoidance. The child's lifestyle is often limited, particularly in respect to clothing, holidays, staying with friends, owning pets, swimming or the ability to play or do sports. Restriction of normal family life, difficulties with complicated treatment regimes and increased work in caring for a child with eczema lead to parental exhaustion and feelings of hopelessness, guilt, anger and depression. The hidden costs involved in eczema management can be significant and have particular impact on lower income families. The impairment of quality of life caused by childhood eczema has been shown to be greater than or equal to other common childhood diseases such as asthma and diabetes, emphasising the importance of eczema as a major chronic childhood disease. HRQoL measures are proving to be valuable tools for use in the clinical setting, as outcome measures for pharmaceutical studies, for health economics and audit purposes. It is therefore recommended that in future, they should be used in conjunction with objective measures of severity, as part of the assessment process of a child with atopic eczema. Lack of information on eczema and treatments heightens parental anxiety. Education of all individuals involved in the care of children with eczema is fundamental in the management of AD and it is essential to provide simple clear, unambiguous information on treatment and disease management in order to reduce the negative impact on HRQoL. PMID:16893440

  5. Evidence for linkage of a new region (11p14) to eczema and allergic diseases

    PubMed Central

    Guilloud-Bataille, Michel; Bouzigon, Emmanuelle; Annesi-Maesano, Isabella; Bousquet, Jean; Charpin, Denis; Gormand, Frédéric; Hochez, Joëlle; Just, Jocelyne; Lemainque, Arnaud; Le Moual, Nicole; Matran, Régis; Neukirch, Françoise; Oryszczyn, Marie-Pierre; Paty, Evelyne; Pin, Isabelle; Vervloet, Daniel; Kauffmann, Francine; Lathrop, Mark; Demenais, Florence; Dizier, Marie-Hélène

    2008-01-01

    SUMMARY Asthma, allergic rhinitis (AR) and atopic dermatitis also called eczema are allergic co-morbidites which are likely to depend on pleiotropic genetic effects as well as on specific genetic factors. After a previous genome-wide linkage screen conducted for asthma and AR in a sample of 295 French EGEA families ascertained through asthmatic subjects, the aim here was to search for genetic factors involved in eczema and more particularly those ones shared by the three allergic diseases using the same EGEA data. In this sake, eczema and phenotypes of ‘allergic disease’ accounting for the joint information on the presence/absence of the three diseases were examined by linkage analyses using the Maximum Likelihood Binomial (MLB) method. A fine mapping was carried out in regions detected for potential linkage, followed by association studies using the Family Based Association Test (FBAT). Evidence for linkage to 11p14 region was shown for ‘allergic disease’ and eczema. Linkage was also indicated between eczema and 5q13 and between ‘allergic disease’ and both 5p15 and 17q21 regions. Fine mapping supported the evidence of linkage to 11p14 and FBAT analyses showed association between ‘allergic disease’ and a marker located at the linkage peak on 11p14. Further investigations in this region will allow identifying genetic factor(s) which could have pleiotropic effect in the three allergic diseases. PMID:17943316

  6. Detection and genetic characterization of PVL-positive ST8-MRSA-IVa and exfoliative toxin D-positive European CA-MRSA-Like ST1931 (CC80) MRSA-IVa strains in Bangladesh.

    PubMed

    Paul, Shyamal Kumar; Ghosh, Souvik; Kawaguchiya, Mitsuyo; Urushibara, Noriko; Hossain, Mohammad Akram; Ahmed, Salma; Mahmud, Chand; Jilani, Md Shariful Alam; Haq, Jalaluddin Ashraful; Ahmed, Abdullah Akhtar; Kobayashi, Nobumichi

    2014-08-01

    Severe skin lesions caused by Staphylococcus aureus infection are associated with production from bacterial cells of Panton-Valentine leukocidin (PVL), a typical virulence factor of community-acquired methicillin-resistant S. aureus (CA-MRSA), as well as other toxins represented by exfoliative toxins. Through a retrospective study of 26 S. aureus strains isolated from skin lesions of diabetic patients admitted to a hospital in Bangladesh, 2 PVL-gene-positive MRSA-IVa strains and 8 PVL-negative, exfoliative toxin D (ETD) gene (etd)-positive MRSA-IVa strains were isolated. A PVL-positive MRSA-IVa strain had a type I arginine catabolic mobile element (ACME), belonged to ST8/agr-type I/spa-type t121 (a variant of t008), and harbored blaZ, tet(K), msrA, and aph(3')-IIIa, which are mostly typical characteristics found in USA300, a predominant CA-MRSA clone in the United States. Another PVL-positive MRSA strain, belonging to ST1929 (CC88)/agr-type III/spa-type t3341, was negative for ACME, but possessed blaZ and tet(K). The etd-positive MRSA-IVa strains possessed the epidermal cell differentiation inhibitor B (EDIN-B)-encoding gene (edinB) and belonged to ST1931 (CC80)/agr-type III/spa-type t11023 (a variant of t044), which was genetic trait similar to that of the European CA-MRSA ST80 clone. However, unlike the European ST80 strains, the etd-positive MRSA strains detected in the present study harbored seb, sek, and seq, while they were negative for tet(K), aph(3')-IIIa, and fusB, showing susceptibility to fusidic acid. These findings suggested that etd-positive ST1931 MRSA strains belong to the same lineage as the European ST80 MRSA clone, evolving from a common ancestral clone via acquisition of a different pathogenicity island. This is the first report of a USA300-like MRSA-IV strain, PVL-positive ST1929 (CC88) MRSA-IV, and European ST80 CA-MRSA-like etd-positive ST1931 (CC80) MRSA-IV strains isolated in Bangladesh. PMID:24552553

  7. Multihospital Infection Prevention Collaborative: Informatics Challenges and Strategies to Prevent MRSA

    PubMed Central

    Doebbeling, Bradley N.; Flanagan, Mindy E.; Nall, Glenna; Hoke, Shawn; Rosenman, Marc; Kho, Abel

    2013-01-01

    We formed a collaborative to spread effective MRSA prevention strategies. We conducted a two-phase, multisite, quasi-experimental study of seven hospital systems (11 hospitals) in IN, MT, ME and Ontario, Canada over six years. Patients with prior MRSA were identified at admission using regional health information exchange data. We developed a system to return an alert message indicating a prior history of MRSA, directed to infection preventionists and admissions. Alerts indicated the prior anatomic site, and the originating institution. The combined approach of training and coaching, implementation of MRSA registries, notifying hospitals on admission of previously infected or colonized patients, and change strategies was effective in reducing MRSA infections over 80%. Further research and development of electronic surveillance tools is needed to better integrate the varied data source and support preventing MRSA infections. Our study supports the importance of hospitals collaborating to share data and implement effective strategies to prevent MRSA. PMID:24551340

  8. Alitretinoin for the treatment of severe chronic hand eczema.

    PubMed

    Paulden, M; Rodgers, M; Griffin, S; Slack, R; Duffy, S; Ingram, J R; Woolacott, N; Sculpher, M

    2010-05-01

    This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of alitretinoin for the treatment of adults with severe chronic hand eczema refractory to topical steroid treatment in accordance with the licensed indication, based upon the evidence submission from Basilea Pharmaceuticals Ltd to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The clinical evidence came from a single placebo-controlled randomised controlled trial of daily treatment with alitretinoin for 12-24 weeks, with follow-up for a further 24 weeks, in patients with severe chronic hand eczema (CHE) unresponsive to topical steroids. A statistically significantly greater proportion of patients using alitretinoin achieved the primary end point of clear or almost clear hands by week 24 than did those with placebo. Dose-dependent headache was the most commonly reported adverse event in patients treated with alitretinoin. Serious adverse events were rare, but alitretinoin was associated with increases in both total cholesterol and triglycerides, which has implications for risks of future cardiovascular events. The manufacturer submitted a de novo decision analytic model to estimate, over a time horizon of 3 years, the cost-effectiveness of alitretinoin versus the other relevant comparators identified by NICE. In response to the points of clarification put to it by the ERG regarding the initial submission, the manufacturer provided additional evidence and a revised decision analytic model with a 'placebo' arm. In the manufacturer's original submission to NICE, the base-case incremental cost-effectiveness ratios (ICERs) reported for alitretinoin were 8614 pounds per quality-adjusted life-year (QALY) versus ciclosporin, -469 pounds per QALY versus psoralen + UVA (with alitretinoin dominant) and 10,612 pounds per QALY versus azathioprine. These ICERs decreased as the time horizon was extended in sensitivity analyses. In patients with hyperkeratotic CHE and in women of child-bearing potential, the ICER remained below 20,000. pounds When the health-related quality of life (HRQoL) values used in the model were replaced with those derived from an alternative study, these ICERs increased significantly (to 22,312 pounds per QALY for alitretinoin versus azathioprine). In the revised model, alitretinoin was reported to have an ICER of 12,931 pounds per QALY gained versus supportive care (placebo). However, the model underestimates the costs of treatment associated with alitretinoin. The manufacturer assumed that patients receiving alitretinoin visited the dermatologist every 4 weeks and ceased treatment as soon as they responded to it. If, in practice, patients would receive treatment for longer than this, then the manufacturer's model will have significantly underestimated the costs to the NHS. Additional analyses undertaken by the ERG produced ICERs close to 30,000 pounds per QALY gained for alitretinoin versus supportive care. This was largely due to uncertainty surrounding the impact of alitretinoin on HRQoL. The placebo-controlled trials conducted to date have established that alitretinoin can be efficacious for the treatment of severe CHE refractory to topical steroids, but longer term follow-up of trials or the implementation of registries is required to better establish the longer term efficacy or safety of alitretinoin. NICE recommended the use of alitretinoin for patients with severe CHE and a Dermatology Life Quality Index (DLQI) score of at least 15. Treatment was recommended to be stopped as soon as an adequate response was observed, or if CHE remained severe at 12 weeks, or if response was inadequate at 24 weeks. PMID:20507802

  9. Resolution of cutaneous leishmaniasis after acute eczema due to intralesional meglumine antimoniate.

    PubMed

    Ferreira e Vasconcellos, Erica de Camargo; Pimentel, Maria Inês Fernandes; Valete-Rosalino, Cláudia Maria; Madeira, Maria de Fátima; Schubach, Armando de Oliveira

    2014-01-01

    We report a case of a 42 year-old female, who came to a leishmaniasis reference center in Rio de Janeiro, Brazil, presenting a cutaneous leishmaniasis lesion in the right forearm. Treatment with low-dose intramuscular meglumine antimoniate (MA) (5 mg Sb5+/kg/day) was initiated, with improvement after 28 days, although with the development of generalized eczema. After 87 days, the lesion worsened. Patient refused treatment with amphotericin B. MA was then infiltrated in the lesion, in two sessions, resulting in local eczema, with bullae formation; however, twenty days after, both the ulcer and eczema receded. Intralesional administration of MA should be used carefully when previous cutaneous hypersensitivity is detected. PMID:25076440

  10. Prevalence and risk factors of atopic eczema in Turkish adolescents.

    PubMed

    Akcay, Ahmet; Tamay, Zeynep; Ergin, Ahmet; Guler, Nermin

    2014-01-01

    Atopic eczema (AE) is the most common childhood inflammatory skin condition. The aim of this study was to evaluate the prevalence of AE and its relation to various risk factors. In a cross-sectional study, 9,991 children ages 13 to 14 years in 61 primary schools in 32 districts of Istanbul were evaluated. The prevalence of AE and associated symptoms was assessed using the International Study of Asthma and Allergies in Childhood protocol. The relationship between risk factors and AE was evaluated using multivariate logistic regression analysis. Ten thousand nine hundred eighty-four questionnaires were distributed to 13- and 14-year-old children in 61 schools in 32 districts of Istanbul, 9,991 of which were suitable for analysis, for an overall response rate of 91.7%. There were 4,746 boys (47.9%) and 5,166 girls (52.1%) (M/F ratio 0.920). The rates of itchy rash ever, 12-month itchy rash, and doctor-diagnosed AE ever were 18.2%, 12.0%, and 2.8%, respectively. The difference between rates for itchy rash ever, 12-month itchy rash and doctor-diagnosed AE was high (12.8-31.3, 5.8-24.8, and 0-17.2, respectively) between the districts of Istanbul. Female sex, AE family history, watching television more than 5 hours a day, region of the district, and tonsillectomy history were found to be significantly associated with doctor-diagnosed AE at p < 0.05 in multivariate analysis. This study found a low prevalence of doctor-diagnosed AE and related symptoms in Istanbul. Several risk factors were found to be associated with doctor-diagnosed AE. PMID:24475933

  11. Fusidic acid in skin infections and infected atopic eczema.

    PubMed

    Bonamonte, D; Belloni Fortina, A; Neri, L; Patrizi, A

    2014-08-01

    Skin infections represent an important public health issue and cost-driver. Additionally, chronic skin lesions are sometimes colonized by Gram-negative species. Topical therapies are a key component in the management of mild-to-moderate skin infections. In such cases, topical antibiotics may be preferable to systemic treatment, since they maximize the effective doses at the site of infection while minimizing the systemic side effects of the drugs. However, the prevalence of resistant strains is steadily increasing and cases of sensitization are not uncommon. As a consequence, the ideal topical antibiotic should be selective (thus, minimizing cross-resistance), have weak sensitization potential, penetrate the skin efficiently, reach adequate local doses at the site of infection, and finally be available in different formulations matching patients' preferences and needs. Fusidic acid (FA) is a selective antibiotic available in several topical formulations. Pharmacokinetic and pharmacodynamic studies have shown that, contrary to other topical antibiotics such as gentamicin or mupirocin, FA reaches high antimicrobial concentration at deep skin layers after topical application either on intact or damaged epidermis. Several randomized controlled trials demonstrated that FA, in its various topical formulations, is very effective in treating skin infections, given its high bactericidal activity against S. aureus (including strains resistant to penicillin, methicillin, ampicillin, cloxacillin), S. epidermidis, Streptococcus pyogenes, Propionibacterium acnes, Corinebatteria, Clostridia. Additionally, FA presents a low risk of resistance even in methicillin-resistant S. aureus strains, a common pathogen implied in the etiology of skin infections and infected atopic eczema. Such feature makes FA particularly useful in the management of these medical conditions. Finally, possibly due to its large steric effect, FA has proved a very low risk of contact sensitization. Overall, data on FA efficacy, safety, sensitization potential, resistance profile and spectrum selectivity make it a first-choice option in the treatment of primary and secondary skin infection. PMID:25068235

  12. Egg and cows' milk hypersensitivity in exclusively breast fed infants with eczema, and detection of egg protein in breast milk.

    PubMed Central

    Cant, A; Marsden, R A; Kilshaw, P J

    1985-01-01

    Forty nine eczematous infants who were still solely and exclusively breast fed and who had never received anything but breast milk were studied for evidence of sensitisation to foods. Thirty four similar infants without eczema formed a control group. The eczematous infants were divided into three groups according to clinical criteria: (1) definite atopic eczema; (2) possible atopic eczema; (3) atopic eczema unlikely. Twenty three infants showed cutaneous hypersensitivity to foods, usually egg and cows' milk. Seven of 14 infants in group 1 and nine of 20 in group 2 were sensitised compared with four of 15 in group 3 and three of 34 controls (p less than 0.01). Ovalbumin was detected in breast milk from 14 of 19 mothers tested after ingestion of egg, the concentrations being the same for mothers feeding eczematous and normal infants. Breast fed babies developing eczema may be sensitised by foods eaten by their mothers. PMID:3929969

  13. Prospective comparison of the clinical impacts of heterogeneous vancomycin-intermediate methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-susceptible MRSA.

    PubMed

    Horne, K C; Howden, B P; Grabsch, E A; Graham, M; Ward, P B; Xie, S; Mayall, B C; Johnson, P D R; Grayson, M L

    2009-08-01

    Although methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) strains with reduced susceptibility to vancomycin (RVS-MRSA; including vancomycin-intermediate S. aureus [VISA] and heterogeneous VISA [hVISA]) have been linked with vancomycin treatment failure, it is unclear whether they are more pathogenic than vancomycin-susceptible MRSA (VS-MRSA). We prospectively assessed patients with clinical MRSA isolates during a 10-month period to determine clinical status (infection versus colonization) and therapeutic outcome before correlating these findings with the results of detailed in vitro assessment of vancomycin susceptibility, including population analysis profile (PAP) testing. hVISA and VISA were defined by standard PAP criteria (area-under-the-curve ratio compared to that of the reference hVISA strain Mu3 [>or=0.9]) and routine CLSI criteria (vancomycin MIC, 4 to 8 microg/ml), respectively. Among the 117 patients assessed, 58 had RVS-MRSA isolates (56 hVISA and 2 VISA) and 59 had VS-MRSA isolates; the patient demographics and comorbidities were similar. RVS-MRSA was associated with a lower rate of infection than VS-MRSA (29/58 versus 46/59; P = 0.003), including a lower rate of bacteremia (3/58 versus 20/59, respectively; P < 0.001). The cure rates in RVS-MRSA and VS-MRSA groups were not statistically different (16/26 versus 31/42; P = 0.43), but the post hoc assessment of treatment regimes and study size made detailed conclusions difficult. The results of the macro method Etest correlated well with the PAP results (sensitivity, 98.3%, and specificity, 91.5%), but broth microdilution and our preliminary RVS-MRSA detection method correlated poorly. All isolates were susceptible to linezolid and daptomycin. These data suggest that detailed prospective laboratory identification of RVS-MRSA isolates may be of limited value and that, instead, such in vitro investigation should be reserved for isolates from patients who are failing appropriate anti-MRSA therapy. PMID:19506056

  14. MRSA in Africa: Filling the Global Map of Antimicrobial Resistance

    PubMed Central

    Falagas, Matthew E.; Karageorgopoulos, Drosos E.; Leptidis, John; Korbila, Ioanna P.

    2013-01-01

    We sought to assess the prevalence of methicillin-resistance among Staphylococcus aureus isolates in Africa. We included articles published in 2005 or later reporting for the prevalence of MRSA among S. aureus clinical isolates. Thirty-two studies were included. In Tunisia, the prevalence of MRSA increased from 16% to 41% between 2002–2007, while in Libya it was 31% in 2007. In South Africa, the prevalence decreased from 36% in 2006 to 24% during 2007–2011. In Botswana, the prevalence varied from 23–44% between 2000–2007. In Algeria and Egypt, the prevalence was 45% and 52% between 2003–2005, respectively. In Nigeria, the prevalence was greater in the northern than the southern part. In Ethiopia and the Ivory Coast, the prevalence was 55% and 39%, respectively. The prevalence of MRSA was lower than 50% in most of the African countries, although it appears to have risen since 2000 in many African countries, except for South Africa. PMID:23922652

  15. Infant feeding and the development of food allergies and atopic eczema: An update.

    PubMed

    Gamboni, Sarah E; Allen, Katrina J; Nixon, Rosemary L

    2013-05-01

    There is an increasing awareness of food allergies in the community. Dermatologists frequently see patients with atopic eczema, where parents are extremely concerned about the role of food allergy. Advice given to parents regarding the timing of introduction of solid foods has changed markedly over the past decade. Whereas previous advice advocated delaying the introduction of solid foods until the infant's gastrointestinal system had matured, recent studies suggest that the introduction of solids from around 4 to 6 months may actually prevent the development of allergies. Studies on maternal dietary restrictions during pregnancy and lactation have led researchers to believe that antigen avoidance does not play a significant role in the prevention of atopic disease. Breastfeeding exclusively for 4 to 6 months has multiple benefits for mother and child, however, it does not convincingly prevent food allergies or decrease atopic eczema. New evidence suggests that the use of hydrolysed formulas does not delay or prevent atopic eczema or food allergy. This article aims to highlight current evidence and provide an update for dermatologists on the role of food exposure in the development of atopic disease, namely atopic eczema. PMID:23083457

  16. Identifying Chinese Herbal Medicine Network for Eczema: Implications from a Nationwide Prescription Database

    PubMed Central

    Chen, Hsing-Yu; Lin, Yi-Hsuan; Hu, Sindy; Yang, Sien-hung; Chen, Jiun-liang; Chen, Yu-Chun

    2015-01-01

    Eczema is a highly prevalent dermatological disease that can severely affect the patient's quality of life. Chinese herbal medicine (CHM) is commonly used in combination for eczema due to the complicated pathogenesis. This study aimed to identify a CHM network for the treatment of eczema by using a nationwide database. During 2011, 381,282 CHM prescriptions made for eczema (ICD-9-CM 692.x) were obtained from the National Health Insurance Research Database (NHIRD) in Taiwan and analyzed by using association rule mining and social network analysis. Among 661 available CHMs, 44 important combinations were identified. Among the CHM networks, seven clusters with the predominant traditional Chinese medicine (TCM) pattern were recognized. The largest CHM cluster was used to treat the wind-dampness-heat pattern, and Xiao-Feng-San (24.1% of all prescriptions) was the core of this cluster with anti-inflammation, antioxidation, and antiallergic effects. Lonicera japonica (11.0% of all prescriptions) with Forsythia suspense (17.0% of all prescriptions) was the most commonly used CHM combination and was also the core treatment for treating the heat pattern, in which an antimicrobial effect is found. CHM network analysis is helpful for TCM doctors or researchers to choose candidates for clinical practice or further studies. PMID:25685167

  17. Total and specific IgG4 antibody levels in atopic eczema.

    PubMed Central

    Merrett, J; Barnetson, R S; Burr, M L; Merrett, T G

    1984-01-01

    Total IgG4 and IgG4 antibody levels specific for 10 allergens (three inhaled and seven ingested) were measured by radioimmunoassay of sera taken from three groups of adult patients: (1) 32 cases of atopic eczema, (2) 28 cases of respiratory allergy and (3) 156 normal volunteers. In all three groups IgG4 antibody activity was mainly directed against common foods, and generally the group with atopic eczema had higher total and specific IgG4 levels than the cases of respiratory allergy, who in turn had higher titres than the normal group. There was within each group a tendency for men to have more total IgG4 than women and the difference was statistically significant among the normals. There was evidence of an IgG4 restricted response in atopic eczema because despite the group's elevated total IgG4 its total IgG4 remained within normal limits. Furthermore specific IgG4 was correlated with the corresponding specific IgE level in five of the 10 allergens examined. These results are generally consistent with the view that IgG4 levels are raised in cases of atopic eczema due to prolonged exposure to an allergen which initiated an IgE response. PMID:6744664

  18. Comparison of cellular and humoral immunoassays for the assessment of summer eczema in horses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study was to compare and analyze three common diagnostic methods for summer eczema (SE) in horses, an allergic dermatitis caused by bites of Culicoides spp. Nine horses with a medical history of SE and nine control animals were intradermally challenged with whole body extracts ...

  19. Impact of Anthelminthic Treatment in Pregnancy and Childhood on Immunisations, Infections and Eczema in

    E-print Network

    MacDonald, Mark

    Impact of Anthelminthic Treatment in Pregnancy and Childhood on Immunisations, Infections that anthelminthic treatment in pregnancy and early childhood would improve responses to immunisation and modulate, respectively. Albendazole during pregnancy caused an increased rate of eczema in the children (HR 1.58 (95% CI

  20. Harlequin ichthyosis in an infant born to a father with eczema.

    PubMed

    Fatima, Saba; Rafiq, Ali; Majid, Zain

    2015-04-01

    Harlequin ichthyosis is characterized by thickening of the layer of the skin which contains keratin. Eczema is a chronic relapsing skin disorder which is also associated with disrupted epidermal barrier. We report the case of a 6-hour-old male patient who was brought to the neonatal intensive care unit of our hospital with crusting skin lesions all over the body, presence of a severe ectropion and deranged electrolytes. A diagnosis of harlequin ichthyosis was made, and the neonate was managed accordingly. However, the infant eventually expired on the seventh day of life. The infant's father was a patient of eczema with a chronic relapsing course and was on oral steroid therapy. As per our knowledge, this is the first reported case of an infant with harlequin ichthyosis born to a father suffering from eczema. The similarities in the pathogenesis of the two diseases and the genetic mutation of filaggrin might suggest an association between the two conditions. Harlequin ichthyosis can hence be looked out for in infants born of parents with eczema. PMID:25539778

  1. Influence of weather and climate on subjective symptom intensity in atopic eczema

    NASA Astrophysics Data System (ADS)

    Vocks, E.; Busch, R.; Fröhlich, C.; Borelli, S.; Mayer, H.; Ring, J.

    The frequent clinical observation that the course of atopic eczema, a skin disease involving a disturbed cutaneous barrier function, is influenced by climate and weather motivated us to analyse these relationships biometrically. In the Swiss high-mountain area of Davos the intensity of itching experienced by patients with atopic eczema was evaluated and compared to 15 single meteorological variables recorded daily during an entire 7-year observation period. By means of univariate analyses and multiple regressions, itch intensity was found to be correlated with some meteorological variables. A clear-cut inverse correlation exists with air temperature (coefficient of correlation: -0.235, P<0.001), but the effects of water vapour pressure, air pressure and hours of sunshine are less pronounced. The results show that itching in atopic eczema is significantly dependent on meteorological conditions. The data suggest that, in patients with atopic eczema, a certain range of thermo-hygric atmospheric conditions with a balance of heat and water loss on the skin surface is essential for the skin to feel comfortable.

  2. Mapping Systematic Reviews on Atopic Eczema—An Essential Resource for Dermatology Professionals and Researchers

    PubMed Central

    Futamura, Masaki; Thomas, Kim S.; Grindlay, Douglas J. C.; Doney, Elizabeth J.; Torley, Donna; Williams, Hywel C.

    2013-01-01

    Background Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs). Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. Methods SRs were searched for in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Database of Systematic Reviews, DARE and NHS Evidence. Selected SRs were assessed against the pre-defined eligibility criteria and relevant articles were grouped by treatment category for the included interventions. All identified systematic reviews are included in the Global Resource of EczemA Trials (GREAT) database (www.greatdatabase.org.uk) and key clinical messages are summarised here. Results A total of 128 SRs reviews were identified, including three clinical guidelines. Of these, 46 (36%) were found in the Cochrane Library. No single database contained all of the SRs found. The number of SRs published per year has increased substantially over the last thirteen years, and reviews were published in a variety of clinical journals. Of the 128 SRs, 1 (1%) was on mechanism, 37 (29%) were on epidemiology, 40 (31%) were on eczema prevention, 29 (23%) were on topical treatments, 31 (24%) were on systemic treatments, and 24 (19%) were on other treatments. All SRs included searches of MEDLINE in their search methods. One hundred six SRs (83%) searched more than one electronic database. There were no language restrictions reported in the search methods of 52 of the SRs (41%). Conclusions This mapping of atopic eczema reviews is a valuable resource. It will help healthcare practitioners, guideline writers, information specialists, and researchers to quickly identify relevant up-to-date evidence in the field for improving patient care. PMID:23505516

  3. A Traditional Diet Is Associated with a Reduced Risk of Eczema and Wheeze in Colombian Children

    PubMed Central

    Cepeda, Alfonso M.; Del Giacco, Stefano R.; Villalba, Sara; Tapias, Elmy; Jaller, Rodolfo; Segura, Ana María; Reyes, Gloria; Potts, James; Garcia-Larsen, Vanessa

    2015-01-01

    Background: Diet might influence the risk of allergic diseases. Evidence from developing countries with high prevalence of childhood asthma is scant. Methods: Information on wheeze, rhinitis, and eczema was collected from 3209 children aged 6–7 years in 2005, who were taking part in the International Study on Asthma and Allergy in Children (ISAAC) in Colombia. Intake frequency of twelve food groups was assessed. Associations between each food group and current wheeze, rhino-conjunctivitis, and eczema were investigated with multiple logistic regressions, adjusting for potential confounders. Simes’ procedure was used to test for multiple comparisons. Results: 14.9% of children reported wheeze in the last 12 months, 16% rhino-conjunctivitis, and 22% eczema. Eczema was negatively associated with consumption of fresh fruits and pulses three or more times per week (adjusted Odds ratio (aOR): 0.64; 95% Confidence Interval (CI): 0.49 to 0.83; p value = 0.004; and aOR: 0.62, 95% CI: 0.47 to 0.80; p value < 0.001, respectively). Current wheeze was negatively associated with intake of potatoes (aOR: 0.44, 95% CI: 0.31 to 0.62, p value = 0.005), whilst this outcome was positively associated with consumption of fast food (aOR: 1.76, 95% CI: 1.32 to 2.35, p value = 0.001). These associations remained statistically significant after controlling for multiple comparisons. Conclusions: A traditional diet might have a protective effect against eczema and wheeze in Colombian children, whilst intake of fast foods increases this risk. PMID:26121530

  4. Advances in MRSA drug discovery: where are we and where do we need to be?

    PubMed Central

    Kurosu, Michio; Siricilla, Shajila; Mitachi, Katsuhiko

    2013-01-01

    Introduction Methicillin-resistant Staphylococcus aureus (MRSA) have been on the increase during the past decade, due to the steady growth of the elderly and immunocompromised patients, and the emergence of multi-drug-resistant (MDR) bacterial strains. Although, only a limited number of anti-MRSA drugs are available, a number of different combination antimicrobial drug regimens have been used to treat serious MRSA infections. Thus, addition of several new antistaphylococcal drugs into clinical practice should broaden therapeutic options. Because MRSA is one of the most common and problematic bacteria associated with increasing antimicrobial resistance, continuous efforts on discovery of lead compounds as well as development of alternative therapies and faster diagnostics to ensure effective antistaphylococcal therapy are required. Areas covered This article summarizes the FDA approved drugs to treat MRSA infections, the drugs in clinical trials, and the drug leads for MRSA and related Gram-positive bacterial infections. In addition, the mode of action of antistaphylococcal molecules and resistant mechanisms of some molecules are briefly discussed. Expert opinion The number of pipeline drugs presently undergoing clinical trials is not particularly encouraging. There are limited and rather expensive therapeutic options for the infections by MRSA in the critically ill. This review article provides an update on antistaphylococcal drugs in clinical trials and antibacterial molecules effective against Gram-positive bacteria including MRSA. The structural and biological information of antibacterials summarized here are very useful for designing drug leads to develop into new anti-MRSA drugs. PMID:23829425

  5. CC8 MRSA Strains Harboring SCCmec Type IVc are Predominant in Colombian Hospitals

    PubMed Central

    Jiménez, J. Natalia; Ocampo, Ana M.; Vanegas, Johanna M.; Rodriguez, Erika A.; Mediavilla, José R.; Chen, Liang; Muskus, Carlos E.; A. Vélez, Lázaro; Rojas, Carlos; Restrepo, Andrea V.; Ospina, Sigifredo; Garcés, Carlos; Franco, Liliana; Bifani, Pablo; Kreiswirth, Barry N.; Correa, Margarita M.

    2012-01-01

    Background Recent reports highlight the incursion of community-associated MRSA within healthcare settings. However, knowledge of this phenomenon remains limited in Latin America. The aim of this study was to evaluate the molecular epidemiology of MRSA in three tertiary-care hospitals in Medellín, Colombia. Methods An observational cross-sectional study was conducted from 2008–2010. MRSA infections were classified as either community-associated (CA-MRSA) or healthcare-associated (HA-MRSA), with HA-MRSA further classified as hospital-onset (HAHO-MRSA) or community-onset (HACO-MRSA) according to standard epidemiological definitions established by the U.S. Centers for Disease Control and Prevention (CDC). Genotypic analysis included SCCmec typing, spa typing, PFGE and MLST. Results Out of 538 total MRSA isolates, 68 (12.6%) were defined as CA-MRSA, 243 (45.2%) as HACO-MRSA and 227 (42.2%) as HAHO-MRSA. The majority harbored SCCmec type IVc (306, 58.7%), followed by SCCmec type I (174, 33.4%). The prevalence of type IVc among CA-, HACO- and HAHO-MRSA isolates was 92.4%, 65.1% and 43.6%, respectively. From 2008 to 2010, the prevalence of type IVc-bearing strains increased significantly, from 50.0% to 68.2% (p?=?0.004). Strains harboring SCCmec IVc were mainly associated with spa types t1610, t008 and t024 (MLST clonal complex 8), while PFGE confirmed that the t008 and t1610 strains were closely related to the USA300-0114 CA-MRSA clone. Notably, strains belonging to these three spa types exhibited high levels of tetracycline resistance (45.9%). Conclusion CC8 MRSA strains harboring SCCmec type IVc are becoming predominant in Medellín hospitals, displacing previously reported CC5 HA-MRSA clones. Based on shared characteristics including SCCmec IVc, absence of the ACME element and tetracycline resistance, the USA300-related isolates in this study are most likely related to USA300-LV, the recently-described ‘Latin American variant’ of USA300. PMID:22745670

  6. Overview of Reviews The prevention of eczema in infants and children: an overview of Cochrane and non-Cochrane reviews

    PubMed Central

    Foisy, Michelle; Boyle, Robert J.; Chalmers, Joanne R.; Simpson, Eric L.; Williams, Hywel C.

    2012-01-01

    Background Eczema is the most common inflammatory skin disease of childhood, characterized by an itchy red rash that usually involves the face and skin folds. There is currently no curative treatment for eczema, so the reduction of eczema incidence through disease prevention is a desirable goal. Potential interventions for preventing eczema include exclusive breastfeeding, hydrolysed protein formulas and soy formulas when bottle feeding, maternal antigen avoidance, omega oil supplementation, prebiotics and probiotics. Objectives This overview of reviews aims to present the current body of data from Cochrane and non-Cochrane reviews to provide the most up-to-date evidence on the efficacy and safety of interventions to prevent eczema in infants and children at different risk levels for developing allergic disease. Methods Our pool of Cochrane and non-Cochrane reviews came from the 2010 United Kingdom National Health Service (NHS) Evidence Skin Disorders Annual Evidence Updates Mapping Exercise on Atopic Eczema. This group used a comprehensive search strategy last conducted in August 2010 to identify all systematic reviews on eczema prevention. We identified all reviews that met our pre-specified inclusion criteria, and data were extracted, analysed, compiled into tables and synthesized using quantitative and qualitative methods. Main results Seven systematic reviews containing 39 relevant trials with 11 897 participants were included in this overview. Overall, there was no clear evidence that any of the main interventions reviewed reduced eczema incidence. In subgroup analyses of infants at high risk of allergic disease, an observational study found that exclusive breastfeeding for at least six months compared with introduction of solids at three to six months decreased the incidence of eczema by 60% (risk ratio (RR): 0.40; 95% confidence interval (CI): 0.21, 0.78), and a randomized controlled trial found that prebiotics compared with no prebiotics decreased incidence by 58% (RR: 0.42; 95% CI: 0.21, 0.84). However, each of these findings was based on the results of a single small trial, and no intervention reduced eczema incidence beyond the first two years of life. Although we pre-specified incidence of atopic eczema (i.e. eczema associated with immunoglobulin E (IgE) sensitization) as a primary outcome, data on whether participants diagnosed with eczema were truly atopic were largely lacking from systematic reviews. Similarly, data on atopy, measured using skin prick tests or specific IgE tests to allergens, were not reported in many reviews. No interventions were found to decrease atopy when reported. Adverse events data were generally lacking, but data from a trial of probiotics versus no probiotics showed significantly more spitting up in the first one (RR: 1.88; 95% CI: 1.03, 3.45) and two (RR: 1.69; 95% CI: 1.02, 2.80) months of life, but no overall increase in risk of gastrointestinal symptoms in the first year. Authors’ conclusions Although there is currently no clear evidence showing that any of the interventions examined in this overview prevent eczema in participants not selected for risk of allergic disease, there is some evidence that exclusive breastfeeding for at least six months and prebiotics might reduce eczema incidence in high-risk participants. However, these conclusions are based on limited evidence with methodological shortcomings. Future research on prevention of eczema is needed and should examine different types of hydrolysed formulas, prebiotics and probiotics, as well as enhancement of the skin barrier and other novel approaches in infants at different risk levels for developing allergic disease. PMID:22822349

  7. The direct anti-MRSA effect of emodin via damaging cell membrane.

    PubMed

    Liu, Ming; Peng, Wei; Qin, Rongxin; Yan, Zifei; Cen, Yanyan; Zheng, Xinchuan; Pan, Xichun; Jiang, Weiwei; Li, Bin; Li, Xiaoli; Zhou, Hong

    2015-09-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become an important bacterium for nosocomial infection. Only a few antibiotics can be effective against MRSA. Therefore, searching for new drugs against MRSA is important. Herein, anti-MRSA activities of emodin and its mechanisms were investigated. Firstly, in vitro antimicrobial activity was investigated by minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-growth curve, and multipassage resistance testing was performed. Secondly, protection of emodin on mice survival and blood bacterial load in mice challenged with lethal or sublethal dose of MRSA were investigated. Subsequently, the influences of emodin on the bacterial morphology, messenger RNA (mRNA) expressions related to cell wall synthesis and lysis, ?-lactamase activity, drug accumulation, membrane fluidity, and integrity were performed to investigate its mechanisms. Lastly, in vitro cytotoxicity assay were performed using the 3-(4,5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium bromide (MTT) method. The results showed MICs and MBCs of emodin against MRSA252 and 36 clinical MRSA strains were among 2-8 and 4-32 ?g/mL, respectively. There was no MIC increase for emodin during 20 passages. In vivo, emodin dose-dependently protected mice challenged with lethal dose of MRSA and decreased bacterial load in mice challenged with sublethal dose of MRSA. Morphology observation showed emodin might disrupt cell wall and membrane of MRSA. Although emodin had no influence on genes related to cell wall synthesis and lysis as well as ?-lactamase activity and drug accumulation, emodin reduced membrane fluidity and disrupted membrane integrity. Based on the fact that emodin had no significant cytotoxicity against mammalian cells, it could be further investigated as a membrane-damage bactericide against MRSA in the future. PMID:25998658

  8. Molecular analysis of infant fecal microbiota in an Asian at-risk cohort–correlates with infant and childhood eczema

    PubMed Central

    2014-01-01

    Background Studies have suggested that selective microbial targets prevail in the fecal microbiota of infants with eczema. This study evaluated the composition of fecal microbiota of infants who developed eczema in the first 5 years of life and compared these with those of healthy controls. Findings Children who developed eczema in the first 2 years, those with eczema at 5 years of age and healthy controls were selected from the placebo arm of a birth cohort of at-risk infants participating in a randomized double-blind trial on the protective effects of supplemental probiotics in early life on allergic outcomes. Molecular evaluation of fecal microbiota were conducted using Fluorescence In Situ Hybridization-Flow Cytometry (FISH-FC) for fecal samples collected. Longitudinal analysis of fecal microbiota composition at three days, one and three months and one year of life revealed higher abundance of Enterobacteriaceae [coefficient (B): 1.081, 95% CI: 0.229-1.933, adj p?=?0.014] and Clostridium perfringens [coefficient (B): 0.521, 95% CI: 0.556-0.988, adj p?=?0.03] in those who developed eczema in the first 2 years life. In those with eczema at 5 years of age, a lower abundance of Bifidobacterium was observed [coefficient (B): -27.635, 95% CI: -50.040 - -5.231, adj p?=?0.018]. Conclusions The differences in infant fecal microbiota observed in eczema subjects in this study support the notion that relative abundance of selective microbial targets may contribute to the subsequent development of eczema in childhood. PMID:24650346

  9. Building a genomic framework for prospective MRSA surveillance in the United Kingdom and the Republic of Ireland

    E-print Network

    Reuter, Sandra; Török, Estee M.; Holden, Matthew T. G.; Reynolds, Rosy; Raven, Kathy E.; Blane, Beth; Donker, Tjibbe; Bentley, Stephen D.; Aanensen, David M.; Grundmann, Hajo; Feil, Edward J.; Spratt, Brian G.; Parkhill, Julian; Peacock, Sharon J.

    2015-12-15

    over 1,000 methicillin-resistant Staphylococcus aureus (MRSA) genomes drawn from England, Northern Ireland, Wales, Scotland and the Republic of Ireland over a decade. We sequenced 1,013 MRSA submitted to the British Society for Antimicrobial...

  10. Page 1 of 4 GenMAPP Gene Database for Staphylococcus aureus (strain MRSA252)

    E-print Network

    Dahlquist, Kam D.

    Page 1 of 4 GenMAPP Gene Database for Staphylococcus aureus (strain MRSA252) Sa for Staphylococcus aureus (strain MRSA252) that was built by the Loyola Marymount University (LMU) Bioinformatics Database. 4. Gene Database Specifications a. Gene ID Systems This Staphylococcus aureus Gene Database

  11. Extensive Dissemination of Methicillin-Resistant Staphylococcus aureus (MRSA) between the Hospital and the Community in a Country with a High Prevalence of Nosocomial MRSA

    PubMed Central

    Espadinha, Diana; Faria, Nuno A.; Miragaia, Maria; Lito, Luís Marques; Melo-Cristino, José; de Lencastre, Hermínia

    2013-01-01

    According to the EARS-Net surveillance data, Portugal has the highest prevalence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) in Europe, but the information on MRSA in the community is very scarce and the links between the hospital and community are not known. In this study we aimed to understand the events associated to the recent sharp increase in MRSA frequency in Portugal and to evaluate how this has shaped MRSA epidemiology in the community. With this purpose, 180 nosocomial MRSA isolates recovered from infection in two time periods and 14 MRSA isolates recovered from 89 samples of skin and soft tissue infections (SSTI) were analyzed by pulsed-field gel electrophoresis (PFGE), staphylococcal chromosome cassette mec (SCCmec) typing, spa typing and multilocus sequence typing (MLST). All isolates were also screened for the presence of Panton Valentine leukocidin (PVL) and arginine catabolic mobile element (ACME) by PCR. The results showed that ST22-IVh, accounting for 72% of the nosocomial isolates, was the major clone circulating in the hospital in 2010, having replaced two previous dominant clones in 1993, the Iberian (ST247-I) and Portuguese (ST239-III variant) clones. Moreover in 2010, three clones belonging to CC5 (ST105-II, ST125-IVc and ST5-IVc) accounted for 20% of the isolates and may represent the beginning of new waves of MRSA in this hospital. Interestingly, more than half of the MRSA isolates (8/14) causing SSTI in people attending healthcare centers in Portugal belonged to the most predominant clones found in the hospital, namely ST22-IVh (n?=?4), ST5-IVc (n?=?2) and ST105-II (n?=?1). Other clones found included ST5-V (n?=?6) and ST8-VI (n?=?1). None of the MRSA isolates carried PVL and only five isolates (ST5-V-t179) carried ACME type II. The emergence and spread of EMRSA-15 may be associated to the observed increase in MRSA frequency in the hospital and the consequent spillover of MRSA into the community. PMID:23593155

  12. Role of Raktamokshana by Jalaukavacharana and Siravedhana in the management of Vicharchika (Eczema)

    PubMed Central

    Raval, Hiren N.; Thakar, A. B.

    2012-01-01

    Eczema is most common skin disease which has social impact. The clinical picture of Eczema resembles with Vicharchika—a skin problem mentioned in Ayurvedic literature with Kapha and Pitta morbidly/pathology. In classical text of Ayurveda, Acharyas emphasize the Shodhana therapy as the line of treatment at various places. Among these various Shodhana therapy, Raktamokshan is indicated specially because Rakta is mainly involved as Dushya in Samprapti Ghataka. In the present comparative study, Raktamokshana with two different methods were selected to find out which method is more appropriate for Raktamokshana in Vicharchika. In A group, Jalaukavacharana Karma with Jalauka (Hirudinea medicinalis) and in B group, Siravedhana Karma with Syringe as method of Raktamokshana was selected. Better result was found in A group. So, it is better to manage Vicharchika using Jalaukavacharana as method of Raktamokshana in place of Siravedhana. PMID:23049187

  13. [Effect of diet therapy on the serum immunoglobulin level in chronic eczema].

    PubMed

    Samsonov, M A; Kalinina, A A

    1982-01-01

    A group of 23 patients with acute chronic eczema received hypoallergenic diet providing for maximal exclusion of obligate allergens, extractive and aromatizing substances and food additives, with this diet being full value as to the chemical, vitamin and trace element content. In the diet applied, sugar was completely replaced by xylite, table salt was excluded and liquid restricted. The dietetic management was carried out under the control over the clinical picture of the skin status and the time course of changes in serum concentrations of IgA, IgM, IgG and IgE. The results indicate that adequate dietetic management of patients with acute chronic eczema leads to a significant decrease in serum concentrations of IgE, stabilization and partial regression of skin manifestations. PMID:7090319

  14. Hygiene, atopy and wheeze–eczema–rhinitis symptoms in schoolchildren from urban and rural Ecuador

    PubMed Central

    Cooper, Philip J; Vaca, Maritza; Rodriguez, Alejandro; Chico, Martha E; Santos, Darci N; Rodrigues, Laura C; Barreto, Mauricio L

    2014-01-01

    Background Rural residence is protective against atopy and wheeze–rhinitis–eczema symptoms in developed countries, an effect attributed to farming and poor hygiene exposures. There are few data from developing countries addressing this question. We compared atopy and wheeze–rhinitis–eczema symptoms between urban and rural Ecuador, and explored the effects of farming and poor hygiene exposures. Methods We performed cross sectional studies of schoolchildren living in rural and urban Ecuador. Data on symptoms and farming/hygiene exposures were collected by parental questionnaire, atopy by allergen skin prick test reactivity and geohelminth infections by stool examinations. Results Among 2526 urban and 4295 rural schoolchildren, prevalence was: atopy (10.0% vs 12.5%, p=0.06), wheeze (9.4% vs 10.1%, p=0.05), rhinitis (8.1% vs 6.4%, p=0.02) and eczema (5.9% vs 4.7%, p=0.06). A small proportion of symptoms were attributable to atopy (range 3.9–10.7%) with greater attributable fractions for respiratory symptoms observed in urban schoolchildren. Respiratory symptoms were associated with poor hygiene/farming exposures: wheeze with lack of access to potable water; and rhinitis with household pets, no bathroom facilities and contact with large farm animals. Birth order was inversely associated with respiratory symptoms. Area of residence and atopy had few effects on these associations. Conclusions Urban schoolchildren living in Ecuador have a similar prevalence of atopy, eczema and wheeze but a higher prevalence of rhinitis compared with rural children. Some farming and poor hygiene exposures were associated with an increase in the prevalence of wheeze or rhinitis while birth order was inversely associated with these symptoms. PMID:24105783

  15. Outbreak of eczema and rhinitis in a group of office workers in Greenland

    PubMed Central

    Ebbehøj, Niels E.; Agner, Tove; Zimerson, Erik; Bruze, Magnus

    2015-01-01

    Introduction Disturbed indoor climate may in some cases be associated with illness. In the present paper, we report the results from a thorough investigation of office workers in Greenland, who developed skin and/or airway problems after moving into renewed offices. Material and methods In 2009 the office of the Bank of Greenland had a total renovation of the building, including new furniture and carpets. Symptoms developed within the first year after moving back into the renewed buildings. After removal of carpets in the building, symptoms significantly improved. Workers were examined in 2009 and re-examined in 2013, including clinical examination, patch test and when relevant also skin prick tests and histamine release test. Isothiazolinones and fumarates, both able to cause airway as well as skin symptoms, were isolated from carpets before testing, and included in the test series. Results In total, 32 out of 80 workers (40%) developed symptoms; 27 reported eczema, 20 rhinitis and 4 urticaria. Eczema was located on the hands and/or lower arms in 18 workers, on the face in 10 workers and on legs/trunk in 12 workers. After intervention in the office, 22 workers with eczema reported significant improvement, all cases of hand eczema cleared and 16 workers with rhinitis also improved. Positive patch tests to carpet extracts were found significantly more frequent in the worker cohort than in a control group comprising 47 dermatitis patients (p<0.001). Only few workers reacted with a positive response to skin prick test or in the HR test, no obvious pattern in reactions was found, and no conclusions can be made from these reactions. Conclusion The results indicate that the reported symptoms are related to exposures from the building after renovation in 2009. A specific triggering exposure could not be identified, although chemicals from the glued carpets are suspected. The study is an example of a work place investigation, and illustrates the diversity of symptoms and exposures involved in “Sick Building” cases. PMID:26140387

  16. Alternative Use for Spectra MRSA Chromogenic Agar in Detection of Methicillin-Resistant Staphylococcus aureus from Positive Blood Cultures ?

    PubMed Central

    Peterson, Jess F.; Dionisio, Alexander A.; Riebe, Katherine M.; Hall, Gerri S.; Wilson, Deborah A.; Whittier, Susan; DiPersio, Joseph R.; Ledeboer, Nathan A.

    2010-01-01

    Spectra MRSA agar (Remel, Lenexa, KS), a novel chromogenic medium originally developed to detect methicillin-resistant Staphylococcus aureus (MRSA) from nasal swabs, was evaluated in this multicenter study for the detection of MRSA from positive blood cultures exhibiting Gram-positive cocci upon initial Gram staining. PMID:20392925

  17. A QA System for the MRSA Web Portal Evaluating Retrieval Techniques for a Domain-Specific Corpus

    E-print Network

    Theune, Mariët

    A QA System for the MRSA Web Portal Evaluating Retrieval Techniques for a Domain-Specific Corpus to their questions regarding the MRSA pathogen. This paper focuses on how these questions can be answered by using MRSA, information retrieval, natural language processing, character n-gramming. 1. INTRODUCTION

  18. Comparison of Environmental MRSA Levels on High-Touch Surfaces in Contact Isolation and Noncontact Isolation Patient Rooms.

    PubMed

    Villamaria, Frank C; Berlanga, Gemma; Liao, I-Chia; Ganachari-Mallappa, Nagaraja; Stock, Eileen M; Zeber, John E; Jinadatha, Chetan

    2015-12-01

    Environmental samples were collected from 100 hospital rooms, 32 noncontact rooms, and 68 contact isolation rooms. We isolated 202 and 1,830 MRSA colonies in noncontact and contact isolation rooms, respectively. The study identified MRSA isolates in hospital rooms of patients without colonization or infection with MRSA. Infect. Control Hosp. Epidemiol. 2015;36(12):1472-1475. PMID:26311001

  19. Spectra MRSA, a New Chromogenic Agar Medium To Screen for Methicillin-Resistant Staphylococcus aureus?

    PubMed Central

    Peterson, Jess F.; Riebe, Katherine M.; Hall, Gerri S.; Wilson, Deborah; Whittier, Susan; Palavecino, Elizabeth; Ledeboer, Nathan A.

    2010-01-01

    A novel chromogenic medium, Spectra MRSA (Remel, Lenexa, KS), was designed to detect methicillin-resistant Staphylococcus aureus (MRSA) rapidly and more efficiently than traditional media (i.e., tryptic soy agar with 5% sheep blood [SBA] and mannitol salt agar [MSA]). A multicenter study (including four clinical trial sites and the Medical College of Wisconsin [MCW] Milwaukee, WI) compared the performance characteristics of Spectra MRSA to those of the traditional media for the detection of MRSA. For this study, 767 nasal swab specimens from the multicenter study (traditional medium used, SBA) and 667 nasal swab specimens from MCW (traditional medium used, MSA) were plated on each test medium and examined after 24 and 48 h of incubation. At 24 h, the sensitivity and the specificity of each medium were as follows: in the multicenter study, 95.4% and 99.7%, respectively, for Spectra MRSA and 93.6% and 100%, respectively, for SBA; at MCW, 95.2% and 99.5%, respectively, for Spectra MRSA and 88.7% and 94.0%, respectively, for MSA. The positive predictive values of each medium at 24 h were as follows: in the multicenter study, 98.1% for Spectra MRSA and 100% for SBA; at MCW, 95.2% for Spectra MRSA and 60.4% for MSA. In our evaluation, we found that Spectra MRSA was able to rapidly identify and differentiate methicillin-resistant S. aureus from methicillin-susceptible S. aureus on the basis of the utilization of chromogens that result in denim blue colonies, thus eliminating the need for biochemical analysis and antimicrobial susceptibility testing. Extending the incubation beyond 24 h did not significantly improve the recovery of MRSA and resulted in decreased specificity. PMID:19889898

  20. Methicillin-Resistant Staphylococcus aureus (MRSA) Detected at Four U.S. Wastewater Treatment Plants

    PubMed Central

    Goldstein, Rachel E. Rosenberg; Micallef, Shirley A.; Gibbs, Shawn G.; Davis, Johnnie A.; He, Xin; George, Ashish; Kleinfelter, Lara M.; Schreiber, Nicole A.; Mukherjee, Sampa; Joseph, Sam W.

    2012-01-01

    Background: The incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections is increasing in the United States, and it is possible that municipal wastewater could be a reservoir of this microorganism. To date, no U.S. studies have evaluated the occurrence of MRSA in wastewater. Objective: We examined the occurrence of MRSA and methicillin-susceptible S. aureus (MSSA) at U.S. wastewater treatment plants. Methods: We collected wastewater samples from two Mid-Atlantic and two Midwest wastewater treatment plants between October 2009 and October 2010. Samples were analyzed for MRSA and MSSA using membrane filtration. Isolates were confirmed using biochemical tests and PCR (polymerase chain reaction). Antimicrobial susceptibility testing was performed by Sensititre® microbroth dilution. Staphylococcal cassette chromosome mec (SCCmec) typing, Panton-Valentine leucocidin (PVL) screening, and pulsed field gel electrophoresis (PFGE) were performed to further characterize the strains. Data were analyzed by two-sample proportion tests and analysis of variance. Results: We detected MRSA (n = 240) and MSSA (n = 119) in 22 of 44 (50%) and 24 of 44 (55%) wastewater samples, respectively. The odds of samples being MRSA-positive decreased as treatment progressed: 10 of 12 (83%) influent samples were MRSA-positive, while only one of 12 (8%) effluent samples was MRSA-positive. Ninety-three percent and 29% of unique MRSA and MSSA isolates, respectively, were multidrug resistant. SCCmec types II and IV, the pvl gene, and USA types 100, 300, and 700 (PFGE strain types commonly found in the United States) were identified among the MRSA isolates. Conclusions: Our findings raise potential public health concerns for wastewater treatment plant workers and individuals exposed to reclaimed wastewater. Because of increasing use of reclaimed wastewater, further study is needed to evaluate the risk of exposure to antibiotic-resistant bacteria in treated wastewater. PMID:23124279

  1. Methicillin-resistant Staphylococcus aureus (MRSA) in slaughtered pigs and abattoir workers in Italy.

    PubMed

    Normanno, Giovanni; Dambrosio, Angela; Lorusso, Vanessa; Samoilis, Georgios; Di Taranto, Pietro; Parisi, Antonio

    2015-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen present in the hospital environment (HA-MRSA), in the community (CA-MRSA) and in livestock, including pigs (LA-MRSA). MRSA may enter the human food chain during slaughtering and may infect humans coming into direct contact with pigs or pork products. This study aimed to determine the prevalence and characteristics of MRSA isolated from pigs and workers at industrial abattoirs in southern Italy. A total of 215 pig nasal swabs were screened for the presence of MRSA using PCR. An MRSA isolate was detected from each mecA/nuc PCR-positive sample and characterized by spa-typing, Multi-Locus Sequence Typing, SCC-mec and Panton-Valentine Leukocidin (PVL), and also tested for the production of staphylococcal enterotoxins (SEs). Eighty-one MRSA isolates (37.6%) were obtained from the 215 pig nasal swabs; 37 of these isolates were further characterized, and showed 18 different spa-types and 8 different STs. The most frequently recovered STs were ST398 (CC398-t034, t011, t899, t1939 - 43.2%) followed by ST8 (CC8-t008, t064, t2953, t5270 - 24.3%) and ST1 (CC1-t127, t174, t2207 - 10.8%). Nine MRSA isolates were obtained from the 113 human swabs; the isolates showed 5 different spa-types and 5 different STs, including the novel ST2794 (t159). The most representative STs recovered were ST1 (CC1-t127) and ST398 (CC398-t034) (33.3%). None of the MRSA isolates showed the ability to produce SEs and PVL and all resulted resistant to two or more classes of antimicrobials. This study shows the great genetic diversity of MRSA strains in slaughtered pigs and in abattoir employees in Italy, and clearly demonstrates the need for improved hygiene standards to reduce the risk of occupational and food-borne infection linked to the handling/consumption of raw pork containing MRSA. PMID:26187827

  2. Dose-Response Relationship between Antimicrobial Drugs and Livestock-Associated MRSA in Pig Farming1

    PubMed Central

    Dohmen, Wietske; Bos, Marian E.H.; Verstappen, Koen M.; Houben, Manon; Wagenaar, Jaap A.; Heederik, Dick J.J.

    2015-01-01

    The farming community can be a vehicle for introduction of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in hospitals. During 2011–2013, an 18-month longitudinal study aimed at reducing the prevalence of LA-MRSA was conducted on 36 pig farms in the Netherlands. Evaluations every 6 months showed a slight decrease in MRSA prevalence in animals and a stable prevalence in farmers and family members. Antimicrobial use, expressed as defined daily dosages per animal per year, decreased 44% during the study period and was associated with declining MRSA prevalence in pigs. MRSA carriage in animals was substantially higher at farms using cephalosporins. Antimicrobial use remained strongly associated with LA-MRSA in humans regardless of the level of animal contact. A risk factor analysis outlined potential future interventions for LA-MRSA control. These results should encourage animal and public health authorities to maintain their efforts in reducing antimicrobial use in livestock and ask for future controlled intervention studies. PMID:25989456

  3. Bioreductively Activated Reactive Oxygen Species (ROS) Generators as MRSA Inhibitors.

    PubMed

    Khodade, Vinayak S; Sharath Chandra, Mallojjala; Banerjee, Ankita; Lahiri, Surobhi; Pulipeta, Mallikarjuna; Rangarajan, Radha; Chakrapani, Harinath

    2014-07-10

    The number of cases of drug resistant Staphylococcus aureus infections is on the rise globally and new strategies to identify drug candidates with novel mechanisms of action are in urgent need. Here, we report the synthesis and evaluation of a series of benzo[b]phenanthridine-5,7,12(6H)-triones, which were designed based on redox-active natural products. We find that the in vitro inhibitory activity of 6-(prop-2-ynyl)benzo[b]phenanthridine-5,7,12(6H)-trione (1f) against methicillin-resistant Staphylococcus aureus (MRSA), including a panel of patient-derived strains, is comparable or better than vancomycin. We show that the lead compound generates reactive oxygen species (ROS) in the cell, contributing to its antibacterial activity. PMID:25050164

  4. Laboratory Maintenance of Methicillin-Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Vitko, Nicholas P.; Richardson, Anthony R.

    2014-01-01

    Staphylococcus aureus is an important bacterial pathogen in the hospital and community settings, especially Staphylococcus aureus clones that exhibit methicillin-resistance (MRSA). Many strains of S. aureus are utilized in the laboratory, underscoring the genetic differences inherent in clinical isolates. S. aureus grows quickly at 37°C with aeration in rich media (e.g. BHI) and exhibits a preference for glycolytic carbon sources. Furthermore, S. aureus has a gold pigmentation, exhibits ?-hemolysis, and is catalase and coagulase positive. The four basic laboratory protocols presented in this unit describe how to culture S. aureus on liquid and solid media, how to identify S. aureus strains as methicillin resistant, and how to generate a freezer stock of S. aureus for long-term storage. PMID:23408135

  5. Genome sequencing and molecular characterisation of Staphylococcus aureus ST772-MRSA-V, “Bengal Bay Clone”

    PubMed Central

    2013-01-01

    Background The PVL-positive ST772-MRSA-V is an emerging community-associated (CA-) MRSA clone that has been named Bengal Bay Clone since most patients have epidemiological connections to the Indian subcontinent. It is found increasingly common in other areas of the world. Methods One isolate of ST772-MRSA-V was sequenced using the Illumina Genome Analyzer System. After initial assembling the multiple sequence contigs were analysed using different in-house annotation scripts. Results were compared to microarray hybridisation results of clinical isolates of ST772-MRSA-V, of related strains and to another ST772-MRSA-V genome sequence. Results According to MLST e-burst analysis, ST772-MRSA-V belongs to Clonal Complex (CC)1, differing from ST1 only in one MLST allele (pta-22). However, there are several additional differences including agr alleles (group II rather than III), capsule type (5 rather than 8), the presence of the egc enterotoxin gene cluster and of the enterotoxin homologue ORF CM14 as well as the absence of the enterotoxin H gene seh. Enterotoxin genes sec and sel are present. ST772-MRSA-V harbours the genes encoding enterotoxin A (sea) and PVL (lukS/F-PV). Both are located on the same prophage. Conclusions ST772-MRSA-V may have emerged from the same lineage as globally spread CC1 and CC5 strains. It has acquired a variety of virulence factors, and for a CA-MRSA strain it has an unusually high number of genes associated with antibiotic resistance. PMID:24359724

  6. Do Active Surveillance and Contact Precautions Reduce MRSA Acquisition? A Prospective Interrupted Time Series

    PubMed Central

    Marshall, Caroline; Richards, Michael; McBryde, Emma

    2013-01-01

    Background Consensus for methicillin-resistant Staphylococcus aureus (MRSA) control has still not been reached. We hypothesised that use of rapid MRSA detection followed by contact precautions and single room isolation would reduce MRSA acquisition. Methods This study was a pre-planned prospective interrupted time series comparing rapid PCR detection and use of long sleeved gowns and gloves (contact precautions) plus single room isolation or cohorting of MRSA colonised patients with a control group. The study took place in a medical-surgical intensive care unit of a tertiary adult hospital between May 21st 2007 and September 21st 2009. The primary outcome was the rate of MRSA acquisition. A segmented regression analysis was performed to determine the trend in MRSA acquisition rates before and after the intervention. Findings The rate of MRSA acquisition was 18.5 per 1000 at risk patient days in the control phase and 7.9 per 1000 at-risk patient days in the intervention phase, with an adjusted hazard ratio 0.39 (95% CI 0.24 to 0.62). Segmented regression analysis showed a decline in MRSA acquisition of 7% per month in the intervention phase, (95%CI 1.9% to 12.8% reduction) which was a significant change in slope compared with the control phase. Secondary analysis found prior exposure to anaerobically active antibiotics and colonization pressure were associated with increased acquisition risk. Conclusion Contact precautions with single room isolation or cohorting were associated with a 60% reduction in MRSA acquisition. While this study was a quasi-experimental design, many measures were taken to strengthen the study, such as accounting for differences in colonisation pressure, hand hygiene compliance and individual risk factors across the groups, and confining the study to one centre to reduce variation in transmission. Use of two research nurses may limit its generalisability to units in which this level of support is available. PMID:23555568

  7. IgE antibodies and urinary trimethylarsine oxide accounted for 1-7 % population attributable risks for eczema in adults: USA NHANES 2005-2006.

    PubMed

    Shiue, Ivy

    2015-12-01

    Population attributable risks from serum IgE and dust miteallergen concentrations and environmental chemicals for eczema are unclear. Therefore, it was aimed to examine serum IgE and allergen concentrations and environmental chemicals for eczema in adults and to calculate population attributable risks in a national and population-based setting. Data retrieved from the National Health and Nutrition Examination Survey, 2005-2006, was analyzed. Information on demographics and self-reported ever eczema was obtained by household interview. Bloods and urines (sub-sample) were also collected during the interview. Adults aged 20-85 were included. Statistical analyses were using chi-square test, t test, survey-weighted logistic regression modeling, and population attributable risk (PAR) estimation. Of all the included American adults (n?=?4979), 310 (6.2 %) reported ever eczema. Moreover, more eczema cases were observed in female adults but fewer cases in people born in Mexico. There were no significant associations observed between commonly known biomarkers (including vitamin D) and eczema or between dust mite allergens and eczema. Serum D. Farinae (PAR 1.0 %), D. Pteronyssinus (PAR 1.1 %), cat (PAR 1.8 %), dog (PAR 1.6 %), and muse (PAR 3.2 %) IgE antibodies were associated with eczema. Adults with ever eczema were found to have higher levels of urinary trimethylarsine oxide concentrations (PAR 7.0 %) but not other speciated arsenic concentrations. There were no clear associations between other environmental chemicals including heavy metals, phthalates, phenols, parabens, pesticides, nitrate, perchlorate, polycyclic hydrocarbons and eczema as well. Elimination of environmental risks might help delay or stop eczema up to 7 % in the adult population. PMID:26233738

  8. Skin care education and individual counselling versus treatment as usual in healthcare workers with hand eczema: randomised clinical trial

    PubMed Central

    2012-01-01

    Objective To evaluate the effect of a secondary prevention programme with education on skin care and individual counselling versus treatment as usual in healthcare workers with hand eczema. Design Randomised, observer blinded parallel group superiority clinical trial. Setting Three hospitals in Denmark. Participants 255 healthcare workers with self reported hand eczema within the past year randomised centrally and stratified by profession, severity of eczema, and hospital. 123 were allocated to the intervention group and 132 to the control group. Interventions Education in skin care and individual counselling based on patch and prick testing and assessment of work and domestic related exposures. The control was treatment as usual. Main outcome measures The primary outcome was clinical severity of disease at five month follow-up measured by scores on the hand eczema severity index. The secondary outcomes were scores on the dermatology life quality index, self evaluated severity of hand eczema, skin protective behaviours, and knowledge of hand eczema from onset to follow-up. Results Follow-up data were available for 247 of 255 participants (97%). At follow-up, the mean score on the hand eczema severity index was significantly lower (improved) in the intervention group than control group: difference of means, unadjusted ?3.56 (95% confidence interval ?4.92 to ?2.14); adjusted ?3.47 (?4.80 to ?2.14), both P<0.001 for difference. The mean score on the dermatology life quality index was also significantly lower (improved) in the intervention group at follow-up: difference of means: unadjusted ?0.78, non-parametric test P=0.003; adjusted ?0.92, ?1.48 to ?0.37). Self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves were also statistically significantly better in the intervention group, whereas this was not the case for knowledge of hand eczema. Conclusion A secondary prevention programme for hand eczema improved severity and quality of life and had a positive effect on self evaluated severity and skin protective behaviour by hand washings and wearing of protective gloves. Trial registration ClinicalTrials.gov NCT01012453. PMID:23236031

  9. Analysis of Transmission of MRSA and ESBL-E among Pigs and Farm Personnel.

    PubMed

    Schmithausen, Ricarda Maria; Schulze-Geisthoevel, Sophia Veronika; Stemmer, Franziska; El-Jade, Mohamed; Reif, Marion; Hack, Sylvia; Meilaender, Alina; Montabauer, Gabriele; Fimmers, Rolf; Parcina, Marijo; Hoerauf, Achim; Exner, Martin; Petersen, Brigitte; Bierbaum, Gabriele; Bekeredjian-Ding, Isabelle

    2015-01-01

    Livestock-associated bacteria with resistance to two or more antibiotic drug classes have heightened our awareness for the consequences of antibiotic consumption and spread of resistant bacterial strains in the veterinary field. In this study we assessed the prevalence of concomitant colonization with livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) and enterobacteriaceae expressing extended-spectrum betalactamases (ESBL-E) in farms at the German-Dutch border region. Nasal colonization of pigs with MRSA (113/547 (20.7%)) was less frequent than rectal colonization with ESBL-E (163/540 (30.2%)). On the individual farm level MRSA correlated with ESBL-E recovery. The data further provide information on prevalence at different stages of pig production, including abattoirs, as well as in air samples and humans living and working on the farms. Notably, MRSA was detected in stable air samples of 34 out of 35 pig farms, highlighting air as an important MRSA transmission reservoir. The majority of MRSA isolates, including those from humans, displayed tetracycline resistance and spa types t011 and t034 characteristic for LA-MRSA, demonstrating transmission from pigs to humans. ESBL-E positive air samples were detected on 6 out of 35 farms but no pig-to-human transmission was found. Detection of ESBL-E, e.g. mostly Escherichia coli with CTX-M-type ESBL, was limited to these six farms. Molecular typing revealed transmission of ESBL-E within the pig compartments; however, related strains were also found on unrelated farms. Although our data suggest that acquisition of MRSA and ESBL-E might occur among pigs in the abattoirs, MRSA and ESBL-E were not detected on the carcasses. Altogether, our data define stable air (MRSA), pig compartments (ESBL-E) and abattoir waiting areas (MRSA and ESBL-E) as major hot spots for transmission of MRSA and/or ESBL-E along the pig production chain. PMID:26422606

  10. Analysis of Transmission of MRSA and ESBL-E among Pigs and Farm Personnel

    PubMed Central

    Stemmer, Franziska; El-Jade, Mohamed; Reif, Marion; Hack, Sylvia; Meilaender, Alina; Montabauer, Gabriele; Fimmers, Rolf; Parcina, Marijo; Hoerauf, Achim; Exner, Martin; Petersen, Brigitte; Bierbaum, Gabriele; Bekeredjian-Ding, Isabelle

    2015-01-01

    Livestock-associated bacteria with resistance to two or more antibiotic drug classes have heightened our awareness for the consequences of antibiotic consumption and spread of resistant bacterial strains in the veterinary field. In this study we assessed the prevalence of concomitant colonization with livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) and enterobacteriaceae expressing extended-spectrum betalactamases (ESBL-E) in farms at the German-Dutch border region. Nasal colonization of pigs with MRSA (113/547 (20.7%)) was less frequent than rectal colonization with ESBL-E (163/540 (30.2%)). On the individual farm level MRSA correlated with ESBL-E recovery. The data further provide information on prevalence at different stages of pig production, including abattoirs, as well as in air samples and humans living and working on the farms. Notably, MRSA was detected in stable air samples of 34 out of 35 pig farms, highlighting air as an important MRSA transmission reservoir. The majority of MRSA isolates, including those from humans, displayed tetracycline resistance and spa types t011 and t034 characteristic for LA-MRSA, demonstrating transmission from pigs to humans. ESBL-E positive air samples were detected on 6 out of 35 farms but no pig-to-human transmission was found. Detection of ESBL-E, e.g. mostly Escherichia coli with CTX-M-type ESBL, was limited to these six farms. Molecular typing revealed transmission of ESBL-E within the pig compartments; however, related strains were also found on unrelated farms. Although our data suggest that acquisition of MRSA and ESBL-E might occur among pigs in the abattoirs, MRSA and ESBL-E were not detected on the carcasses. Altogether, our data define stable air (MRSA), pig compartments (ESBL-E) and abattoir waiting areas (MRSA and ESBL-E) as major hot spots for transmission of MRSA and/or ESBL-E along the pig production chain. PMID:26422606

  11. Thiol activated prodrugs of sulfur dioxide (SO2) as MRSA inhibitors.

    PubMed

    Pardeshi, Kundansingh A; Malwal, Satish R; Banerjee, Ankita; Lahiri, Surobhi; Rangarajan, Radha; Chakrapani, Harinath

    2015-07-01

    Drug resistant infections are becoming common worldwide and new strategies for drug development are necessary. Here, we report the synthesis and evaluation of 2,4-dinitrophenylsulfonamides, which are donors of sulfur dioxide (SO2), a reactive sulfur species, as methicillin-resistant Staphylococcus aureus (MRSA) inhibitors. N-(3-Methoxyphenyl)-2,4-dinitro-N-(prop-2-yn-1-yl)benzenesulfonamide (5e) was found to have excellent in vitro MRSA inhibitory potency. This compound is cell permeable and treatment of MRSA cells with 5e depleted intracellular thiols and enhanced oxidative species both results consistent with a mechanism involving thiol activation to produce SO2. PMID:25981687

  12. Cecal ligation and puncture followed by MRSA pneumonia increases mortality in mice and blunts production of local and systemic cytokines

    PubMed Central

    Jung, Enjae; Perrone, Erin E.; Liang, Zhe; Breed, Elise R.; Dominguez, Jessica A.; Clark, Andrew T.; Fox, Amy C.; Dunne, W. Michael; Burd, Eileen M.; Farris, Alton B.; Hotchkiss, Richard S.; Coopersmith, Craig M.

    2011-01-01

    Mortality in the ICU frequently results from the synergistic effect of two temporally-distinct infections. This study examined the pathophysiology of a new model of intraabdominal sepsis followed by methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Mice underwent cecal ligation and puncture (CLP) or sham laparotomy followed three days later by an intratracheal injection of MRSA or saline. Both CLP/saline and sham/MRSA mice had 100% survival while animals with CLP followed by MRSA pneumonia had 67% seven-day survival. Animals subjected to CLP/MRSA had increased bronchoalveolar lavage (BAL) concentrations of MRSA compared to sham/MRSA animals. Animals subjected to sham/MRSA pneumonia had increased BAL levels of IL-6, TNF-?, and G-CSF compared to those given intratracheal saline while CLP/MRSA mice had a blunted local inflammatory response with markedly decreased cytokine levels. Similarly, animals subjected to CLP/saline had increased peritoneal lavage levels of IL-6 and IL-1? compared to those subjected to sham laparotomy while this response was blunted in CLP/MRSA mice. Systemic cytokines were upregulated in both CLP/saline and sham/MRSA mice, and this was blunted by the combination of CLP/MRSA. In contrast, no synergistic effect on pneumonia severity, white blood cell count or lymphocyte apoptosis was identified in CLP/MRSA mice compared to animals with either insult in isolation. These results indicate that a clinically relevant model of CLP followed by MRSA pneumonia causes higher mortality than could have been predicted from studying either infection in isolation, and this was associated with a blunted local (pulmonary and peritoneal) and systemic inflammatory response and decreased ability to clear infection. PMID:21937950

  13. Successful treatment of refractory chronic hand eczema with calcipotriol/betamethasone ointment: A report of three cases

    PubMed Central

    YANG, MIN; CHANG, JIAN-MIN

    2015-01-01

    Chronic hand eczema (CHE) is a common skin disorder with frequent relapses, and its treatment comprises a challenge due to its uncertain etiology. In particular, certain cases of CHE exhibiting severe keratinization have a very poor response to various treatments. The Daivobet ointment, a complex product comprising calcipotriol and betamethasone, has been successfully used for the treatment of patients with plaque-type psoriasis for ~10 years; however, there are few reports on the effect of the ointment on other skin disorders of abnormal keratinization, such as eczema. The present study reported 3 cases of refractory hyperkeratotic eczema of the hand that did not respond to several treatments, but responded well to topical Daivobet treatment. PMID:26640577

  14. Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema.

    PubMed

    Korting, H C; Schäfer-Korting, M; Klövekorn, W; Klövekorn, G; Martin, C; Laux, P

    1995-01-01

    In a double-blind, randomized, paired trial lasting 14 days in 72 patients with moderately severe atopic eczema, hamamelis distillate cream (5.35 g hamamelis distillate with 0.64 mg ketone/100 g) was compared with the corresponding drug-free vehicle and 0.5% hydrocortisone cream, and reductions of the basic criteria of severe atopic eczema (delta values of the sum scores), i.e. itching, erythema and scaling, were evaluated. Thirty-six patients in each group were treated, which allowed the detection of a 10% difference between verum and control (confirmatory study). Effects were compared using Wilcoxon's test. The mean sum scores of the basic criteria of the test areas were 5.3-5.5. All treatment regimens significantly reduced itching, erythema and scaling after 1 week. Hydrocortisone proved superior to hamamelis distillate. The basic criteria scores decreased by 2.7 and 1.6, respectively. The delta values of the minor criteria and the global rating of efficacy were also used to indicate the difference between these preparations. Hamamelis distillate cream, however, did not differ from the vehicle. Mean delta values of basic criteria were 1.8 and 2.0, respectively. All preparations were well tolerated. Unwanted cutaneous reactions occurred in six patients, although due to their inflammatory nature and their confinement to vehicle-treated patients, they may not represent true adverse effects but rather a lack of efficacy. The results prove the superiority of low-dose hydrocortisone cream over hamamelis distillate cream, and the therapeutic outcome following this preparation was no better than following the base preparation. The mild, yet unmistakable anti-inflammatory effect of hamamelis cream in experimental models of inflammatory skin disease was thus not reflected by an efficacy in patients with atopic eczema greater than that obtained from the base preparation. PMID:8582464

  15. Isolation of a potent anti-MRSA sesquiterpenoid quinone from Ulmus davidiana var. japonica.

    PubMed

    Shin, D Y; Kim, H S; Min, K H; Hyun, S S; Kim, S A; Huh, H; Choi, E C; Choi, Y H; Kim, J; Choi, S H; Kim, W B; Suh, Y G

    2000-11-01

    A highly potent anti-MRSA sesquiterpenoid has been isolated from Ulmus davidiana var. japonica, which has been traditionally used to treat infectious diseases in Korea. This naturally occurring antibiotic was identified as mansonone F (1). This compound has been found to be highly active specifically against MRSA and showed an MIC range of 0.39-3.13 microg/ml which is comparable to that of vancomycin. PMID:11086922

  16. Descriptive Analysis of Antibiotic-Resistant Patterns of Methicillin-Resistant Staphylococcus aureus (MRSA) st398 Isolated from Healthy Swine

    PubMed Central

    Morcillo, Ana; Castro, Beatriz; Rodríguez-Álvarez, Cristobalina; Abreu, Rossana; Aguirre-Jaime, Armando; Arias, Angeles

    2015-01-01

    Background: Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) such as the MRSA ST398 strain has spread all over the World and the most worrying aspect of this fact appears to be its capacity to easily spread to humans. The excessive use of antibiotics has made swine a reservoir of MRSA. The aim of the present study was to determine the antibiotic resistance profile of MRSA samples isolated from healthy swine of the island of Tenerife (Spain). Methods: A total of 256 MRSA isolates from swine samples and five MRSA isolates from pig worker samples were investigated for MRSA antibiotic resistant patterns. Results: Analysis of the susceptibility status of MRSA pig isolates revealed that 39 isolates were resistant to one antibiotic, 71 isolates were resistant to two antibiotics and 96 isolates were resistant to three or more antibiotics. SCCmec typing revealed the presence of types IV and V. Isolates having SCCmec IV had an increased resistance to the antimicrobial agents tested than those having SCCmec V. We observed significant differences when comparing the most common resistance patterns and SCCmec type. Conclusions: MRSA isolated from humans showed similar resistance to those isolated from pigs, excepting erythromycin, since all the workers’ isolates were sensitive to this antibiotic. The evolution of new MRSA clones has emphasized the need for infection control practices in animals and humans in close contact. PMID:25588155

  17. Genotypic and phenotypic characteristics of Methicillin-resistant Staphylococcus aureus (MRSA) strains, isolated on three different geography locations

    PubMed Central

    Ostoji?, Maja; Huki?, Mirsada

    2015-01-01

    Staphylococcus aureus is a major cause of hospital-acquired infections worldwide. Increased frequency of methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized patients and possibility of vancomycin resistance requires rapid and reliable characterization of isolates and control of MRSA spread in hospitals. Typing of isolates helps to understand the route of a hospital pathogen spread. The aim of this study was to investigate and compare genotypic and phenotypic characteristics of MRSA samples on three different geography locations. In addition, our aim was to evaluate three different methods of MRSA typing: spa-typing, agr-typing and GenoType MRSA. We included 104 samples of MRSA, isolated in 3 different geographical locations in clinical hospitals in Zagreb, Mostar, and Heidelberg, during the period of six months. Genotyping and phenotyping were done by spa-typing, agr-typing and dipstick assay GenoType MRSA. We failed to type all our samples by spa-typing. The most common spa-type in clinical hospital Zagreb was t041, in Mostar t001, and in Heidelberg t003. We analyzed 102/104 of our samples by agr-typing method. We did not find any agr-type IV in our locations. We analyzed all our samples by the dipstick assay GenoType MRSA. All isolates in our study were MRSA strains. In Zagreb there were no positive strains to PVL gene. In Mostar we have found 5/25 positive strains to PVL gene, in Heidelberg there was 1/49. PVL positive isolates were associated with spa-type t008 and agr-type I, thus, genetically, they were community-associated MRSA (CA-MRSA). Dipstick assay GenoType MRSA has demonstrated sufficient specificity, sensibility, simple performance and low cost, so we could introduce it to work in smaller laboratories. Using this method may expedite MRSA screening, thus preventing its spread in hospitals. PMID:26295294

  18. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) at ambient freshwater beaches

    USGS Publications Warehouse

    Fogarty, Lisa R.; Haack, Sheridan K.; Johnson, Heather E.; Brennan, Angela K.; Isaacs, Natasha M.; Spencer, Chelsea

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) are a threat to human health worldwide, and although detected at marine beaches, they have been largely unstudied at freshwater beaches. Genes indicating S. aureus (SA; femA) and methicillin resistance (mecA) were detected at 11 and 12 of 13 US Great Lakes beaches and in 18% or 27% of 287 recreational water samples, respectively. Eight beaches had mecA + femA (potential MRSA) detections. During an intensive study, higher bather numbers, staphylococci concentrations, and femA detections were found in samples collected after noon than before noon. Local population density, beach cloud cover, and beach wave height were significantly correlated with SA or MRSA detection frequency. The Panton-Valentine leukocidin gene, associated with community-acquired MRSA, was detected in 12 out of 27 potential MRSA samples. The femA gene was detected less frequently at beaches that met US enterococci criteria or EU enterococci ‘excellent’ recreational water quality, but was not related to Escherichia coli-defined criteria. Escherichia coli is often the only indicator used to determine water quality at US beaches, given the economic and healthcare burden that can be associated with infections caused by SA and MRSA, monitoring of recreational waters for non-fecal bacteria such as staphylococci and/or SA may be warranted.

  19. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) at ambient freshwater beaches.

    PubMed

    Fogarty, Lisa R; Haack, Sheridan K; Johnson, Heather E; Brennan, Angela K; Isaacs, Natasha M; Spencer, Chelsea

    2015-09-01

    Methicillin-resistant Staphylococcus aureus (MRSA) are a threat to human health worldwide, and although detected at marine beaches, they have been largely unstudied at freshwater beaches. Genes indicating S. aureus (SA; femA) and methicillin resistance (mecA) were detected at 11 and 12 of 13 US Great Lakes beaches and in 18% or 27% of 287 recreational water samples, respectively. Eight beaches had mecA+femA (potential MRSA) detections. During an intensive study, higher bather numbers, staphylococci concentrations, and femA detections were found in samples collected after noon than before noon. Local population density, beach cloud cover, and beach wave height were significantly correlated with SA or MRSA detection frequency. The Panton-Valentine leukocidin gene, associated with community-acquired MRSA, was detected in 12 out of 27 potential MRSA samples. The femA gene was detected less frequently at beaches that met US enterococci criteria or EU enterococci 'excellent' recreational water quality, but was not related to Escherichia coli-defined criteria. Escherichia coli is often the only indicator used to determine water quality at US beaches, given the economic and healthcare burden that can be associated with infections caused by SA and MRSA, monitoring of recreational waters for non-fecal bacteria such as staphylococci and/or SA may be warranted. PMID:26322754

  20. Permeability of the small intestine to (/sup 51/Cr)EDTA in children with acute gastroenteritis or eczema

    SciTech Connect

    Forget, P.; Sodoyez-Goffaux, F.; Zappitelli, A.

    1985-06-01

    Increased gut permeability to macromolecules is thought to be an important factor in the development of food hypersensitivity. The latter can develop in the course of acute gastroenteritis and could play a role in infantile eczema. The authors studied gut permeability in 10 normal adults, 11 control children, 7 children with acute gastroenteritis, and 8 patients with infantile eczema, making use of (/sup 51/Cr)EDTA as probe molecule. (/sup 51/Cr)EDTA was given orally (50-100 microCi); 24-h urinary excretion of (/sup 51/Cr)EDTA was measured and expressed as a percentage of the oral dose. Mean and standard error were 2.35 +/- 0.24, 2.51 +/- 0.21, 9.96 +/- 3.44, and 10.90 +/- 2.05 in normal adults, control children, and gastroenteritis and eczema patients, respectively. Differences between controls and either gastroenteritis (p less than 0.001) or eczema (p less than 0.001) patients are significant. The results support the hypothesis that increased gut permeability could play a role in food hypersensitivity.

  1. Formulation and clinical evaluation of topical dosage forms of Indian Penny Wort, walnut and turmeric in eczema.

    PubMed

    Khiljee, Sonia; Rehman, Nisarur; Khiljee, Tanzila; Loebenberg, Raimar; Ahmad, Rao Saeed

    2015-11-01

    Eczema is characterized by itching, lichenification, scaling, oedema and erythema. Current management strategies include corticosteroids, which are limited due to side effects. Many herbal remedies are used traditionally but unfortunately have not been validated in controlled clinical trials. Three popular traditional treatments of eczema include Indian pennywort, Walnut and Turmeric. In this study three topical formulations (micro emulsion, gel and ointment) were prepared from extracts of Indian pennywort, Walnut and Turmeric. These formulations were monitored for stability for a period of three months. Controlled clinical trials were conducted on 360 eczema patients. Clinical parameters observed were degree of erythema, oedema, scaling, itching and lichenification. Effects of each formulation on these clinical parameters were compared with placebo formulations. Micro emulsion formulations in all cases proved to be more effective in reducing semi quantitative scores of erythema and oedema. Itching was relieved more by gel formulation. The ointment showed more efficacy towards scaling and lichenification. Comparison of the effects of placebo and the specific formulations was performed by chi-square statistics and found to be highly significant. In summary it is concluded that all the formulations could be used as promising source for treatment of eczema. PMID:26639477

  2. Siblings, asthma, rhinoconjunctivitis and eczema: a worldwide perspective from the International Study of Asthma and Allergies in Childhood

    PubMed Central

    Strachan, D P; Aït-Khaled, N; Foliaki, S; Mallol, J; Odhiambo, J; Pearce, N; Williams, H C

    2015-01-01

    Background Associations of larger families with lower prevalences of hay fever, eczema and objective markers of allergic sensitization have been found fairly consistently in affluent countries, but little is known about these relationships in less affluent countries. Methods Questionnaire data for 210 200 children aged 6–7 years from 31 countries, and 337 226 children aged 13–14 years from 52 countries, were collected by Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations of disease symptoms and labels of asthma, rhinoconjunctivitis and eczema were analysed by numbers of total, older and younger siblings, using mixed (multi-level) logistic regression models to adjust for individual covariates and at the centre level for region, language and national affluence. Results In both age groups, inverse trends (P < 0.0001) were observed for reported ‘hay fever ever’ and ‘eczema ever’ with increasing numbers of total siblings, and more specifically older siblings. These inverse associations were significantly (P < 0.005) stronger in more affluent countries. In contrast, symptoms of severe asthma and severe eczema were positively associated (P < 0.0001) with total sibship size in both age groups. These associations with disease severity were largely independent of position within the sibship and national GNI per capita. Conclusions These global findings on sibship size and childhood asthma, rhinoconjunctivitis and eczema suggest at least two distinct trends. Inverse associations with older siblings (observations which prompted the ‘hygiene hypothesis’ for allergic disease) are mainly a phenomenon of more affluent countries, whereas greater severity of symptoms in larger families is globally more widespread. PMID:24912652

  3. Risk factors for eczema in infants born in Cuba: a population-based cross-sectional study

    PubMed Central

    2014-01-01

    Background There is a concern that allergic disease in childhood is higher than expected in Cuba. The aim of this study was to determine the risk factors for eczema of infants aged 12–15 months living in Havana. Methods We used a cross-sectional epidemiological study design. Data on eczema symptoms and a wide range of lifestyle factors were collected by researcher administered questionnaires. Results Data were collected on 1956 children (96% response rate), of whom 672 (34%) were reported as having had eczema. Independent risk factors for eczema included young maternal age (adjusted odds ratio (OR) 0.98 per additional year of age; 95% confidence interval (CI) 0.97-0.99), child’s weight (OR 1.13 per additional kg; 95% CI: 1.03-1.25), insect sting allergy (OR 2.11; 95% CI: 1.33-3.35), rodents in the home (OR 1.39; 95% CI: 1.10-1.76), attendance at childcare facilities (OR 1.34: 95% CI: 1.05-1.70) and self-reported mould in the home (OR 1.23; 95% CI: 1.07-1.41). Infant exposure to paracetamol was associated with an increased risk of eczema even after adjustment for wheeze (OR 1.22; 95% CI: 1.03-1.46). Conclusion Despite a very different culture and environment, the consistency of these findings with those from more economically developed countries suggests potential causal associations. The association with paracetamol, even after adjustment for wheeze, suggests that intervention studies are required in young infants, to ascertain if this commonly used anti-pyretic medication increases allergic disease. PMID:24666750

  4. MRSA from Santa Catarina State, Southern Brazil: intriguing epidemiological differences compared to other Brazilian regions.

    PubMed

    Silveira, Alessandro C O; Cunha, Gabriela R; Caierão, Juliana; Cordova, Caio M de; d'Azevedo, Pedro A

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most frequently isolated agents in both nosocomial and community settings. It is a constant challenge for antibacterial therapy. Therefore, it becomes essential to understand the epidemiology of MRSA isolates in the institution and/or region to guide empirical therapy. The objective of this study was to evaluate the epidemiological characteristics of MRSA isolates in the state of Santa Catarina, Brazil, and determine if there is a clonal spread. We evaluated 124 clinical isolates of MRSA obtained from various anatomical sites from patients in the state of Santa Catarina in Southern Brazil. The antimicrobial susceptibility profile was evaluated by disk diffusion and minimum inhibitory concentration (MIC) was determined by Etest and broth macrodilution. SCCmec types were determined by multiplex PCR and the clonal relationship among isolates was assessed by pulsed field gel electrophoresis. Antimicrobials that have demonstrated lower rates of resistance were tetracycline (20.2%), sulfamethoxazole-trimethoprim (20.2%) and chloramphenicol (12.9%). We did not detect any resistance to glycopeptides, daptomycin, linezolid, and tigecycline. SCCmec type III was predominant (54%), followed by type II (21.8%), consistent with other Brazilian studies. Twenty-six clones were observed grouping 72 (58%) isolates and no clonal relationship was observed between our isolates and the major epidemic clones circulating in Brazil. An intriguing distinct MRSA epidemiology was observed in Santa Catarina, compared to other Brazilian regions. PMID:26119853

  5. Quorum Quenching and Antimicrobial Activity of Goldenseal (Hydrastis canadensis) against Methicillin-Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Cech, Nadja B.; Junio, Hiyas A.; Ackermann, Laynez W.; Kavanaugh, Jeffrey S.; Horswill, Alexander R.

    2015-01-01

    The popular herbal remedy goldenseal (Hydrastis canadensis L.) is traditionally used to treat skin infections. With this study, we show activity of H. canadensis extracts in vitro against methicillin-resistant Staphylococcus aureus (MRSA). An extract from H. canadensis leaves demonstrated more potent antimicrobial activity than the alkaloid berberine alone (MICs of 75 µg/mL and 150 µg/mL, respectively). LC-MS detected alkaloids and efflux-pump inhibitory flavonoids in the extract, and the latter may explain the enhanced efficacy of the extract compared to berberine alone. We also show evidence of anti-virulence activity as a second mechanism by which H. canadensis acts against S. aureus. The H. canadensis leaf extract (but not the isolated alkaloids berberine, hydrastine, and canadine) demonstrated quorum quenching activity against several clinically relevant MRSA isolates (USA300 strains). Our data suggest that this occurs by attenuation of signal transduction through the AgrCA two-component system. Consistent with this observation, the extract inhibited toxin production by MRSA, and prevented damage by MRSA to keratinocyte cells in vitro. Collectively, our results show that H. canadensis leaf extracts possess a mixture of constituents that act against MRSA via several different mechanisms. These findings lend support for the traditional application of crude H. canadensis extracts in the treatment of prevention of infection. PMID:22814821

  6. Dyshidrotic Eczema

    MedlinePLUS

    ... 2006-2013 Logical Images, Inc. All rights reserved. Advertising Notice This Site and third parties who place ... would like to obtain more information about these advertising practices and to make choices about online behavioral ...

  7. Nummular eczema

    MedlinePLUS

    ... But there usually is a personal or family history of: Allergies Asthma Atopic dermatitis Things that can make the condition worse, include: Dry skin Environmental irritants Stress Temperature changes

  8. Dyshidrotic eczema

    MedlinePLUS

    ... common along the edges of the fingers, toes, palms, and soles. These blisters can be very itchy. ... are best. Petroleum jelly (such as Vaseline), mineral oil, or vegetable shortening may be best, but these ...

  9. A New Local Variant (ST764) of the Globally Disseminated ST5 Lineage of Hospital-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) Carrying the Virulence Determinants of Community-Associated MRSA

    PubMed Central

    Takano, Tomomi; Hung, Wei-Chun; Shibuya, Michiko; Higuchi, Wataru; Iwao, Yasuhisa; Nishiyama, Akihito; Reva, Ivan; Khokhlova, Olga E.; Yabe, Shizuka; Ozaki, Kyoko; Takano, Misao

    2013-01-01

    The ST5 lineage of methicillin-resistant Staphylococcus aureus (MRSA) is one of the most globally disseminated hospital-associated MRSA (HA-MRSA) lineages. We isolated a new local variant (designated ST764) over at least 5 years that causes invasive infections, including necrotizing fasciitis, and is carried by medical students, as well as household members. Analysis of the genome sequence of one isolate compared to that of the reference ST5 strain revealed that ST764 had acquired virulence traits similar to those of community-associated MRSA (CA-MRSA) through the acquisition of two new mobile genetic elements, ACMEII and SaPInn54, which carried ACME arcA and the staphylococcal enterotoxin B gene (seb), respectively, and through enhanced expression of cytolytic peptide genes, although ST764 was negative for Panton-Valentine leukocidin. Other differences between ST764 and ST5 included the acquisition of an ACMEII-related cassette (cJR1), prophage ?2NN54, and streptococcal Tn5251 and decreased numbers of copies of Tn554. As for superantigen genes, although the two possessed seg, sei, sem, sen, and seo, ST764 lacked tst, sec, sel, and sep. The data suggest that ST764 MRSA is a novel hybrid variant of ST5 HA-MRSA with the characteristics of CA-MRSA and that the evolution of ST764 includes multiple steps, e.g., acquisition of novel or nonstaphylococcal mobile elements. PMID:23318800

  10. Detection of methicillin resistant Staphylococcus aureus (MRSA) from recreational beach using the mecA gene

    NASA Astrophysics Data System (ADS)

    Zulkifli, Aisya; Ahmad, Asmat

    2015-09-01

    Water samples were collected in triplicates from three different locations choosen from the recreational beach of Teluk Kemang, Port Dickson as sampling station including main area of recreation activity for the public. Bacteria were isolated from the water and cultured. Out of 286 presumptive Staphylococcus aureus enumerated by using culture method, only 4 (1.4 %) confirmed as Meticillin Resistant S. aureus (MRSA) based on PCR detection of mecA gene. Interestingly, all of MRSA detections were found at the main area of recreational activity. Our results suggested that public beaches may be reservoir for transmission of MRSA to beach visitors and PCR using the mecA gene is the fastest way to detect this pathogenic bacteria.

  11. From bone to heart: a case of MRSA osteomyelitis with haematogenous spread to the pericardium.

    PubMed

    Dherange, Parinita A; Patel, Sarah; Enakpene, Evbu; Suryanarayana, Prakash

    2015-01-01

    We report a case of a 55-year-old woman with a history of type 2 diabetes mellitus, Charcot arthropathy and end-stage renal disease, who presented with a syncopal episode after undergoing haemodialysis. She had a history of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia from an unknown source 3?months earlier, which was treated with an 8-week course of intravenous antibiotics. At the time of presentation to the emergency room, she was found to be in refractory shock. Bedside echocardiogram was performed, which showed moderate pericardial effusion. The effusion was later found to be due to MRSA, which was identified in blood and in pericardial fluid cultures. The patient was successfully treated with intravenous daptomycin for 6?weeks. Acute osteomyelitis of her right foot was the source of the MRSA, for which a right below-knee amputation was ultimately performed. PMID:26643184

  12. Improved exposure characterization with robotic (PIPER) sampling and association with children's respiratory symptoms, asthma and eczema.

    PubMed

    Ramagopal, Maya; Wang, Zuocheng; Black, Kathleen; Hernandez, Marta; Stambler, Adam A; Emoekpere, Osiloke H; Mainelis, Gediminas; Shalat, Stuart L

    2014-07-01

    Particulate matter (PM) and its constituents are recognized risk factors for the development of respiratory symptoms and illness in children. Most measurements of exposure have relied upon stationary indoor monitors (SIMs), overlooking the role of resuspended PM. To improve exposure characterization to resuspended aerosol PM, a recently developed methodology has been employed. The goal of this study was to characterize the resuspendable fraction of house dust and early childhood exposures to PM and its constituents in the child's home and compare conventional SIM and the Pre-toddler Inhalable Particulate Environmental Robotic (PIPER), an innovative mobile sampler. The study seeks to demonstrate that PIPER provides a more relevant estimate of exposure from inhalable particulate matter through improved correlation with respiratory symptoms in young children. Seventy-five households with children between 3 and 59 months of age were recruited from clinics in central New Jersey. Demographic information, and responses to a health questionnaire based upon that used by the International Study of Allergies and Asthma in Childhood (ISAAC), and household data were collected. Household exposures to inhalable PM (PM100) and endotoxin were determined with simultaneous SIM and mobile (PIPER) sampling. Univariate and multivariate analyses were carried out. History of wheeze ("recent" (<1 year) and "ever"), cough, asthma and eczema was evaluated. Multivariate analysis models included PM100 and endotoxin levels by tertiles of exposure. Risk of asthma for the highest tertile of PM100, as measured by PIPER (odds ratio=4.2; 95% confidence interval 0.7-24.0), was compared with measurements by SIM (odds ratio=0.7; 95% confidence interval 0.2-2.6). Measurements of PM and its constituents with PIPER are more strongly associated with asthma, eczema and wheeze compared with measurements using SIMs. Application of this methodology may provide useful insights into early childhood exposures related to the etiology of childhood illnesses associated with inhalation exposures. PMID:24802555

  13. Global Expression Profiling in Atopic Eczema Reveals Reciprocal Expression of Inflammatory and Lipid Genes

    PubMed Central

    Sääf, Annika M.; Tengvall-Linder, Maria; Chang, Howard Y.; Adler, Adam S.; Wahlgren, Carl-Fredrik; Scheynius, Annika; Nordenskjöld, Magnus; Bradley, Maria

    2008-01-01

    Background Atopic eczema (AE) is a common chronic inflammatory skin disorder. In order to dissect the genetic background several linkage and genetic association studies have been performed. Yet very little is known about specific genes involved in this complex skin disease, and the underlying molecular mechanisms are not fully understood. Methodology/Findings We used human DNA microarrays to identify a molecular picture of the programmed responses of the human genome to AE. The transcriptional program was analyzed in skin biopsy samples from lesional and patch-tested skin from AE patients sensitized to Malassezia sympodialis (M. sympodialis), and corresponding biopsies from healthy individuals. The most notable feature of the global gene-expression pattern observed in AE skin was a reciprocal expression of induced inflammatory genes and repressed lipid metabolism genes. The overall transcriptional response in M. sympodialis patch-tested AE skin was similar to the gene-expression signature identified in lesional AE skin. In the constellation of genes differentially expressed in AE skin compared to healthy control skin, we have identified several potential susceptibility genes that may play a critical role in the pathological condition of AE. Many of these genes, including genes with a role in immune responses, lipid homeostasis, and epidermal differentiation, are localized on chromosomal regions previously linked to AE. Conclusions/Significance Through genome-wide expression profiling, we were able to discover a distinct reciprocal expression pattern of induced inflammatory genes and repressed lipid metabolism genes in skin from AE patients. We found a significant enrichment of differentially expressed genes in AE with cytobands associated to the disease, and furthermore new chromosomal regions were found that could potentially guide future region-specific linkage mapping in AE. The full data set is available at http://microarray-pubs.stanford.edu/eczema. PMID:19107207

  14. Genomic Insights into the Atopic Eczema-Associated Skin Commensal Yeast Malassezia sympodialis

    PubMed Central

    Gioti, Anastasia; Nystedt, Björn; Li, Wenjun; Xu, Jun; Andersson, Anna; Averette, Anna F.; Münch, Karin; Wang, Xuying; Kappauf, Catharine; Kingsbury, Joanne M.; Kraak, Bart; Walker, Louise A.; Johansson, Henrik J.; Holm, Tina; Lehtiö, Janne; Stajich, Jason E.; Mieczkowski, Piotr; Kahmann, Regine; Kennell, John C.; Cardenas, Maria E.; Lundeberg, Joakim; Saunders, Charles W.; Boekhout, Teun; Dawson, Thomas L.; Munro, Carol A.; de Groot, Piet W. J.; Butler, Geraldine; Heitman, Joseph; Scheynius, Annika

    2013-01-01

    ABSTRACT Malassezia commensal yeasts are associated with a number of skin disorders, such as atopic eczema/dermatitis and dandruff, and they also can cause systemic infections. Here we describe the 7.67-Mbp genome of Malassezia sympodialis, a species associated with atopic eczema, and contrast its genome repertoire with that of Malassezia globosa, associated with dandruff, as well as those of other closely related fungi. Ninety percent of the predicted M. sympodialis protein coding genes were experimentally verified by mass spectrometry at the protein level. We identified a relatively limited number of genes related to lipid biosynthesis, and both species lack the fatty acid synthase gene, in line with the known requirement of these yeasts to assimilate lipids from the host. Malassezia species do not appear to have many cell wall-localized glycosylphosphatidylinositol (GPI) proteins and lack other cell wall proteins previously identified in other fungi. This is surprising given that in other fungi these proteins have been shown to mediate interactions (e.g., adhesion and biofilm formation) with the host. The genome revealed a complex evolutionary history for an allergen of unknown function, Mala s 7, shown to be encoded by a member of an amplified gene family of secreted proteins. Based on genetic and biochemical studies with the basidiomycete human fungal pathogen Cryptococcus neoformans, we characterized the allergen Mala s 6 as the cytoplasmic cyclophilin A. We further present evidence that M. sympodialis may have the capacity to undergo sexual reproduction and present a model for a pseudobipolar mating system that allows limited recombination between two linked MAT loci. PMID:23341551

  15. Pediatricians' perspectives on the impact of MRSA in primary care: a qualitative study

    PubMed Central

    Hersh, Adam L; Cabana, Michael D; Gonzales, Ralph; Shenkin, Budd N; Cho, Christine S

    2009-01-01

    Background The incidence of skin and soft-tissue infections (SSTIs) has rapidly increased among children in primary care settings since the emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Recent treatment recommendations emphasize CA-MRSA as the primary cause, performing incision and drainage (I&D) as the primary therapy, and not prescribing antibiotics for uncomplicated cases. It is unknown how this epidemic has impacted primary care pediatricians in terms of their practice patterns and barriers they face to providing recommended therapies. Methods 3 Focus groups among 29 primary care pediatricians in the San Francisco Bay Area were conducted. Transcripts were reviewed and coded into major themes by two investigators using modified grounded theory. Results Substantial changes in clinical practice have occurred since the emergence of CA-MRSA. These include increased office visits for SSTIs, patients with multiple recurrences and transmission within households. Additionally, our participants reported increased visits for mild skin problems due to media reports contributing to fears about CA-MRSA. Participants routinely prescribed antibiotics for SSTIs, however, few performed I&D. Few were aware of recent SSTI treatment recommendations. Barriers to prescribing antibiotics with CA-MRSA activity included concerns about side-effects and lack of local epidemiologic data showing that it is the primary etiology. Barriers to performing I&D included lack of training, resources and skepticism about its necessity. Important clinical challenges included increased time demands for follow-up visits and patient education along with the lack of evidence-based strategies for preventing recurrent inections and household transmission. Conclusion CA-MRSA has influenced the presentation and treatment of SSTIs especially in terms of case numbers and recurrences. Barriers to providing recommended therapies can be addressed through improved dissemination of treatment guidelines and epidemiologic data. Studies are urgently needed toimprove theevidence-base for treatment and prevention strategies. PMID:19366461

  16. Diversity of Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Isolated from Inpatients of 30 Hospitals in Orange County, California

    PubMed Central

    Hudson, Lyndsey O.; Murphy, Courtney R.; Spratt, Brian G.; Enright, Mark C.; Elkins, Kristen; Nguyen, Christopher; Terpstra, Leah; Gombosev, Adrijana; Kim, Diane; Hannah, Paul; Mikhail, Lydia; Alexander, Richard; Moore, Douglas F.; Huang, Susan S.

    2013-01-01

    There is a need for a regional assessment of the frequency and diversity of MRSA to determine major circulating clones and the extent to which community and healthcare MRSA reservoirs have mixed. We conducted a prospective cohort study of inpatients in Orange County, California, systematically collecting clinical MRSA isolates from 30 hospitals, to assess MRSA diversity and distribution. All isolates were characterized by spa typing, with selective PFGE and MLST to relate spa types with major MRSA clones. We collected 2,246 MRSA isolates from hospital inpatients. This translated to 91/10,000 inpatients with MRSA and an Orange County population estimate of MRSA inpatient clinical cultures of 86/100,000 people. spa type genetic diversity was heterogeneous between hospitals, and relatively high overall (72%). USA300 (t008/ST8), USA100 (t002/ST5) and a previously reported USA100 variant (t242/ST5) were the dominant clones across all Orange County hospitals, representing 83% of isolates. Fifteen hospitals isolated more t008 (USA300) isolates than t002/242 (USA100) isolates, and 12 hospitals isolated more t242 isolates than t002 isolates. The majority of isolates were imported into hospitals. Community-based infection control strategies may still be helpful in stemming the influx of traditionally community-associated strains, particularly USA300, into the healthcare setting. PMID:23637976

  17. Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) isolates of swine origin form robust biofilms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methicillin-resistant Staphylococcus aureus (MRSA) colonization of livestock animals is common and prevalence rates for pigs have been reported to be as high as 49%. One hypothesis to explain the high prevalence of MRSA in swine herds is the ability of these organisms to exist as biofilms. To invest...

  18. Poorly Cross-Linked Peptidoglycan in MRSA Due to mecA Induction Activates the Inflammasome and Exacerbates Immunopathology.

    PubMed

    Müller, Sabrina; Wolf, Andrea J; Iliev, Iliyan D; Berg, Bethany L; Underhill, David M; Liu, George Y

    2015-11-11

    Methicillin-resistant S. aureus (MRSA) is a leading health problem. Compared to methicillin-sensitive S. aureus, MRSA infections are associated with greater morbidity and mortality, but the mechanisms underlying MRSA pathogenicity are unclear. Here we show that the protein conferring ?-lactam antibiotic resistance, penicillin-binding protein 2A (encoded by the mecA gene), directly contributes to pathogenicity during MRSA infection. MecA induction leads to a reduction in peptidoglycan cross-linking that allows for enhanced degradation and detection by phagocytes, resulting in robust IL-1? production. Peptidoglycan isolated from ?-lactam-challenged MRSA strongly induces the NLRP3 inflammasome in macrophages, but these effects are lost upon peptidoglycan solubilization. Mutant MRSA bacteria with naturally occurring reduced peptidoglycan cross-links induce high IL-1? levels in vitro and cause increased pathology in vivo. ?-lactam treatment of MRSA skin infection exacerbates immunopathology, which is IL-1 dependent. Thus, antibiotic-induced expression of mecA during MRSA skin infection contributes to immunopathology by altering peptidoglycan structure. PMID:26567511

  19. Epidemiology of Methicillin-Resistant Staphylococcus aureus Carriage and MRSA Surgical Site Infections in Patients Undergoing Colorectal Surgery: A Cohort Study in Two Centers

    PubMed Central

    Huttner, Benedikt; Robicsek, Ari A.; Gervaz, Pascal; Perencevich, Eli N.; Schiffer, Eduardo; Schrenzel, Jacques

    2012-01-01

    Abstract Background Surgical site infections (SSIs) after colorectal surgery usually are caused by commensal intestinal bacteria. Methicillin-resistant Staphylococcus aureus (MRSA) may be responsible for additional SSI-related morbidity. The aim of this retrospective cohort study was to describe the epidemiology of SSIs caused by MRSA after colorectal surgery in two tertiary-care centers, one in Geneva, Switzerland (G), and the other in Chicago, Illinois (C). Methods Adult patients undergoing colorectal resections during periods of universal screening for MRSA on admission were identified retrospectively. Demographic characteristics, surgery-related factors, and occurrence of MRSA SSI were compared in patients with and without MRSA carriage before surgery. Results There were 1,069 patients (G=194, C=875) with a median age of 67 years fulfilling the inclusion criteria. Of these, 45 patients (4.2%) had a positive MRSA screening result within 30 days before surgery (G=18, C=27; p<0.001). Ten patients (0.9%; G=6, C=4) developed MRSA SSI, detected a median of 17.5 days after surgery, but only two of them were MRSA-positive before surgery. Nine of the 45 MRSA carriers identified by screening received pre-operative prophylaxis with vancomycin (G 6/18, C 3/27), and 17 of these patients (37.8%; G 7/18, C 10/27) were started on MRSA decolonization therapy before surgery. Pre-operative administration of either decolonization or vancomycin was not protective against MRSA SSI (p=0.49). Conclusion Methicillin-resistant S. aureus seems to be an infrequent cause of SSI after colorectal resections, even in MRSA carriers. Systematic universal screening for MRSA carriage prior to colorectal surgery may not be beneficial for the individual patient. Post-operative factors seem to be important in MRSA infections, as the majority of MRSA SSIs occurred in patients negative for MRSA carriage. PMID:23240722

  20. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    PubMed Central

    Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN; Block, J; Borok, N; Burton, T; Chamlin, SL; Deckert, S; DeKlotz, CC; Graff, LB; Hanifin, JM; Hebert, AA; Humphreys, R; Katoh, N; Kisa, RM; Margolis, DJ; Merhand, S; Minnillo, R; Mizutani, H; Nankervis, H; Ohya, Y; Rodgers, P; Schram, ME; Stalder, JF; Svensson, A; Takaoka, R; Teper, A; Tom, WL; von Kobyletzki, L; Weisshaar, E; Zelt, S; Williams, HC

    2014-01-01

    Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure. What's already known about this topic? Many different scales have been used to measure eczema, making it difficult to compare trials in meta-analyses and hampering improvements in clinical practice. HOME core outcome measures must pass the OMERACT (Outcome Measures in Rheumatology) filter of truth (validity), discrimination (sensitivity to change and responsiveness) and feasibility (ease of use, costs, time to perform and interpret). It has been previously agreed as part of the consensus process that four domains should be measured by the core outcomes: clinical signs, patient-reported symptoms, long-term control and health-related quality of life. What does this study add? Progress was made towards developing a core outcome set for measuring eczema in clinical trials. The group established the essential items to be included in the outcome measure for the clinical signs of eczema and was able to recommend a scale for the core set. The remaining three domains of patient-reported symptoms, long-term control and health-related quality of life require further work and meetings to determine the core outcome measures. PMID:24980543

  1. Dissemination of Methicillin-Resistant Staphylococcus aureus (MRSA), USA300 Sequence Type 8 Lineage in Latin-America

    PubMed Central

    Reyes, Jinnethe; Rincón, Sandra; Díaz, Lorena; Panesso, Diana; Contreras, Germán A.; Zurita, Jeannete; Carrillo, Carlos; Rizzi, Adele; Guzmán, Manuel; Adachi, Javier; Chowdhury, Shahreen; Murray, Barbara E.; Arias, Cesar A.

    2009-01-01

    Background Methicillin-resistant Staphylococus aureus (MRSA) is an important nosocomial and community-associated (CA) pathogen. Recently, a variant of the MRSA USA300 clone emerged and disseminated in South-America causing important clinical problems. Methods S. aureus isolates were prospectively collected (2006 to 2008) from 32 tertiary hospitals in Colombia, Ecuador, Peru, and Venezuela. MRSA isolates were subjected to antimicrobial susceptibility testing, pulsed field gel electrophoresis (PFGE), and categorized as healthcare-associated (HA)-like or CA-like clones based on genotypic characteristics and detection of genes encoding the Panton-Valentine leukocidin (PVL) and staphylococcal cassette mec (SCCmec) IV. Additionally, MLST of representative isolates of each major CA-MRSA pulsotype, and detection of USA300-associated toxins and the arcA gene were performed in all isolates categorized as CA-MRSA. Results A total of 1570 S. aureus were included; 651 were MRSA (41%), with the highest rates of MRSA isolation in Peru (62%), and lowest in Venezuela (26%) and 71%, 27%, and 2% were classified as HA-like, CA-like, and non-CA/HA-like clones, respectively. Only 9 MRSA isolates were confirmed to have reduced susceptibility to glycopeptides (GISA phenotype). The most common pulsotype (designated ComA) amongst the CA-like MRSA strains was found in 96% of isolates with the majority (81%) having ?6 bands difference with the USA300-0114 strain. Representative isolates of this clone were ST8 but, unlike the USA300-0114 strain, they harbored a different SCCmec IV subtype and lacked arcA (an indicator of the arginine catabolic mobile element (ACME)). Conclusion A variant CA-MRSA USA300 clone has now become established in South America and, in some countries, is endemic in hospital settings. PMID:19911971

  2. Nocturnal eczema: Review of sleep and circadian rhythms in children with atopic dermatitis and future research directions.

    PubMed

    Fishbein, Anna B; Vitaterna, Olivia; Haugh, Isabel M; Bavishi, Aakash A; Zee, Phyllis C; Turek, Fred W; Sheldon, Stephen H; Silverberg, Jonathan I; Paller, Amy S

    2015-11-01

    Children with atopic dermatitis (AD) experience significant sleep disruption, and clinically, the disease is noted to worsen in a circadian manner at night. Epidemiologic findings highlight many negative consequences of AD, such as impaired linear growth, which is uniquely related to disturbed sleep. Clinical guidelines currently recommend assessing sleep in patients with AD as a crucial parameter of disease control with appropriate treatment. In this review we describe our current understanding of the roles of sleep cycles and circadian rhythms in the nighttime exacerbation of AD (nocturnal eczema). We present a schematic to explain the mechanism of nocturnal eczema. Treatment options for sleep disturbance and future directions for research are discussed in the context of AD. PMID:26549635

  3. Environmental tobacco smoke and the risk of eczema symptoms among school children in South Africa: a cross-sectional study

    PubMed Central

    Shirinde, Joyce; Wichmann, Janine; Voyi, Kuku

    2015-01-01

    Objective The aim of this study was to investigate the association between eczema ever (EE) and current eczema symptoms (ES) in relation to exposure to environmental tobacco smoke (ETS). Design A cross-sectional study using the International Study of Asthma and Allergies in Childhood questionnaire. Setting 16 schools were randomly selected from two neighbourhoods situated in Ekurhuleni Metropolitan Municipality, Gauteng Province, South Africa. Participants From a total population of 3764 school children aged 12–14?years, 3468 completed the questionnaire (92% response rate). A total of 3424 questionnaires were included in the final data analysis. Primary outcome The prevalence of EE and current ES was the primary outcome in this study. Results Data were analysed using Multilevel Logistic Regression Analysis (MLRA). The likelihood of EE was increased by exposure to ETS at home (OR 1.30 95% CI 1.01 to 1.67) and at school (OR 1.26 95% CI 1.00 to 1.60). The likelihood of EE was lower for males (OR 0.66 95% CI 0.51 to 0.84). The likelihood of ES was increased by ETS at home (OR 1.93 95% CI 1.43 to 2.59) and school (1.44 95% CI 1.09 to 1.90). The likelihood of ES was again lower for males (OR 0.56 95% CI 0.42 to 0.76). Smoking by mother/female guardian increased the likelihood of EE and ES, however, this was not significant in the multivariate analysis. Conclusions Symptoms of eczema were positively associated with exposure to ETS at home and school. The results support the hypothesis that ETS is an important factor in understanding the occurrence of eczema. PMID:26310401

  4. "Not Rocket Science" or "No Silver Bullet"? Media and Government Discourses about MRSA and Cleanliness

    ERIC Educational Resources Information Center

    Koteyko, Nelya; Nerlich, Brigitte; Crawford, Paul; Wright, Nick

    2008-01-01

    Methicillin-resistant "Staphylococcus aureus" (MRSA), commonly called a superbug, has recently been a major political issue in the UK, playing a significant role in debates over health policy in the general election held in 2005. While science recognizes the lack of evidence with regards to the effectiveness of existing measures implemented to…

  5. Staphylococcus aureus and MRSA Growth and Biofilm Formation after Treatment with Antibiotics and SeNPs

    PubMed Central

    Cihalova, Kristyna; Chudobova, Dagmar; Michalek, Petr; Moulick, Amitava; Guran, Roman; Kopel, Pavel; Adam, Vojtech; Kizek, Rene

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a dangerous pathogen resistant to ?-lactam antibiotics. Due to its resistance, it is difficult to manage the infections caused by this strain. We examined this issue in terms of observation of the growth properties and ability to form biofilms in sensitive S. aureus and MRSA after the application of antibiotics (ATBs)—ampicillin, oxacillin and penicillin—and complexes of selenium nanoparticles (SeNPs) with these ATBs. The results suggest the strong inhibition effect of SeNPs in complexes with conventional ATBs. Using the impedance method, a higher disruption of biofilms was observed after the application of ATB complexes with SeNPs compared to the group exposed to ATBs without SeNPs. The biofilm formation was intensely inhibited (up to 99% ± 7% for S. aureus and up to 94% ± 4% for MRSA) after application of SeNPs in comparison with bacteria without antibacterial compounds whereas ATBs without SeNPs inhibited S. aureus up to 79% ± 5% and MRSA up to 16% ± 2% only. The obtained results provide a basis for the use of SeNPs as a tool for the treatment of bacterial infections, which can be complicated because of increasing resistance of bacteria to conventional ATB drugs. PMID:26501270

  6. Potential therapeutic failure of generic vancomycin in a liver transplant patient with MRSA peritonitis and bacteremia.

    PubMed

    Rodriguez, Carlos A; Agudelo, Maria; Cataño, Juan C; Zuluaga, Andres F; Vesga, Omar

    2009-10-01

    We report a case of generic vancomycin treatment failure in a liver transplant patient with MRSA peritonitis and bacteremia, followed by a rapid sterilization of blood and peritoneal fluid after switching to the branded product. It raises concern about therapeutic equivalence of generic vancomycin. PMID:19698745

  7. hVISA and MRSA endocarditis: an 8-year experience in a tertiary care centre.

    PubMed

    Maor, Y; Belausov, N; Ben-David, D; Smollan, G; Keller, N; Rahav, G

    2014-10-01

    It is not clear if patients with heterogeneous intermediate resistance to vancomycin (hVISA) infectious endocarditis (IE) differ from methicillin-resistant S. aureus (MRSA) IE patients. All cases of hVISA and MRSA IE diagnosed at the Sheba Medical Centre from 2003 to 2010 were included. Isolates were screened prospectively for hVISA. Medical records were reviewed. The t-test, chi-square test, Fisher exact test and Kaplan Meier analysis were used. Fourteen hVISA IE and 32 MRSA IE were identified. The mean age was 76 years, mean Charlson score was 4.5 and 24% of patients had prosthetic valves. Pacemakers and implantable cardioverter-defibrillators (P/ICDs) were more common in the hVISA group (50% vs. 22%, p 0.05). P/ICDs IE occurred in 29% of hVISA patients vs. 6.3% of MRSA patients (p 0.06). hVISA patients had more positive blood cultures (eight vs. five, p 0.007) and a trend toward longer bacteraemia (15 vs. 7.5 days, p 0.08). Vancomycin minimal inhibitory concentrations (MICs) were similar in the two groups (1.5 ?g/mL vs. 1.1 ?g/mL, p 0.11). The MIC to daptomycin was higher in hVISA (0.75 ?g/mL vs. 0.32 ?g/mL, p 0.049). MRSA patients received vancomycin. hVISA patients were switched to other antibiotics. Cardiac surgery and/or P/ICD extraction was performed more commonly in hVISA patients (50% vs. 16%, p 0.027). Mortality was high in both groups (57-66%). The median time to death was 39 days in the hVISA group and 19 days in the MRSA group (p 0.3). hVISA IE is associated with P/ICDs. Both hVISA and MRSA are associated with high mortality. Low rates of surgical intervention and P/ICD extraction reflect the high co-morbidity of patients. Caution should be employed in the empirical use of daptomycin in hVISA patients. PMID:24329974

  8. Evaluating Written Patient Information for Eczema in German: Comparing the Reliability of Two Instruments, DISCERN and EQIP

    PubMed Central

    McCool, Megan E.; Wahl, Josepha; Schlecht, Inga; Apfelbacher, Christian

    2015-01-01

    Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters’ scores for each instrument was measured with Pearson’s correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters’ scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema. PMID:26440612

  9. Molecular epidemiology of environmental MRSA at an equine teaching hospital: introduction, circulation and maintenance

    PubMed Central

    2014-01-01

    The role that environmental contamination might play as a reservoir and a possible source of Methicillin-resistant Staphylococcus aureus (MRSA) for patients and personnel at equine veterinary hospitals remains undefined, as the environment has only been monitored during outbreaks or for short periods. Therefore, the objectives of this study were to determine the monthly presence, distribution, and characteristics of environmental MRSA at an equine hospital, and to establish patterns of contamination over time using molecular epidemiological analyses. For this purpose, a yearlong active MRSA surveillance was performed targeting the environment and incoming patients. Antimicrobial susceptibility testing, SCCmec typing, PFGE typing, and dendrographic analysis were used to characterize and analyze these isolates. Overall, 8.6% of the surfaces and 5.8% of the horses sampled were positive for MRSA. The most common contaminated surfaces were: computers, feed-water buckets, and surgery tables-mats. Ninety percent of the isolates carried SCCmec type IV, and 62.0% were classified as USA500. Molecular analysis showed that new pulsotypes were constantly introduced into the hospital throughout the year. However, maintenance of strains in the environment was also observed when unique clones were detected for 2 consecutive months on the same surfaces. Additionally, pulsotypes were circulating throughout several areas and different contact surfaces of the hospital. Based on these results, it is evident that MRSA is constantly introduced and frequently found in the equine hospital environment, and that some contact surfaces could act as “hot-spots”. These contaminated surfaces should be actively targeted for strict cleaning and disinfection as well as regular monitoring. PMID:24641543

  10. Rifampicin resistance among multi-resistant MRSA clinical isolates from Chennai, India, and their molecular characterization.

    PubMed

    Murugan, K; Kavitha, K; Al-Sohaibani, S

    2015-01-01

    High-level methicillin-resistant Staphylococcus aureus (MRSA) isolates show rapid evolution of rifampicin resistance, forcing reliance upon expensive and often inferior antibiotics to manage these infections. Accordingly, this study was conducted to: 1) evaluate the level of multidrug resistance among hospital-associated MRSA isolates from Chennai, India; 2) determine their rifampicin resistance and molecular characterization; and 3) analyze the identified rpoB gene mutations for predominant high-level rifampicin resistance-associated nucleotide changes. Conventional laboratory techniques and antibiogram evaluation by disc diffusion were utilized for isolate phenotypic identification. Among the 54 isolates obtained, 74% (42) were found to be MRSA. All the isolates exhibited complete susceptibility to linezolid and vancomycin, and variable resistance to conventional antibiotics; the MAR index value calculated was 0.64. Genotypic identification of the high-level rifampicin-resistant isolate S. aureus KM05 was established through rpoB amplification and sequencing. The evolutionary relationship of KM05 to other isolates and its rpoB gene mutation status was determined to understand the genetic basis of its high rifampicin resistance. The S. aureus KM05 rpoB gene yielded ? 98% sequence similarity and a close phylogenetic relationship with other known reference database organisms. It also showed mutational changes in three rpoB codon positions encoding amino acids at positions 455, 481, and 529. These results have established the prevalence of rifampicin resistance among Chennai hospital MRSA isolates, and suggest that the predominant high-level resistance nucleotide changes would serve to form a basis for their diagnosis and control of rifampicin-resistant MRSA. PMID:25867420

  11. Comparative Characterisation of Genotypically Different Clones of MRSA in the Production of Biofilms

    PubMed Central

    Atshan, Salman Sahab; Shamsudin, Mariana Nor; Thian Lung, Leslie Than; Sekawi, Zamberi; Ghaznavi-Rad, Ehsanollah; Pei Pei, Chong

    2012-01-01

    The ability to adhere and produce biofilms is characteristic of enhanced virulence among isolates of methicillin-resistant Staphylococcus aureus (MRSA). The aim of the study is to find out whether these characteristics are consistently similar among isolates variations of MRSA. The study used 30 various isolates of MRSA belong to 13 spa types and 5 MLST types and determined the aggregation, the adherence, and the production of biofilms and slime for each isolate. The methods used to evaluate these characteristics were a modified Congo red agar assay (MCRA), a microtiter plate assay (MPA), high-magnification light microscopy, scanning electron microscopy (SEM), and PCR. The study found that isolates belonging to similar Spa, SCCmec, and ST types have similar abilities to produce biofilms; however, their ability to produce slime on CRA was found to be different. Moreover, isolates that have different Spa types showed high variation in their ability to produce biofilms. The results of light microscope revealed the isolates that produced strong and weak biofilms and formed similar aggregation on the glass surfaces. SEM results showed that all 30 MRSA isolates that were tested were 100% positive for biofilm formation, although to varying degrees. Further testing using PCR confirmed that 100% of the 30 isolates tested were positive for the presence of the icaADBC, fnbA, eno, ebps, clfA, and clfB genes. The prevalence of fib, cna, fnbB, and bbp in MRSA clones was 90, 93.33, 53.33, and 10%, respectively. This study indicate that differences in biofilm production capacities are caused by the differences in surface protein A (Spa) type and are not due to differences in MLST and SCCmec types. PMID:22529705

  12. Healthcare- and Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Fatal Pneumonia with Pediatric Deaths in Krasnoyarsk, Siberian Russia: Unique MRSA's Multiple Virulence Factors, Genome, and Stepwise Evolution

    PubMed Central

    Khokhlova, Olga E.; Hung, Wei-Chun; Wan, Tsai-Wen; Iwao, Yasuhisa; Takano, Tomomi; Higuchi, Wataru; Yachenko, Svetlana V.; Teplyakova, Olga V.; Kamshilova, Vera V.; Kotlovsky, Yuri V.; Nishiyama, Akihito; Reva, Ivan V.; Sidorenko, Sergey V.; Peryanova, Olga V.; Reva, Galina V.; Teng, Lee-Jene; Salmina, Alla B.; Yamamoto, Tatsuo

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a common multidrug-resistant (MDR) pathogen. We herein discussed MRSA and its infections in Krasnoyarsk, Siberian Russia between 2007 and 2011. The incidence of MRSA in 3,662 subjects was 22.0% and 2.9% for healthcare- and community-associated MRSA (HA- and CA-MRSA), respectively. The 15-day mortality rates for MRSA hospital- and community-acquired pneumonia (HAP and CAP) were 6.5% and 50%, respectively. MRSA CAP cases included pediatric deaths; of the MRSA pneumonia episodes available, ?27.3% were associated with bacteremia. Most cases of HA-MRSA examined exhibited ST239/spa3(t037)/SCCmecIII.1.1.2 (designated as ST239Kras), while all CA-MRSA cases examined were ST8/spa1(t008)/SCCmecIV.3.1.1(IVc) (designated as ST8Kras). ST239Kras and ST8Kras strongly expressed cytolytic peptide (phenol-soluble modulin ?, PSM?; and ?-hemolysin, Hld) genes, similar to CA-MRSA. ST239Kras pneumonia may have been attributed to a unique set of multiple virulence factors (MVFs): toxic shock syndrome toxin-1 (TSST-1), elevated PSM?/Hld expression, ?-hemolysin, the staphylococcal enterotoxin SEK/SEQ, the immune evasion factor SCIN/SAK, and collagen adhesin. Regarding ST8Kras, SEA was included in MVFs, some of which were common to ST239Kras. The ST239Kras (strain OC3) genome contained: a completely unique phage, ?Sa7-like (W), with no att repetition; S. aureus pathogenicity island SaPI2R, the first TSST-1 gene-positive (tst+) SaPI in the ST239 lineage; and a super copy of IS256 (?22 copies/genome). ST239Kras carried the Brazilian SCCmecIII.1.1.2 and United Kingdom-type tst. ST239Kras and ST8Kras were MDR, with the same levofloxacin resistance mutations; small, but transmissible chloramphenicol resistance plasmids spread widely enough to not be ignored. These results suggest that novel MDR and MVF+ HA- and CA-MRSA (ST239Kras and ST8Kras) emerged in Siberian Russia (Krasnoyarsk) associated with fatal pneumonia, and also with ST239Kras, a new (Siberian Russian) clade of the ST239 lineage, which was created through stepwise evolution during its potential transmission route of Brazil-Europe-Russia/Krasnoyarsk, thereby selective advantages from unique MVFs and the MDR. PMID:26047024

  13. Healthcare- and Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Fatal Pneumonia with Pediatric Deaths in Krasnoyarsk, Siberian Russia: Unique MRSA's Multiple Virulence Factors, Genome, and Stepwise Evolution.

    PubMed

    Khokhlova, Olga E; Hung, Wei-Chun; Wan, Tsai-Wen; Iwao, Yasuhisa; Takano, Tomomi; Higuchi, Wataru; Yachenko, Svetlana V; Teplyakova, Olga V; Kamshilova, Vera V; Kotlovsky, Yuri V; Nishiyama, Akihito; Reva, Ivan V; Sidorenko, Sergey V; Peryanova, Olga V; Reva, Galina V; Teng, Lee-Jene; Salmina, Alla B; Yamamoto, Tatsuo

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a common multidrug-resistant (MDR) pathogen. We herein discussed MRSA and its infections in Krasnoyarsk, Siberian Russia between 2007 and 2011. The incidence of MRSA in 3,662 subjects was 22.0% and 2.9% for healthcare- and community-associated MRSA (HA- and CA-MRSA), respectively. The 15-day mortality rates for MRSA hospital- and community-acquired pneumonia (HAP and CAP) were 6.5% and 50%, respectively. MRSA CAP cases included pediatric deaths; of the MRSA pneumonia episodes available, ?27.3% were associated with bacteremia. Most cases of HA-MRSA examined exhibited ST239/spa3(t037)/SCCmecIII.1.1.2 (designated as ST239Kras), while all CA-MRSA cases examined were ST8/spa1(t008)/SCCmecIV.3.1.1(IVc) (designated as ST8Kras). ST239Kras and ST8Kras strongly expressed cytolytic peptide (phenol-soluble modulin ?, PSM?; and ?-hemolysin, Hld) genes, similar to CA-MRSA. ST239Kras pneumonia may have been attributed to a unique set of multiple virulence factors (MVFs): toxic shock syndrome toxin-1 (TSST-1), elevated PSM?/Hld expression, ?-hemolysin, the staphylococcal enterotoxin SEK/SEQ, the immune evasion factor SCIN/SAK, and collagen adhesin. Regarding ST8Kras, SEA was included in MVFs, some of which were common to ST239Kras. The ST239Kras (strain OC3) genome contained: a completely unique phage, ?Sa7-like (W), with no att repetition; S. aureus pathogenicity island SaPI2R, the first TSST-1 gene-positive (tst+) SaPI in the ST239 lineage; and a super copy of IS256 (?22 copies/genome). ST239Kras carried the Brazilian SCCmecIII.1.1.2 and United Kingdom-type tst. ST239Kras and ST8Kras were MDR, with the same levofloxacin resistance mutations; small, but transmissible chloramphenicol resistance plasmids spread widely enough to not be ignored. These results suggest that novel MDR and MVF+ HA- and CA-MRSA (ST239Kras and ST8Kras) emerged in Siberian Russia (Krasnoyarsk) associated with fatal pneumonia, and also with ST239Kras, a new (Siberian Russian) clade of the ST239 lineage, which was created through stepwise evolution during its potential transmission route of Brazil-Europe-Russia/Krasnoyarsk, thereby selective advantages from unique MVFs and the MDR. PMID:26047024

  14. Reduction in the incidence of MRSA with use of alcohol-based hand rub solutions and gloves.

    PubMed

    Matsumoto, Kazuaki; Shigemi, Akari; Yaji, Keiko; Shimodozono, Yoshihiro; Takeda, Yasuo; Ikawa, Kazuro; Morikawa, Norifumi; Miyanohara, Hiroaki; Kawamura, Hideki; Orita, Michiyo; Tokuda, Koichi; Nishi, Junichiro; Yamada, Katsushi

    2012-04-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is highly contagious. It is spread by direct contact with MRSA-infected people or objects. Healthcare workers' hands are the most common vehicle for the transmission of healthcare-associated pathogens from patient to patient and within the healthcare environment. The present study aimed to investigate the correlation between the incidence of MRSA among Staphylococcus aureus recovered from clinical culture and the use of alcohol-based hand rub solutions or gloves and antimicrobial use density (AUD). All data were examined every 6 months between January 2005 and June 2008. The increasing use of alcohol-based hand rub solutions was correlated with a decreasing incidence of recovery of MRSA from clinical cultures (r(2) = 0.58). A statistically significant (P < 0.05) correlation (r(2) = 0.68) was observed between glove use and the incidence of MRSA. On the other hand, we did not find any correlation between the AUD of each antibiotic group and the incidence of MRSA. Thus, we suggest that it is important to use not only alcohol-based hand rubs, but also gloves, because MRSA is transmitted from patient to patient by the hands of healthcare workers. PMID:21894454

  15. Livestock-Associated MRSA in Household Members of Pig Farmers: Transmission and Dynamics of Carriage, A Prospective Cohort Study

    PubMed Central

    van Cleef, Brigitte A. G. L.; van Benthem, Birgit H. B.; Verkade, Erwin J. M.; van Rijen, Miranda M. L.; Kluytmans-van den Bergh, Marjolein F. Q.; Graveland, Haitske; Bosch, Thijs; Verstappen, Koen M. H. W.; Wagenaar, Jaap A.; Bos, Marian E. H.; Heederik, Dick; Kluytmans, Jan A. J. W.

    2015-01-01

    This prospective cohort study describes carriage of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in household members from 49 farrowing pig farms in the Netherlands (2010–2011). Of 171 household members, 4% were persistent MRSA nasal carriers, and the MRSA prevalence on any given sampling moment was 10% (range 7-11%). Working in the stables (of which 98% was MRSA-positive, prevalence ratio (PR) = 2.11 per 10 hours), working with sows (PR=1.97), and living with an MRSA-positive pig farmer (PR=4.63) were significant determinants for MRSA carriage. Significant protective factors were carriage of methicillin-susceptible Staphylococcus aureus (MSSA) (PR=0.50), and wearing a facemask when working in the stables (37% decreased prevalence). All MRSA strains during the study period were known livestock-associated types. The bacteriophage ?3 was not found in household members. Transmission from pigs and the environment appeared to be important determinants; human-to-human transmission could not sufficiently be differentiated. Wearing a facemask when working in the stables and carriage of MSSA are potential interventional targets. PMID:25993665

  16. ‘You don't know which bits to believe’: qualitative study exploring carers’ experiences of seeking information on the internet about childhood eczema

    PubMed Central

    Santer, Miriam; Muller, Ingrid; Yardley, Lucy; Burgess, Hana; Ersser, Steven J; Lewis-Jones, Sue; Little, Paul

    2015-01-01

    Objective We sought to explore parents and carers’ experiences of searching for information about childhood eczema on the internet. Design A qualitative interview study was carried out among carers of children aged 5?years or less with a recorded diagnosis of eczema. The main focus of the study was to explore carers’ beliefs and understandings around eczema and its treatment. As part of this, we explored experiences of formal and informal information seeking about childhood eczema. Transcripts of interviews were analysed thematically. Setting Participants were recruited from six general practices in South West England. Participants Interviews were carried out with 31 parents from 28 families. Results Experiences of searching for eczema information on the internet varied widely. A few interviewees were able to navigate through the internet and find the specific information they were looking for (for instance about treatments their child had been prescribed), but more found searching for eczema information online to be a bewildering experience. Some could find no information of relevance to them, whereas others found the volume of different information sources overwhelming. Some said that they were unsure how to evaluate online information or that they were wary of commercial interests behind some information sources. Interviewees said that they would welcome more signposting towards high quality information from their healthcare providers. Conclusions We found very mixed experiences of seeking eczema information on the internet; but many participants in this study found this to be frustrating and confusing. Healthcare professionals and healthcare systems have a role to play in helping people with long-term health conditions and their carers find reliable online information to support them with self-care. PMID:25854963

  17. Inactivating Methicillin Resistant Staphylococcus aureus (MRSA) and Other Pathogens by Bacteriocins OR-7 and E 50-52.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Worldwide, reports document the increasing frequency of methicillin resistant Staphylococcus aureus (MRSA) infections. Other human pathogens are recognized as unresponsive to antibiotics of last resort. These previously treatable infections now account for increased numbers of human disease and de...

  18. Inactivating Methicillin Resistant Staphylococcus aureus (MRSA) and other Pathogens by Bacteriocins OR-7 and E 50-52.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Worldwide, reports document the increasing frequency of methicillin resistant Staphylococcus aureus (MRSA) infections. Other human pathogens are recognized as unresponsive to antibiotics of last resort. These previously treatable infections now account for increased numbers of human disease and de...

  19. [Identification of a novel lytic bacteriophage obtained from clinical MRSA isolates and evaluation of its antibacterial activity].

    PubMed

    Sahin, Fikret; Karasartova, Djursun; Ozsan, T Murat; Gerçeker, Devran; K?yan, Mehmet

    2013-01-01

    Multidrug-resistant bacteria particularly MRSA is well known as a worldwide problem. Since the rate of development of novel antimicrobial agents has been slowed down during the last years, there have been a need for the exploration of alternative solutions for the treatment of resistant bacterial infections. Treatment of infections by bacteriophages (phages) that specifically kill the infecting pathogen, i.e. by the process known as phage therapy, is considered as a possible approach to treat multidrug resistant bacteria. Phage treatment has also been considered to treat Staphylococcus aureus infections. This study was aimed to evaluate the antibacterial and cytotoxic activities of a new lytic phage obtained from clinical MRSA strains. This lytic phage named as f LizAnk was obtained during the phage infectivity studies performed with 13 lysogenic phages against MRSA strains. The antibacterial activity of the f LizAnk phage was determined in vitro in BHI (Brain Heart Infusion) and LB (Leuria Bertani) broths and the in vivo antibacterial activity against MRSA strains and possible cytotoxic effect against mammalian cells were tested on fibroblastic cell cultures (3T3). This study was conducted using 20 MRSA strains isolated from hospitalized patients. Identification of the isolates was performed by conventional methods and methicillin resistance was detected with oxacillin disk diffusion test and mecA gene detection by PCR. The method described by Kaneko et al. [Biosci Biotechnol Biochem 1997; 61(11): 1960-2] was used with some modifications, for induction and isolation of the phages. In vitro studies indicated that this phage killed the six different MRSA strains (in 107 cfu/ml concentrations) in 8 hours, and this powerful lytic effect was similar in both of the liquid media. In vivo studies were performed by using cell cultures prepared in microplates, and the wells have been inoculated with only phage, phage + MRSA mixture, and only MRSA. The cells were then evaluated microscopically as well as by MTT assay which detected alive cells colorimetrically, at 2nd and 24th hours. In our study, the f LizAnk phage did not cause any toxic effect on fibroblast cell cultures, in addition it was observed that the antibacterial effect of the phage against MRSA has proceeded in the cell culture. In conclusion, since the fLizAnk phage described in this study exhibited strong antibacterial activity against MRSA strains and no cytotoxic effect was detected against mammalian cells, it might be safely used alone or in a phage cocktail to treat skin infection caused by MRSA. PMID:23390900

  20. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review

    PubMed Central

    2014-01-01

    Abstarct Background A recent review estimated prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare workers (HCWs) to be 4.6%. However, MRSA carriage in HCWs in non-outbreak settings is thought to be higher than in an outbreak situation, due to increased hygiene awareness in outbreaks, but valid data are missing. The goals of this paper are to summarise the prevalence of MRSA carriage amongst HCWs in non-outbreak situations and to identify occupational groups in healthcare services associated with a higher risk of MRSA colonisation. Methods A systematic search for literature was conducted in the MEDLINE and EMBASE databases. The methodological quality of the studies was assessed using seven criteria. Pooled prevalence rates were calculated. Pooled effect estimates were identified in a meta-analysis. Results 31 studies were included in this review. The pooled MRSA colonisation rate was 1.8% (95% confidence interval [CI], 1.34%-2.50%). The rate increased to 4.4% (95% CI, 3.98%-4.88%) when one study from the Netherlands was excluded. The pooled MRSA rate was highest in nursing staff (6.9%). Nursing staff had an odds ratio of 1.72 (95% CI, 1.07-2.77) when compared with medical staff and an odds ratio of 2.58 (95%, 1.83-3.66) when compared with other healthcare staff. Seven studies were assessed as being of high quality. The pooled MRSA prevalence in high quality studies was 1.1% or 5.4% if the one large study from the Netherlands is not considered. The pooled prevalence in studies of moderate quality was 4.0%. Conclusions MRSA prevalence among HCWs in non-outbreak settings was no higher than carriage rates estimated for outbreaks. Our estimate is in the lower half of the range of the published MRSA rates in the endemic setting. Our findings demonstrate that nursing staff have an increased risk for MRSA colonisation. In order to confirm this finding, more studies are needed, including healthcare professionals with varying degrees of exposure to MRSA. In order to reduce misclassification bias, standardisation of HCWs screening is warranted. PMID:24996225

  1. First report of mecC MRSA in human samples from Austria: molecular characteristics and clinical data

    PubMed Central

    Kerschner, H.; Harrison, E.M.; Hartl, R.; Holmes, M.A.; Apfalter, P.

    2014-01-01

    Reports of mecC methicillin-resistant Staphylococcus aureus (MRSA) strains have been published from several European countries. We describe the first six mecC MRSA isolates of human origin from Austria and report the application of a rapid PCR test. Candidate isolates (n = 295) received between 2009 and 2013 were investigated phenotypically by cefoxitin screening and streaking on ChromID MRSA plates. The presence of mecC was confirmed in six isolates from blood cultures, wound swabs and screening samples of four female and two male patients (age range 7–89 years) by an in-house PCR method and the new Genspeed MRSA test (Greiner Bio-One, Kremsmünster, Austria). The mecC MRSA were further characterized by whole genome sequencing, multilocus sequence and spa typing. Antimicrobial susceptibility testing was performed by Eucast disk-diffusion method and Vitek 2. The six mecC MRSA isolates were from two clonal lineages (CC130, including a new single-locus variant, and CC599) and four different spa types (t843, t1535, t3256, t5930). Analysis for virulence factor genes yielded lukED, eta, etd2 and edin-B (CC130 isolates) and tst, lukED, eta and sel (ST599 isolates). The Genspeed MRSA test identified mecC in all isolates whereas Vitek 2 failed to detect methicillin resistance in one isolate. The strains were susceptible to a wide range of non-?-lactam antibiotics. All patients were successfully treated or decolonized. mecC MRSA are present in Austria as colonizers but may also cause infections. Thus, laboratories must choose appropriate test methods such as cefoxitin screening and confirmation using molecular assays specifically targeting mecC. PMID:25755883

  2. Transmission and Microevolution of USA300 MRSA in U.S. Households: Evidence from Whole-Genome Sequencing

    PubMed Central

    Alam, Md Tauqeer; Petit, Robert A.; Boyle-Vavra, Susan; Miller, Loren G.; Eells, Samantha J.; Daum, Robert S.

    2015-01-01

    ABSTRACT Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a successful S. aureus clone in the United States and a common cause of skin and soft tissue infections (SSTIs). We performed whole-genome sequencing (WGS) of 146 USA300 MRSA isolates from SSTIs and colonization cultures obtained from an investigation conducted from 2008 to 2010 in Chicago and Los Angeles households that included an index case with an S. aureus SSTI. Identifying unique single nucleotide polymorphisms (SNPs) and analyzing whole-genome phylogeny, we characterized isolates to understand transmission dynamics, genetic relatedness, and microevolution of USA300 MRSA within the households. We also compared the 146 USA300 MRSA isolates from our study with the previously published genome sequences of the USA300 MRSA isolates from San Diego (n = 35) and New York City (n = 277). We found little genetic variation within the USA300 MRSA household isolates from Los Angeles (mean number of SNPs ± standard deviation, 17.6 ± 35; ? nucleotide diversity, 3.1 × 10?5) or from Chicago (mean number of SNPs ± standard deviation, 12 ± 19; ? nucleotide diversity, 3.1 × 10?5). The isolates within a household clustered into closely related monophyletic groups, suggesting the introduction into and transmission within each household of a single common USA300 ancestral strain. From a Bayesian evolutionary reconstruction, we inferred that USA300 persisted within households for 2.33 to 8.35 years prior to sampling. We also noted that fluoroquinolone-resistant USA300 clones emerged around 1995 and were more widespread in Los Angeles and New York City than in Chicago. Our findings strongly suggest that unique USA300 MRSA isolates are transmitted within households that contain an individual with an SSTI. Decolonization of household members may be a critical component of prevention programs to control USA300 MRSA spread in the United States. PMID:25759497

  3. Capturing the cloud of MRSA diversity after transmission and during infection reveals complex and heterogenous carriage and transmission

    E-print Network

    Paterson, Gavin K.; Harrison, Ewan M.; Murray, Gemma G. R.; Welch, John J.; Warland, James H.; Holden, Matthew T. G.; Morgan, Fiona J. E.; Ba, Xiaoliang; Koop, Gerrit; Harris, Simon R.; Maskell, Duncan J.; Peacock, Sharon J.; Herrtage, Michael E.; Parkhill, Julian; Holmes, Mark A.

    2015-01-01

    =UTF-8 ARTICLE Received 4 Sep 2014 | Accepted 6 Feb 2015 | Published 27 Mar 2015 Capturing the cloud of diversity reveals complexity and heterogeneity of MRSA carriage, infection and transmission Gavin K. Paterson1,*,w, Ewan M. Harrison1,*, Gemma G... colonized individuals and during transmission, we undertook deep sequencing of a methicillin-resistant S. aureus (MRSA) ‘outbreak’ at a veterinary hospital involving both staff and animal patients. We show that there is considerable within-host diversity...

  4. Evaluation of the Combined Effects of Stilbenoid from Shorea gibbosa and Vancomycin against Methicillin-Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Basri, Dayang Fredalina; Luoi, Chan Kin; Azmi, Abdul Muin; Latip, Jalifah

    2012-01-01

    The aim of this study is to determine the combined effects of stilbenoids from Shorea gibbosa and vancomycin against methicillin-resistant Staphylococcus aureus (MRSA). A total of nine pure compounds, five stilbenoid dimers ?-viniferin, ampelopsin A, balanocarpol, laevifonol and diptoindonesin G and four stilbenoid trimers ?-viniferin, johorenol A, ampelopsin E and vaticanol G were evaluated for their antibacterial activities against ATCC 33591 and a HUKM clinical isolate. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for each active compound were determined using the serial microdilution and plate-streak techniques. The combined effect of stilbenoids with vancomycin against MRSA was evaluated using the checkerboard assay to determine their fractional inhibitory concentration (FIC) index values. The MIC value of ?-viniferin on both MRSA strains was 100 ?g/mL, whereas those of johorenol A on ATCC 33591 and HUKM strain were 100 ?g/mL and 200 ?g/mL, respectively. The MIC values of ampelopsin E and vaticanol G were higher than 400 ?g/mL. Out of the five stilbenoid dimers, only ?-viniferin was capable of inhibiting the growth of both MRSA strains at MIC 400 ?g/mL. The MBC value of ?-viniferin, ?-viniferin and johorenol A showed bacteriostatic action against MRSA. The FIC index value of ?-viniferin and ?-viniferin in combination with vancomycin showed an additive effect (0.5 < FIC ? 2.0) against both MRSA strains. Johorenol A-vancomycin combination was also additive against HUKM strain, but it showed synergistic interaction with vancomycin against ATCC 33591 (FIC < 0.5). Stilbenoid compounds from Shorea gibbosa have anti-MRSA activity and huge potential as an alternative phytotherapy in combating MRSA infections. PMID:24280704

  5. Modelling the effect of antimicrobial treatment on carriage of hospital pathogens with application to MRSA.

    PubMed

    Verykouki, E; Kypraios, T; O'neill, P D

    2016-01-01

    Numerous studies have sought to assess the effectiveness of control measures aimed at reducing the spread of pathogens such as Methicillin-resistant Staphylococcus aureus (MRSA) in hospital settings. Far less is known about possible short-term effects of antibiotics and other antimicrobial treatments on pathogen carriage in patients. This paper is concerned with developing and applying methods for the analysis of detailed data on hospital patients which include information on patient treatments and screening tests for the pathogen in question. The carriage status (colonized, or not) of each patient is modelled as a Markov chain, and models for both perfect and imperfect test sensitivity are developed. Goodness-of-fit procedures based on simulation are also proposed. The methods are illustrated using both simulated data and data on MRSA. PMID:26040911

  6. Successful treatment of persistent MRSA bacteremia using high-dose daptomycin combined with rifampicin.

    PubMed

    Hagiya, Hideharu; Terasaka, Tomohiro; Kimura, Kosuke; Satou, Asuka; Asano, Kikuko; Waseda, Koichi; Hanayama, Yoshihisa; Otsuka, Fumio

    2014-01-01

    We herein report a case of persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia that was successfully treated with combination therapy consisting of high-dose daptomycin (DAP, 10 mg/kg) and rifampicin. The patient's condition was complicated with multiple infectious foci, including an iliopsoas abscess and epidural abscess, as well as discitis and spondylitis at the cervical, thoracic and lumbar levels. Monotherapy treatments with vancomycin, linezolid and usual-dose DAP were all ineffective. It has been shown that usual-dose DAP administration may result in the emergence of a resistant strain and treatment failure. We would like to emphasize the importance of high-dose DAP therapy for MRSA bacteremia, a condition with a potentially high mortality rate. PMID:25224207

  7. Salicylanilide carbamates: Promising antibacterial agents with high in vitro activity against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Zadrazilova, Iveta; Pospisilova, Sarka; Masarikova, Martina; Imramovsky, Ales; Ferriz, Juana Monreal; Vinsova, Jarmila; Cizek, Alois; Jampilek, Josef

    2015-09-18

    A series of twenty-one salicylanilide N-alkylcarbamates was assessed for novel antibacterial characteristics against three clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and S. aureus ATCC 29213 as the reference and quality control strain. The minimum inhibitory concentration was determined by the broth dilution micro-method with subsequent subcultivation of aliquots to assess minimum bactericidal concentration. The bactericidal kinetics was established by time-kill assay. Ampicillin, ciprofloxacin and vancomycin were used as reference antibacterial drugs. All the tested compounds exhibited highly potent anti-MRSA activity (? 0.008-4 ?g/mL) comparable or up to 250× higher than that of vancomycin, the standard in the treatment of serious MRSA infections. 4-Chloro-2-(3,4-dichlorophenylcarbamoyl)phenyl butylcarbamate and 4-chloro-2-(3,4-dichlorophenylcarbamoyl)phenyl ethylcarbamate were the most active compounds. In most cases, compounds provided reliable bacteriostatic activity, except for 4-chloro-2-(4-chlorophenylcarbamoyl)phenyl decylcarbamate exhibiting bactericidal effect at 8h (for clinical isolate of MRSA 63718) and at 24h (for clinical isolates of MRSA SA 630 and MRSA SA 3202) at 4× MIC. Structure-activity relationships are discussed. PMID:26079401

  8. Bacteriophage as effective decolonising agent for elimination of MRSA from anterior nares of BALB/c mice

    PubMed Central

    2014-01-01

    Background Nasal carriers not only pose serious threat to themselves but also to the community by playing an active role in the dissemination of serious and life threatening S. aureus especially MRSA strains. The present study focuses on the use of broad spectrum lytic phage as decolonising agent. In addition, the combined use of lytic phage with mupirocin has also been investigated as an effective decolonising regimen. The effect of phage on the adherence, invasion and cytotoxic effect of MRSA strains on nasal epithelial cells was studied in an ex-vivo model of cultured murine nasal epithelial cells. This was followed by demonstration of therapeutic potential of phage along with mupirocin in decolonising the nares of BALB/c mice using a nasal model of MRSA colonisation. Results Phage was able to significantly reduce the in vitro adherence, invasion and cytotoxicity of MRSA 43300 as well as other clinical MRSA strains on murine nasal epithelial cells as compared to untreated control. Also, the frequency of emergence of spontaneous mutants decreased to negligible levels when both the agents (phage and mupirocin) were used together. Conclusion Phage MR-10, given along with mupirocin showed an additive effect and the combination was able to effectively eradicate the colonising MRSA population from the nares of mice by day 5. PMID:25112504

  9. Performance of 3 real-time PCR assays for direct detection of Staphylococcus aureus and MRSA from clinical samples.

    PubMed

    Mehta, Maitry S; McClure, J T; Mangold, Kathy; Peterson, Lance R

    2015-11-01

    We compared 3 real-time PCR assays: off-label use of 2 commercial assays (BD-GeneOhm™ MRSA assay for methicillin-resistant Staphylococcus aureus [MRSA] detection and BD-GeneOhm StaphSR™ for MRSA and methicillin-susceptible S. aureus detection) and an in-house real-time PCR assay for detection of total S. aureus from clinical specimens. Testing was performed on 200 distinct specimens. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using culture as the gold standard. The prevalence of S. aureus in the samples was 44.5%, and MRSA was 20%. For total S. aureus, the StaphSR-PCR and the in-house PCR assays had a sensitivity and specificity of 94.4% and 96.4% and 93.3% and 99.1%, respectively. For MRSA detection, the StaphSR and the BD GeneOhm assay had a sensitivity and specificity of 92.5% and 98.8% and 92.5% and 96.3%, respectively. This study demonstrates the potential use of tests like the StaphSR-PCR assay for rapid detection of S. aureus and MRSA directly from clinical specimens; however, culture follow-up would be needed to identify other potential pathogens in the specimen. PMID:26341702

  10. Impact of mupirocin resistance on the transmission and control of healthcare-associated MRSA

    PubMed Central

    Deeny, Sarah R.; Worby, Colin J.; Tosas Auguet, Olga; Cooper, Ben S.; Edgeworth, Jonathan; Cookson, Barry; Robotham, Julie V.

    2015-01-01

    Objectives The objectives of this study were to estimate the relative transmissibility of mupirocin-resistant (MupR) and mupirocin-susceptible (MupS) MRSA strains and evaluate the long-term impact of MupR on MRSA control policies. Methods Parameters describing MupR and MupS strains were estimated using Markov chain Monte Carlo methods applied to data from two London teaching hospitals. These estimates parameterized a model used to evaluate the long-term impact of MupR on three mupirocin usage policies: ‘clinical cases’, ‘screen and treat’ and ‘universal’. Strategies were assessed in terms of colonized and infected patient days and scenario and sensitivity analyses were performed. Results The transmission probability of a MupS strain was 2.16 (95% CI 1.38–2.94) times that of a MupR strain in the absence of mupirocin usage. The total prevalence of MupR in colonized and infected MRSA patients after 5 years of simulation was 9.1% (95% CI 8.7%–9.6%) with the ‘screen and treat’ mupirocin policy, increasing to 21.3% (95% CI 20.9%–21.7%) with ‘universal’ mupirocin use. The prevalence of MupR increased in 50%–75% of simulations with ‘universal’ usage and >10% of simulations with ‘screen and treat’ usage in scenarios where MupS had a higher transmission probability than MupR. Conclusions Our results provide evidence from a clinical setting of a fitness cost associated with MupR in MRSA strains. This provides a plausible explanation for the low levels of mupirocin resistance seen following ‘screen and treat’ mupirocin usage. From our simulations, even under conservative estimates of relative transmissibility, we see long-term increases in the prevalence of MupR given ‘universal’ use. PMID:26338047

  11. Factors Contributing to Epidemic MRSA Clones Replacement in a Hospital Setting

    PubMed Central

    Baldan, Rossella; Testa, Francesca; Lorè, Nicola I.; Bragonzi, Alessandra; Cichero, Paola; Ossi, Cristina; Biancardi, Anna; Nizzero, Paola; Moro, Matteo; Cirillo, Daniela M.

    2012-01-01

    The mechanisms governing the epidemiology dynamics and success determinants of a specific healthcare-associated methicillin-resistant S. aureus (HA-MRSA) clone in hospital settings are still unclear. Important epidemiological changes have occurred in Europe since 2000 that have been related to the appearance of the ST22-IV clone. Between 2006 and 2010, we observed the establishment of the ST22-IV clone displacing the predominant Italian clone, ST228-I, in a large Italian university hospital. To investigate the factors associated with a successful spread of epidemic MRSA clones we studied the biofilm production, the competitive behavior in co-culture, the capacity of invasion of the A549 cells, and the susceptibility to infection in a murine model of acute pneumonia of the two major HA-MRSA clones, ST22-IV and ST228-I. We showed that persistence of ST22-IV is associated with its increased biofilm production and capacity to inhibit the growth of ST228-I in co-culture. Compared to ST228-I, ST22-IV had a significantly higher capacity to invade the A549 cells and a higher virulence in a murine model of acute lung infection causing severe inflammation and determining death in all the mice within 60 hours. On the contrary, ST228-I was associated with mice survival and clearance of the infection. ST22-IV, compared with ST228-I, caused a higher number of persistent, long lasting bacteremia. These data suggest that ST22-IV could have exploited its capacity to i) increase its biofilm production over time, ii) maintain its growth kinetics in the presence of a competitor and iii) be particularly invasive and virulent both in vitro and in vivo, to replace other well-established MRSA clones, becoming the predominant European clone. PMID:22905220

  12. Factors contributing to epidemic MRSA clones replacement in a hospital setting.

    PubMed

    Baldan, Rossella; Testa, Francesca; Lorè, Nicola I; Bragonzi, Alessandra; Cichero, Paola; Ossi, Cristina; Biancardi, Anna; Nizzero, Paola; Moro, Matteo; Cirillo, Daniela M

    2012-01-01

    The mechanisms governing the epidemiology dynamics and success determinants of a specific healthcare-associated methicillin-resistant S. aureus (HA-MRSA) clone in hospital settings are still unclear. Important epidemiological changes have occurred in Europe since 2000 that have been related to the appearance of the ST22-IV clone. Between 2006 and 2010, we observed the establishment of the ST22-IV clone displacing the predominant Italian clone, ST228-I, in a large Italian university hospital. To investigate the factors associated with a successful spread of epidemic MRSA clones we studied the biofilm production, the competitive behavior in co-culture, the capacity of invasion of the A549 cells, and the susceptibility to infection in a murine model of acute pneumonia of the two major HA-MRSA clones, ST22-IV and ST228-I. We showed that persistence of ST22-IV is associated with its increased biofilm production and capacity to inhibit the growth of ST228-I in co-culture. Compared to ST228-I, ST22-IV had a significantly higher capacity to invade the A549 cells and a higher virulence in a murine model of acute lung infection causing severe inflammation and determining death in all the mice within 60 hours. On the contrary, ST228-I was associated with mice survival and clearance of the infection. ST22-IV, compared with ST228-I, caused a higher number of persistent, long lasting bacteremia. These data suggest that ST22-IV could have exploited its capacity to i) increase its biofilm production over time, ii) maintain its growth kinetics in the presence of a competitor and iii) be particularly invasive and virulent both in vitro and in vivo, to replace other well-established MRSA clones, becoming the predominant European clone. PMID:22905220

  13. The distribution of pathogenic and toxigenic genes among MRSA and MSSA clinical isolates.

    PubMed

    Imani Fooladi, Abbas Ali; Ashrafi, Elnaz; Tazandareh, Shafie Gorbani; Koosha, Roohollah Zarei; Rad, Hamid Sedighian; Amin, Mohsen; Soori, Mina; Larki, Reza Abbasi; Choopani, Ali; Hosseini, Hamideh Mahmoodzadeh

    2015-04-01

    Staphylococcus aureus (S. aureus) is considered as a notorious nosocomial pathogen among hospitalized patients and community-dwelling subjects. Its increasing morbidity and mortality is believed to be due to antibiotic resistance. However, the data concerning molecular properties of infecting strains are few. In this study, a total of 192 S. aureus strains, including 88 (45.8%) meticillin-sensitive S. aureus (MSSA) and 104 (54.2%) meticillin-resistant S. aureus (MRSA) were recovered from clinical samples. The prevalence of subtypes containing staphylococcal cassette chromosome mec (SSCmec), staphylococcal enterotoxins (SEs), toxic shock syndrome toxin (TSST) and exfoliative toxin was assessed by PCR. Antibiotic susceptibility pattern and vancomycin resistance of each isolate were evaluated by disk diffusion method and micro-dilution method, respectively. 9 (2.3%) strains required MIC > 2 mg/l of vancomycin, which significantly increased among multi drug resistant (MDR), MRSA and SCCmec type III strains (p < 0.05). 171 (89%), 140 (72.91%), 7 (3.6), 78 (48.6%), 5 (2.6%), 151 (78.64%), 129 (67.18%), 178 (92.7%) and 15 (7.8%) of 192 isolates harbored mecA, entA, entB, entC, entD, entE, eta, etb and tsst-1 genes, respectively. 31 (16.14%), 5 (2.6%), 95 (49.48%) and 7 (3.64%) of 192 isolates carried SCCmec type I, II, III and IV, respectively. We found a significantly higher rate of MRSA and resistance to all tested antibiotics, except to penicillin G, kanamycin and linezolide among the SCCmec type III class (p < 0.05). According to our findings, MSSA isolates should be taken as seriously as MRSA strains due to the potential presence of broad spectrum virulence factor genes. PMID:25778391

  14. Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) Transmission

    PubMed Central

    Chowers, Michal; Carmeli, Yehuda; Shitrit, Pnina; Elhayany, Asher; Geffen, Keren

    2015-01-01

    Introduction Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia. Methods We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel. Results An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600. Conclusions A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country. PMID:26406889

  15. Rapid bactericidal action of alpha-mangostin against MRSA as an outcome of membrane targeting.

    PubMed

    Koh, Jun-Jie; Qiu, Shengxiang; Zou, Hanxun; Lakshminarayanan, Rajamani; Li, Jianguo; Zhou, Xiaojun; Tang, Charles; Saraswathi, Padmanabhan; Verma, Chandra; Tan, Donald T H; Tan, Ai Ling; Liu, Shouping; Beuerman, Roger W

    2013-02-01

    The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has created the need for better therapeutic options. In this study, five natural xanthones were extracted and purified from the fruit hull of Garcinia mangostana and their antimicrobial properties were investigated. ?-Mangostin was identified as the most potent among them against Gram-positive pathogens (MIC=0.78-1.56 ?g/mL) which included two MRSA isolates. ?-Mangostin also exhibited rapid in vitro bactericidal activity (3-log reduction within 5 min). In a multistep (20 passage) resistance selection study using a MRSA isolated from the eye, no resistance against ?-mangostin in the strains tested was observed. Biophysical studies using fluorescence probes for membrane potential and permeability, calcein encapsulated large unilamellar vesicles and scanning electron microscopy showed that ?-mangostin rapidly disrupted the integrity of the cytoplasmic membrane leading to loss of intracellular components in a concentration-dependent manner. Molecular dynamic simulations revealed that isoprenyl groups were important to reduce the free energy for the burial of the hydrophobic phenyl ring of ?-mangostin into the lipid bilayer of the membrane resulting in membrane breakdown and increased permeability. Thus, we suggest that direct interactions of ?-mangostin with the bacterial membrane are responsible for the rapid concentration-dependent membrane disruption and bactericidal action. PMID:22982495

  16. Synergism between Medihoney and Rifampicin against Methicillin-Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Müller, Patrick; Alber, Dagmar G.; Turnbull, Lynne; Schlothauer, Ralf C.; Carter, Dee A.; Whitchurch, Cynthia B.; Harry, Elizabeth J.

    2013-01-01

    Skin and chronic wound infections caused by highly antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) are an increasing and urgent health problem worldwide, particularly with sharp increases in obesity and diabetes. New Zealand manuka honey has potent broad-spectrum antimicrobial activity, has been shown to inhibit the growth of MRSA strains, and bacteria resistant to this honey have not been obtainable in the laboratory. Combinational treatment of chronic wounds with manuka honey and common antibiotics may offer a wide range of advantages including synergistic enhancement of the antibacterial activity, reduction of the effective dose of the antibiotic, and reduction of the risk of antibiotic resistance. The aim of this study was to investigate the effect of Medihoney in combination with the widely used antibiotic rifampicin on S. aureus. Using checkerboard microdilution assays, time-kill curve experiments and agar diffusion assays, we show a synergism between Medihoney and rifampicin against MRSA and clinical isolates of S. aureus. Furthermore, the Medihoney/rifampicin combination stopped the appearance of rifampicin-resistant S. aureus in vitro. Methylglyoxal (MGO), believed to be the major antibacterial compound in manuka honey, did not act synergistically with rifampicin and is therefore not the sole factor responsible for the synergistic effect of manuka honey with rifampicin. Our findings support the idea that a combination of honey and antibiotics may be an effective new antimicrobial therapy for chronic wound infections. PMID:23469049

  17. First report of identification of livestock-associated MRSA ST9 in retail meat in England.

    PubMed

    Dhup, V; Kearns, A M; Pichon, B; Foster, H A

    2015-10-01

    Sixty percent of all meat consumed in the UK is imported from European countries where there have been increasing reports of methicillin-resistant Staphylococcus aureus (MRSA) identified in food-producing animals, but rarely from such animals in the UK. Thirty samples each of raw chicken, pork and beef, sourced in England, were collected from retail outlets in Greater Manchester. MRSA was recovered from three chicken samples and one each of pork and beef, all from prepackaged supermarket meat. Four isolates were identified as representatives of the most common human healthcare-associated MRSA clone in the UK [EMRSA-15, spa type t032, belonging to multilocus sequence type clonal complex 22 (MLST-CC22)], suggesting contamination from human source(s) during meat processing. The fifth isolate (from chicken) was multiply-resistant (including oxacillin, ciprofloxacin, erythromycin, clindamycin and tetracycline), identified as ST9-SCCmecIV, spa type t1939 and lacked the immune evasion cluster, a characteristic of livestock-associated strains. This lineage has been identified previously from animals and meat products in Asia and mainland Europe but not the UK. PMID:25697759

  18. Mechanisms of NDV-3 vaccine efficacy in MRSA skin versus invasive infection

    PubMed Central

    Yeaman, Michael R.; Filler, Scott G.; Chaili, Siyang; Barr, Kevin; Wang, Huiyuan; Kupferwasser, Deborah; Hennessey, John P.; Fu, Yue; Schmidt, Clint S.; Edwards, John E.; Xiong, Yan Q.; Ibrahim, Ashraf S.

    2014-01-01

    Increasing rates of life-threatening infections and decreasing susceptibility to antibiotics urge development of an effective vaccine targeting Staphylococcus aureus. This study evaluated the efficacy and immunologic mechanisms of a vaccine containing a recombinant glycoprotein antigen (NDV-3) in mouse skin and skin structure infection (SSSI) due to methicillin-resistant S. aureus (MRSA). Compared with adjuvant alone, NDV-3 reduced abscess progression, severity, and MRSA density in skin, as well as hematogenous dissemination to kidney. NDV-3 induced increases in CD3+ T-cell and neutrophil infiltration and IL-17A, IL-22, and host defense peptide expression in local settings of SSSI abscesses. Vaccine induction of IL-22 was necessary for protective mitigation of cutaneous infection. By comparison, protection against hematogenous dissemination required the induction of IL-17A and IL-22 by NDV-3. These findings demonstrate that NDV-3 protective efficacy against MRSA in SSSI involves a robust and complementary response integrating innate and adaptive immune mechanisms. These results support further evaluation of the NDV-3 vaccine to address disease due to S. aureus in humans. PMID:25489065

  19. Synergistic effect of tetrandrine and ethidium bromide against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Lee, Young-Seob; Han, Sin-Hee; Lee, Su-Hwan; Kim, Young-Guk; Park, Chung-Berm; Kang, Ok-Hwa; Keum, Joon-Ho; Kim, Sung-Bae; Mun, Su-Hyun; Shin, Dong-Won; Kwon, Dong-Yeul

    2011-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) along with other resistant bacteria have become a significant social and clinical problem. Therefore, there is an urgent need to develop bioactive compounds from natural products as alternatives to the very few antibiotics that remain effective. Recently, the efflux mechanism has been identified as the main contributor to antibiotic resistance in bacteria. This study therefore aimed to evaluate tetrandrine (TET), an efflux pump inhibitor (EPI), as a potential antibiotic against MRSA. We investigated the antimicrobial activity of TET against 17 MRSA strains, of which 3 selected strains were studied in further detail using a time-kill assay. When these bacterial strains (1 × 10(6) colony-forming units (cfu)/ml) were incubated with TET in a time-kill assay, log-scale bactericidal activity was observed, which lasted for 24 hr. In addition, TET exhibits a synergistic effect when combined with the multi-drug resistance (MDR)-efflux pump substrate ethidium bromide (EtBr). Structure-function studies of the antibiotic activity of TET in combination with EtBr may lead to the discovery of more effective efflux pump inhibitors. PMID:22008539

  20. Protein biomarkers in vernix with potential to predict the development of atopic eczema in early childhood

    PubMed Central

    Holm, T; Rutishauser, D; Kai-Larsen, Y; Lyutvinskiy, Y; Stenius, F; Zubarev, R A; Agerberth, B; Alm, J; Scheynius, A

    2014-01-01

    Background Atopic eczema (AE) is a chronic inflammatory skin disease, which has increased in prevalence. Evidence points toward lifestyle as a major risk factor. AE is often the first symptom early in life later followed by food allergy, asthma, and allergic rhinitis. Thus, there is a great need to find early, preferentially noninvasive, biomarkers to identify individuals that are predisposed to AE with the goal to prevent disease development. Objective To investigate whether the protein abundances in vernix can predict later development of AE. Methods Vernix collected at birth from 34 newborns within the Assessment of Lifestyle and Allergic Disease During INfancy (ALADDIN) birth cohort was included in the study. At 2 years of age, 18 children had developed AE. Vernix proteins were identified and quantified with liquid chromatography coupled to tandem mass spectrometry. Results We identified and quantified 203 proteins in all vernix samples. An orthogonal projections to latent structures-discriminant analysis (OPLS-DA) model was found with R2 = 0.85, Q2 = 0.39, and discrimination power between the AE and healthy group of 73.5%. Polyubiquitin-C and calmodulin-like protein 5 showed strong negative correlation to the AE group, with a correlation coefficient of 0.73 and 0.68, respectively, and a P-value of 8.2 E-7 and 1.8 E-5, respectively. For these two proteins, the OPLS-DA model showed a prediction accuracy of 91.2%. Conclusion The protein abundances in vernix, and particularly that of polyubiquitin-C and calmodulin-like protein 5, are promising candidates as biomarkers for the identification of newborns predisposed to develop AE. PMID:24205894

  1. What's new in atopic eczema? An analysis of systematic reviews published in 2010-11.

    PubMed

    Torley, D; Futamura, M; Williams, H C; Thomas, K S

    2013-07-01

    This review provides a summary of key findings from 24 systematic reviews of atopic eczema (AE) published or indexed between 1 August 2010 and 31 December 2011, updating published summaries from previous years. Epidemiological evidence points to the protective effects of early daycare, endotoxin exposure, consumption of unpasteurized milk, and early exposure to dogs, but antibiotic use in early life may increase the risk for AE. With regard to prevention of AE, there is currently no strong evidence of benefit for exclusive breastfeeding, hydrolysed protein formulas, soy formulas, maternal antigen avoidance, omega-3 or omega-6 fatty-acid supplementation, or use of prebiotics or probiotics. With respect to AE treatments, the most compelling new systematic review evidence was for proactive treatment with topical anti-inflammatory agents (topical corticosteroids and topical calcineurin inhibitors) for the prevention of AE flares in patients with moderate to severe AE. A meta-analysis of 4 trials confirmed the superiority of tacrolimus 0.1% over pimecrolimus for the treatment of AE, and a review of 17 trials found that tacrolimus (0.1% or 0.03%) was broadly similar in efficacy to mild/moderate topical corticosteroids. Evidence for the role of education in the management of AE was less conclusive, with evidence from randomized controlled trials showing mixed results. Further work is needed in this area to conduct high-quality trials of educational interventions that are clearly described and reproducible. There is no clear evidence for the efficacy of homeopathy, botanical extracts or Chinese herbal medicine in the treatment of AE, as large well-designed trials are lacking in these areas. PMID:23750610

  2. Characterisation of Australian MRSA Strains ST75- and ST883-MRSA-IV and Analysis of Their Accessory Gene Regulator Locus

    PubMed Central

    Monecke, Stefan; Kanig, Hanna; Rudolph, Wolfram; Müller, Elke; Coombs, Geoffrey; Hotzel, Helmut; Slickers, Peter; Ehricht, Ralf

    2010-01-01

    Background Community-acquired methicillin-resistant Staphylococcus aureus have become a major problem in Australia. These strains have now been isolated throughout Australia including remote Indigenous communities that have had minimal exposure to healthcare facilities. Some of these strains, belonging to sequence types ST75 and ST883, have previously been reported to harbour highly divergent alleles of the housekeeping genes used in multilocus sequence typing. Methodology/Principal Findings ST75-MRSA-IV and ST883-MRSA-IV isolates were characterised in detail. Morphological features as well as 16S sequences were identical to other S. aureus strains. Although a partial rnpB gene sequence was not identical to previously known S. aureus sequences, it was found to be more closely related to S. aureus than to other staphylococci. Isolates also were screened using diagnostic DNA microarrays. These isolates yielded hybridisation results atypical for S. aureus. Primer directed amplification assays failed to detect species markers (femA, katA, sbi, spa). However, arbitrarily primed amplification indicated the presence of unknown alleles of these genes. Isolates could not be assigned to capsule types 1, 5 or 8. The allelic group of the accessory gene regulator (agr) locus was not determinable. Sequencing of a region of agrB, agrC and agrD (approximately 2,100 bp) revealed a divergent sequence. However, this sequence is more related to S. aureus agr alleles I and IV than to agr sequences from other Staphylococcus species. The predicted auto-inducing peptide (AIP) sequence of ST75 was identical to that of agr group I, while the predicted AIP sequence of ST883 was identical to agr group IV. Conclusions/Significance The genetic properties of ST75/ST883-MRSA may be due to a series of evolutionary events in ancient insulated S. aureus strains including a convergent evolution leading to agr group I- or IV-like AIP sequences and a recent acquisition of SCCmec IV elements. PMID:21103340

  3. Preventing introduction of livestock associated MRSA in a pig population--benefits, costs, and knowledge gaps from the Swedish perspective.

    PubMed

    Höjgård, Sören; Aspevall, Olov; Bengtsson, Björn; Hæggman, Sara; Lindberg, Maria; Mieziewska, Kristina; Nilsson, Svante; Ericsson Unnerstad, Helle; Viske, Diana; Wahlström, Helene

    2015-01-01

    Antibiotic resistance is a growing concern in human, as well as in veterinary medicine. Part of the problem concerns how to respond to the risk presented by animal reservoirs of resistant bacteria with the potential of spreading to humans. One example is livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA). In countries where LA-MRSA is endemic in the pig population, people in contact with pigs have a higher risk of being colonised with LA-MRSA, and persons from this group are subjected to precautionary measures when visiting health care facilities. In the present study, it is assumed that, if LA-MRSA was introduced to the Swedish pig population, the prevalence in the risk groups would be the same as in Denmark or the Netherlands (two countries with low human prevalence that have implemented measures to detect, trace and isolate human LA-MRSA cases and, therefore, have comprehensive data with good coverage regarding prevalence of LA-MRSA), and that similar interventions would be taken in Swedish health care facilities. It is also assumed that the Swedish pig population is free of MRSA or that the prevalence is very low. We analyse if it would be efficient for Sweden to prevent its introduction by testing imported live breeding pigs. Given that quarantining and testing at import will prevent introduction to the pig population, the study shows that the preventive measures may indeed generate a societal net benefit. Benefits are estimated to be between € 870 720 and € 1 233 511, and costs to € 211 129. Still, due to gaps in knowledge, the results should be confirmed when more information become available. PMID:25923329

  4. Analysis of reporting time for identification of methicillin-resistant Staphylococcus aureus carriers using ChromID MRSA.

    PubMed

    Lee, Yirang; Kim, Jae-Seok; Kim, Han-Sung; Kim, Hyun Soo; Song, Wonkeun; Lee, Kyu Man

    2014-05-01

    We assessed the reporting times for identification of nasal methicillin-resistant Staphylococcus aureus (MRSA) carriers in 2011 in a university-affiliated hospital using surveillance cultures incubated for 1 and 2 days with ChromID MRSA (bioMérieux, France). Of 2,732 nasal swabs tested, MRSA was detected in 829 (85.6%) and 140 (14.4%) swabs after 1 and 2 days of incubation, respectively, and the median reporting times for positive specimens were 33.7 hr (range, 18.2-156.9 hr) and 108.1 hr (range, 69.8-181.0 hr), respectively. Detection rate after 1-day incubation was 85%. Additional 1-day incubation improved detection rate; however, it prolonged the reporting times of positive specimens approximately up to 4 days because of the need for confirmatory tests such as species identification and susceptibility tests. Following a 2-day culture with ChromID MRSA, rapid confirmatory tests are warranted to reduce delay in identifying MRSA carriers. PMID:24790913

  5. Anti-MRSA activity of isoplagiochin-type macrocyclic bis(bibenzyl)s is mediated through cell membrane damage.

    PubMed

    Onoda, Kenji; Sawada, Hiromi; Morita, Daichi; Fujii, Kana; Tokiwa, Hiroaki; Kuroda, Teruo; Miyachi, Hiroyuki

    2015-07-01

    We synthesized three geometrical isomers of a macrocyclic bis(bibenzyl) based on isoplagiochin, a natural product isolated from bryophytes, and evaluated their antibacterial activity towards methicillin-resistant Staphylococcus aureus (anti-MRSA activity). The isomer containing a 1,4-linked ring (5) showed only weak activity, whereas the isomers containing a 1,3-linked (6) or 1,2-linked (7) C ring showed potent anti-MRSA activity. Molecular dynamics calculations indicated that these differences are probably due to differences in the conformational flexibility of the macrocyclic ring; the active compounds 6 and 7 were more rigid than 5. In order to understand the action mechanism of anti-MRSA activity, we investigated the cellular flux of a fluorescent DNA-binder, ethidium bromide (EtBr), in the presence and absence of these macrocycles. The active compound 6 increased the levels of EtBr inflow and outflow in S. aureus cells, as did our potent anti-MRSA riccardin derivative (4), indicating that these compounds increased the permeability of the cytoplasmic membrane. Inactive 5 had no effect on EtBr inflow or outflow. Furthermore, compound 6 abrogated the normal intracellular concentration gradients of Na(+) and K(+) in S. aureus cells, increasing the intracellular Na(+) concentration and decreasing the K(+) concentration, while 5 had no such effect. These results indicate that anti-MRSA-active macrocyclic bis(bibenzyl) derivatives directly damage the gram-positive bacterial membrane, resulting in increased permeability. PMID:25999206

  6. Identification, expression, and characterization of a major salivary allergen (Cul s 1) of the biting midge Culicoides sonorensis relevant for summer eczema in horses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Salivary proteins of Culicoides biting midges are thought to play a key role in the induction of summer eczema (SE), a seasonal recurrent allergic dermatitis in horses. The present study describes the identification of a candidate allergen in artificially collected saliva of the North American speci...

  7. Risk factors for persistence of livestock-associated MRSA and environmental exposure in veal calf farmers and their family members: an observational longitudinal study

    PubMed Central

    Dorado-García, Alejandro; Bos, Marian EH; Graveland, Haitske; Van Cleef, Brigitte AGL; Verstappen, Koen M; Kluytmans, Jan AJW; Wagenaar, Jaap A; Heederik, Dick JJ

    2013-01-01

    Objectives Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) emergence is a major public health concern. This study was aimed at assessing risk factors for persistently carrying MRSA in veal calf farmers and their family members. We also evaluate the dynamics of MRSA environmental load during the veal-calf production cycle. Design Observational, longitudinal, repeated cross-sectional study. Setting 52 veal calf farms in the Netherlands. Participants From the end of 2010 to the end of 2011, a total of 211 farmers, family members and employees were included in the study. Primary outcome and secondary outcome measures Nasal swabs were taken from participants on days 0, 4, 7 and week 12. A persistent MRSA carrier was defined as a person positive for MRSA on days 0, 4 and 7. Participants filled in an extensive questionnaire to identify potential risk factors and confounders. For estimation of MRSA prevalence in calves and environmental contamination, animal nasal swabs and Electrostatic Dust Collectors were taken on day 0 and week 12. Results The presence of potential animal reservoirs (free-ranging farm cats and sheep) and the level of contact with veal calves was positively associated with persistent MRSA carriage. Interestingly, at the end of the study (week 12), there was a twofold rise in animal prevalence and a significantly higher MRSA environmental load in the stables was found on farms with MRSA carriers. Conclusions This study supports the hypothesis that environmental contamination with MRSA plays a role in the acquisition of MRSA in farmers and their household members and suggests that other animal species should also be targeted to implement effective control strategies. PMID:24056480

  8. Future challenges and treatment of Staphylococcus aureus bacteremia with emphasis on MRSA

    PubMed Central

    Rasmussen, Rasmus V.; Fowler, Vance G.; Skov, Robert; Bruun, Niels E.

    2011-01-01

    Summary Staphylococcus aureus bacteremia (SAB) is an urgent medical problem due to its growing frequency and its poor associated outcome. As healthcare delivery increasingly involves invasive procedures and implantable devices, the number of patients at risk for SAB and its complications is likely to grow. Compounding this problem is the growing prevalence of methicillin resistant S. aureus (MRSA) and the dwindling efficacy of vancomycin, long the treatment of choice for this pathogen. Despite the recent availability of several new antibiotics for S. aureus, new strategies for treatment and prevention are required for this serious, common cause of human infection. PMID:21162635

  9. A lean Six Sigma team increases hand hygiene compliance and reduces hospital-acquired MRSA infections by 51%.

    PubMed

    Carboneau, Clark; Benge, Eddie; Jaco, Mary T; Robinson, Mary

    2010-01-01

    A low hand hygiene compliance rate by healthcare workers increases hospital-acquired infections to patients. At Presbyterian Healthcare Services in Albuquerque, New Mexico a Lean Six Sigma team identified the reasons for noncompliance were multifaceted. The team followed the DMAIC process and completed the methodology in 12 months. They implemented multiple solutions in the three areas: Education, Culture, and Environment. Based on methicillin-resistant Staphylococcus aureus (MRSA) mortality research the team's results included an estimated 2.5 lives saved by reducing MRSA infections by 51%. Subsequently this 51% decrease in MRSA saved the hospital US$276,500. For those readers tasked with increasing hand hygiene compliance this article will provide the knowledge and insight needed to overcome multifaceted barriers to noncompliance. PMID:20618572

  10. Surveillance of Physician-Diagnosed Skin and Soft Tissue Infections Consistent With Methicillin-Resistant "Staphylococcus aureus" (MRSA) among Nebraska High School Athletes, 2008-2012

    ERIC Educational Resources Information Center

    Buss, Bryan F.; Connolly, Susan

    2014-01-01

    Though historically confined to hospital settings, methicillin-resistant Staphylococcus aureus (MRSA) has received increasing attention in the wider community, particularly among athletes. A 2007-2008 investigation in Nebraska concluded that MRSA skin infections were an emerging problem among the state's student athletes. Statewide…

  11. Validation of the FluoroType® MRSA assay for the rapid identification of methicillin-resistant Staphylococcus aureus directly from patient material.

    PubMed

    Eigner, Ulrich; Veldenzer, Anke; Holfelder, Martin

    2014-12-01

    We performed the first evaluation study of the new HyBeacon based FluoroType(®) MRSA assay for the detection of MRSA directly from 617 patient specimens. Using culture as the reference method sensitivity and specificity were higher than 95%. Results were available within 2.5h, including DNA extraction. PMID:25193437

  12. Absence of human innate immune evasion complex in LA-MRSA ST5 strains isolated from pigs, swine facilities, and humans with swine contact

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Since its first ties to swine, livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA) has raised public health concerns because livestock may be the largest reservoir of MRSA outside the hospital setting. In contrast to Europe and Asia, where the primary sequence type...

  13. The Efficacy and Safety of Arbekacin and Vancomycin for the Treatment in Skin and Soft Tissue MRSA Infection: Preliminary Study

    PubMed Central

    Hwang, Ji-Hee; Lee, Ju-Hyung; Moon, Mi-Kyoung; Kim, Ju-Sin; Won, Kyoung-Suk

    2013-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA) has become a one of the most important causes of nosocomial infections, and use of vancomycin for the treatment of MRSA infection has increased. Unfortunately, vancomycin-resistant enterococcus have been reported, as well as vancomycin-resistant S. aureus. Arbekacin is an antibacterial agent and belongs to the aminoglycoside family of antibiotics. It was introduced to treat MRSA infection. We studied the clinical and bacteriological efficacy and safety of arbekacin compared to vancomycin in the treatment of infections caused by MRSA. Materials and Methods This was a retrospective case-control study of patients who were admitted to tertiary Hospital from January 1st, 2009 to December 31st, 2010, and received the antibiotics arbekacin or vancomycin. All the skin and soft tissue MRSA infected patients who received arbekacin or vancomycin were enrolled during the study period. The bacteriological efficacy response (BER) was classified with improved and failure. The improved BER was defined as no growth of MRSA, where failure was defined as growth of MRSA, culture at the end of therapy or during treatment. Clinical efficacy response (CER) was classified as improved and failure. Improved CER was defined as resolution or reduction of the majority of signs and symptoms related to the original infection. Failure was defined as no resolution and no reduction of majority of the signs and symptoms, or worsening of one or more signs and symptoms, or new symptoms or signs associated with the original infection or a new infection. Results Totally, 122 patients (63/99 in arbekacin, 59/168 in vancomycin group) with skin and soft tissue infection who recieved arbekacin or vancomcyin at least 4 days were enrolled and analysed. The bacteriological efficacy response [improved, arbekacin vs vancomycin; 73.0% (46/63), 95% confidence interval (CI) 60.3 to 83.4% vs 83.1% (49/59), 95% CI 71.0 to 91.6%] and clinical efficacy response [improved, arbekacin vs vancomycin; 67.2% (41/61), 95% CI 52.0 to 76.7% vs 78.0% (46/59), 95% CI 65.3 to 87.7%] were similar between the two groups (P=0.264, 0.265). The complication rate was significantly higher in the vancomycin group [29/59(49.2%), 95% CI 35.9 to 62.5%] than arbekacin [10/63(15.9%), 95% CI 8.4 to 29.0%] (P<0.001). Conclusions Arbekacin could be considered as an alternative antibiotics for vancomycin in skin and soft tissue infection with MRSA. However, further prospective randomized trials are needed to confirm this finding. PMID:24265951

  14. Discovery of bisindolyl-substituted cycloalkane-anellated indoles as novel class of antibacterial agents against S. aureus and MRSA.

    PubMed

    El-Sayed, Mardia Telep; Suzen, Sibel; Altanlar, Nurten; Ohlsen, Knut; Hilgeroth, Andreas

    2016-01-01

    Antibiotic resistance is an ongoing problem in the treatment of bacterial diseases. Among the various antibacterial infections Staphylococcus aureus infections remain critical due to the increasing resistances, especially against the methicillin-resistant S. aureus (MRSA). We discovered novel antibacterial compounds with activities against both S. aureus and MRSA types. Structure-activity relationships (SAR) are discussed and show that the activity depends on the ring size of the anellated cycloalkane. Moreover, first substituent effects have been investigated for both the cycloalkane and the indole residues. PMID:26590101

  15. Regulation of the Expression of the ?-Lactam Antibiotic-Resistance Determinants in Methicillin-Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    2015-01-01

    ?-Lactam antibiotics have faced obsolescence with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). A complex set of events ensues upon exposure of MRSA to these antibiotics, which culminates in proteolysis of BlaI or MecI, two gene repressors, and results in the induction of resistance. We report studies on the mechanism of binding of these gene repressors to the operator regions by fluorescence anisotropy. Within the range of in vivo concentrations for BlaI and MecI, these proteins interact with their regulatory elements in a reversible manner, as both a monomer and a dimer. PMID:24564530

  16. Direct Detection of Staphylococcus Osteoarticular Infections by Use of Xpert MRSA/SA SSTI Real-Time PCR ?

    PubMed Central

    Dubouix-Bourandy, Anne; de Ladoucette, Aymard; Pietri, Valerie; Mehdi, Nazim; Benzaquen, David; Guinand, Régis; Gandois, Jean-Marc

    2011-01-01

    We evaluated the Xpert MRSA/SA SSTI real-time PCR assay (Cepheid, Sunnyvale, CA) directly on perioperative bone and joint samples. The sensitivity and specificity for detection of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant coagulase-negative Staphylococcus were, respectively, 100% and 98.3%, 100% and 100%, and 100% and 95.3%. The median total test turnaround time was 72 min for PCR versus 79 h for culture. Using these rapid results, appropriate antibiotic treatment could be rapidly initiated. PMID:21998420

  17. Alitretinoin for severe chronic hand eczema: a NICE single technology appraisal.

    PubMed

    Rodgers, Mark; Griffin, Susan; Paulden, Mike; Slack, Russell; Duffy, Steven; Ingram, John R; Woolacott, Nerys; Sculpher, Mark

    2010-01-01

    The National Institute for Health and Clinical Excellence (NICE) invited the manufacturer of alitretinoin (Basilea Pharmaceuticals Ltd, Basel, Switzerland) to submit evidence for the clinical and cost effectiveness of this drug for the treatment of patients with severe chronic hand eczema (CHE), as part of the Institute's single technology appraisal (STA) process. The Centre for Reviews and Dissemination and the Centre for Health Economics at the University of York were commissioned to act as the Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and NICE's subsequent decisions. The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology based upon the manufacturer's submission to NICE. The ERG also independently searched for relevant evidence and modified the manufacturer's decision analytic model to examine the impact of altering some of the key assumptions. The main clinical effectiveness data were derived from a single-placebo randomized controlled trial (RCT) of daily treatment with alitretinoin for 12-24 weeks, with follow-up for a further 24 weeks, in patients with severe CHE unresponsive to topical corticosteroids. A significantly greater proportion of patients achieved 'clear' or 'almost clear' hands by week 24 with alitretinoin than those using placebo: 48% with alitretinoin 30 mg (p < 0.001); 28% with alitretinoin 10 mg (p < 0.005); 17% with placebo. Most patients who responded remained in remission during the 24-week follow-up period. The most commonly reported adverse event was dose-dependent headache, with rates of 20% in the alitretinoin 30 mg group and 11% in the alitretinoin 10 mg group, respectively. Serious adverse events were rare, although alitretinoin was associated with increases in both total cholesterol and triglycerides. No direct or indirect comparisons of alitretinoin with any of the relevant treatment comparators (psoralen + UVA [PUVA], ciclosporin or azathioprine) were available. In the manufacturer's original submission to NICE, the base-case incremental cost-effectiveness ratios (ICERs) reported for alitretinoin were pound8614 per QALY versus ciclosporin, - pound469 per QALY versus PUVA (with alitretinoin dominant) and pound10 612 per QALY versus azathioprine (year 2007-8 values). In response to a request from the ERG, the manufacturers provided a revised model that compared alitretinoin only with placebo, for which the ICER was reported to be pound12 931. However, the omission of adverse events entirely from this revised model, in combination with a number of other factors, led the ERG to conclude that the model underestimated the costs of treatment associated with alitretinoin. Estimates of health-related quality of life (HR-QOL) were the primary source of uncertainty, with the use of values from an alternative source producing ICERs of around pound30 000 per QALY gained. The ERG concluded that, although the evidence presented indicates that alitretinoin is efficacious in the treatment of severe CHE, it gives little indication of alitretinoin's efficacy relative to likely alternative treatment options or its efficacy and safety in the longer term. Although the ICERs estimated by the manufacturer suggested that alitretinoin may be cost effective for use in the UK NHS, utilizing the alternative HR-QOL estimates resulted in a 2-fold increase in the ICER. Thus, there was considerable uncertainty as to the true ICER of alitretinoin versus the relevant treatment comparators. The Appraisal Committee recommended that alitretinoin be provided to those patients with severe CHE and a Dermatology Life Quality Index (DLQI) score of at least 15. They recommended that treatment be stopped as soon as an adequate response was observed, or if CHE remained severe at 12 weeks, or if response was inadequate at 24 weeks. PMID:20131924

  18. Detection of methicillin-resistant Staphylococcus aureus (MRSA) using the NanoLantern Biosensor

    NASA Astrophysics Data System (ADS)

    Strohsahl, Christopher M.; Miller, Benjamin L.; Krauss, Todd D.

    2009-02-01

    Staphylococcus aureus is a leading cause of human illness, and has developed the remarkable ability to resist the bactericidal capabilities of many of the world's leading antibiotics (i.e. MRSA). In an effort to enable rapid detection and treatment of MRSA infections, we have developed a DNA detection technology termed the NanoLantern(TM). The NanoLantern(TM) biosensor technology is based on the simple immobilization of a fluorophore-terminated DNA hairpin onto a gold chip. This produces a label-free sensor that allows for a positive response to be obtained without extensive processing of the sample, saving cost and increasing accuracy. We will also discuss a newly developed method of partial gene analysis, used to develop a DNA hairpin probe that is capable of detecting the presence of the mecR gene, a gene necessary for methicillin resistance to be present in S. aureus, with 100% sequence specificity. The successful incorporation of this probe into the NanoLantern(TM) platform, along with the concomitant development of the paired PCR assay has allowed for the successful detection of methicillin-resistance directly from a culture of S. aureus. These results represent an important step forward in terms of developing the ability to rapidly and effectively detect the presence of antibiotic resistance in bacterial infections.

  19. GenomEra MRSA/SA, a fully automated homogeneous PCR assay for rapid detection of Staphylococcus aureus and the marker of methicillin resistance in various sample matrixes.

    PubMed

    Hirvonen, Jari J; Kaukoranta, Suvi-Sirkku

    2013-09-01

    The GenomEra MRSA/SA assay (Abacus Diagnostica, Turku, Finland) is the first commercial homogeneous PCR assay using thermally stable, intrinsically fluorescent time-resolved fluorometric (TRF) labels resistant to autofluorescence and other background effects. This fully automated closed tube PCR assay simultaneously detects Staphylococcus aureus specific DNA and the mecA gene within 50 min. It can be used for both screening and confirmation of methicillin-resistant and -sensitive S. aureus (MRSA and MSSA) directly in different specimen types or from preceding cultures. The assay has shown excellent performance in comparisons with other diagnostic methods in all the sample types tested. The GenomEra MRSA/SA assay provides rapid assistance for the detection of MRSA as well as invasive staphylococcal infections and helps the early targeting of antimicrobial therapy to patients with potential MRSA infection. PMID:24063393

  20. Ability of the GENSPEED(®) MRSA test kit to detect the novel mecA homologue mecC in Staphylococcus aureus.

    PubMed

    Petersen, Andreas; Medina, Alexandra; Larsen, Anders Rhod

    2015-06-01

    The aim of this study was to evaluate the GENSPEED(®) MRSA Test Kit that in addition to the traditional MRSA gene mecA, also incorporates a probe for detection of the newly described mecA homologue mecC. So far only one commercial system is able to detect this new gene. The specific objective was to evaluate the ability of the kit to detect and separate Stapyhylococcus aureus containing either mecA, mecC or no methicillin-resistance determinant. Ninety-five MRSA isolates from humans were included in the test and additional mecC-positive isolates from animals and methicillin-sensitive S. aureus were tested. The kit demonstrated 100% sensitivity and 100% specificity compared to a standard PCR method. The kit provides the ability to perform rapid and reliable detection of both mecA-MRSA and mecC-MRSA. PMID:25904353

  1. Comparative prevalence of immune evasion complex genes associated with beta-hemolysin converting bacteriophages in MRSA ST5 isolates from swine, swine facilities, humans with swine contact, and humans with no swine contact

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA) draws concern from the public health community because in some countries these organisms may represent the largest reservoir of MRSA outside hospital settings. Recent studies indicate LA-MRSA strains from swine are more genet...

  2. The Clinical Efficacy of Mometasone Furoate in Multi-Lamellar Emulsion for Eczema: A Double-blinded Crossover Study

    PubMed Central

    Kim, Duk Han; Lee, Hyun Jong; Park, Chun Wook; Kim, Kyu Han; Lee, Kwang Hoon; Ro, Byung In

    2013-01-01

    Background Topical application of corticosteroids also has an influence on skin barrier impairment. Physiological lipid mixtures, such as multi-lamellar emulsion (MLE) containing a natural lipid component leads to effective recovery of the barrier function. Objective The purpose of this study was to conduct an evaluation of the therapeutic efficacy and skin barrier protection of topical mometasone furoate in MLE. Methods A multi-center randomized, double-blind, controlled study was performed to assess the efficacy and safety of mometasone furoate cream in MLE for Korean patients with eczema. The study group included 175 patients with eczema, who applied either mometasone furoate in MLE cream or methylprednisolone aceponate cream for 2 weeks. Treatment efficacy was evaluated using the physician's global assessment of clinical response (PGA), trans-epidermal water loss (TEWL), and visual analogue scale (VAS) for pruritus. Patients were evaluated using these indices at days 4, 8, and 15. Results Comparison of PGA score, TEWL, and VAS score at baseline with those at days 4, 8, and 15 of treatment showed a significant improvement in both groups. Patients who applied mometasone furoate in MLE (74.8%) showed better results (p<0.05) than those who applied methylprednisolone aceponate (47.8%). The TEWL improvement ratio was higher in the mometasone furoate in MLE group than that in the methylprednisolone aceponate group, and VAS improvement was also better in the mometasone furoate in MLE group. Conclusion Mometasone furoate in MLE has a better therapeutic efficacy as well as less skin barrier impairment than methylprednisolone aceponate. PMID:23467551

  3. The role of patient isolation and compliance with isolation practices in the control of nosocomial MRSA in acute care.

    PubMed

    Halcomb, Elizabeth J; Griffiths, Rhonda; Fernandez, Ritin

    2008-06-01

    Background? Nosocomial infection remains the most common complication of hospitalisation. Despite infection control efforts, nosocomial methicillin resistant Staphylococcus aureus (MRSA) transmission continues to rise. Various isolation practices are used to minimise MRSA transmission in acute care. However, the effectiveness of these practices has seldom been evaluated. Objectives? This review sought to evaluate the efficacy of isolation practices in minimising MRSA transmission in the acute hospital setting and explore staff, visitor and patient compliance with isolation practices. This review updates a review published in 2002. Search strategy? A systematic search for relevant published or unpublished English language literature was undertaken using electronic databases, the reference lists of retrieved papers and the Internet. This extended the search published in the original review. Databases searched included: Medline, CINAHL, EMBASE, Cochrane Library and Joanna Briggs Institute Evidence Library. Selection criteria? All English language research reports published between 1990 and August 2005 that focused on the role of isolation practices on the nosocomial transmission of MRSA in adult, paediatric or neonatal acute care settings were eligible for inclusion in the review. Studies that evaluated multiple infection control strategies or control of MRSA outbreaks were excluded. The main outcome of interest was the incidence of new cases of MRSA. The secondary outcome was staff, visitor and patient compliance with the isolation practices. Data collection and analysis? Two reviewers assessed each paper against the inclusion criteria and a validated quality scale. Data extraction was undertaken using a tool designed specifically for this review. Statistical comparisons of findings were not possible, so findings are presented in a narrative form. Results? Seven studies met the inclusion criteria. Given the small number of included studies and variable methodological quality, care must be taken when interpreting the review findings. There is some evidence that cessation of single room isolation and cohorting of MRSA patients does not increase nosocomial MRSA transmission when hand-washing compliance and standard precautions are maintained. Indeed, there is some evidence that reduced MRSA transmission can be achieved by improving compliance with contact precautions alone. The low level of hand hygiene compliance reported in the literature suggests that staff compliance with isolation practices is a significant factor in evaluating any infection-controlled intervention in the clinical setting. While staff compliance data are conflicting, regular audit and feedback of performance may improve compliance. Implications for clinical practice? The heterogeneous nature of the topic and methodological weaknesses of included studies impairs the ability to aggregate data and develop specific practice recommendations. While this review presents evidence to suggest that ceasing single room or cohort isolation does not lead to increased MRSA transmission, these studies maintained high levels of hand hygiene or standard precautions. Additionally, the role of extraneous factors, such as environmental reservoirs, specific MRSA strains and patient mix, is unclear. None of the included studies measured financial, social or psychological factors associated with isolation practices. There is an urgent need for well-designed research with significant sample sizes to develop an evidence base upon which to underpin future clinical practice. PMID:21631821

  4. The longitudinal prevalence of MRSA in care home residents and the effectiveness of improving infection prevention knowledge and practice on colonisation using a stepped wedge study design

    PubMed Central

    Horner, C; Barr, B; Hall, D; Hodgson, G; Parnell, P; Tompkins, D

    2012-01-01

    Objectives To determine the prevalence and health outcomes of meticillin-resistant Staphylococcus aureus (MRSA) colonisation in elderly care home residents. To measure the effectiveness of improving infection prevention knowledge and practice on MRSA prevalence. Setting Care homes for elderly residents in Leeds, UK. Participants Residents able to give informed consent. Design A controlled intervention study, using a stepped wedge design, comprising 65 homes divided into three groups. Baseline MRSA prevalence was determined by screening the nares of residents (n=2492). An intervention based upon staff education and training on hand hygiene was delivered at three different times according to group number. Scores for three assessment methods, an audit of hand hygiene facilities, staff hand hygiene observations and an educational questionnaire, were collected before and after the intervention. After each group of homes received the intervention, all participants were screened for MRSA nasal colonisation. In total, four surveys took place between November 2006 and February 2009. Results MRSA prevalence was 20%, 19%, 22% and 21% in each survey, respectively. There was a significant improvement in scores for all three assessment methods post-intervention (p?0.001). The intervention was associated with a small but significant increase in MRSA prevalence (p=0.023). MRSA colonisation was associated with previous and subsequent MRSA infection but was not significantly associated with subsequent hospitalisation or mortality. Conclusions The intervention did not result in a decrease in the prevalence of MRSA colonisation in care home residents. Additional measures will be required to reduce endemic MRSA colonisation in care homes. PMID:22240647

  5. Studying the time trend of Methicillin-resistant Staphylococcus aureus (MRSA) in Norway by use of non-stationary ?-Poisson distributions

    PubMed Central

    Moxnes, John F; Moen, Aina E Fossum; Leegaard, Truls Michael

    2015-01-01

    Objectives Study the time development of methicillin-resistant Staphylococcus aureus (MRSA) and forecast future behaviour. The major question: Is the number of MRSA isolates in Norway increasing and will it continue to increase? Design Time trend analysis using non-stationary ?-Poisson distributions. Setting Two data sets were analysed. The first data set (data set I) consists of all MRSA isolates collected in Oslo County from 1997 to 2010; the study area includes the Norwegian capital of Oslo and nearby surrounding areas, covering approximately 11% of the Norwegian population. The second data set (data set II) consists of all MRSA isolates collected in Health Region East from 2002 to 2011. Health Region East consists of Oslo County and four neighbouring counties, and is the most populated area of Norway. Participants Both data sets I and II consist of all persons in the area and time period described in the Settings, from whom MRSA have been isolated. Primary and secondary outcome measures MRSA infections have been mandatory notifiable in Norway since 1995, and MRSA colonisation since 2004. In the time period studied, all bacterial samples in Norway have been sent to a medical microbiological laboratory at the regional hospital for testing. In collaboration with the regional hospitals in five counties, we have collected all MRSA findings in the South-Eastern part of Norway over long time periods. Results On an average, a linear or exponential increase in MRSA numbers was observed in the data sets. A Poisson process with increasing intensity did not capture the dispersion of the time series, but a ?-Poisson process showed good agreement and captured the overdispersion. The numerical model showed numerical internal consistency. Conclusions In the present study, we find that the number of MRSA isolates is increasing in the most populated area of Norway during the time period studied. We also forecast a continuous increase until the year 2017. PMID:26438133

  6. Isolation of a small molecule with anti-MRSA activity from a mangrove symbiont Streptomyces sp. PVRK-1 and its biomedical studies in Zebrafish embryos

    PubMed Central

    Kannan, Rajaretinam Rajesh; Iniyan, Appadurai Muthamil; Prakash, Vincent Samuel Gnana

    2011-01-01

    Objective The aim of the present study was to isolate the anti-MRSA (Methicillin Resistant Staphylococcus aureus) molecule from the Mangrove symbiont Streptomyces and its biomedical studies in Zebrafish embryos. Methods MRSA was isolated from the pus samples of Colachal hospitals and confirmed by amplification of mecA gene. Anti-MRSA molecule producing strain was identified by 16s rRNA gene sequencing. Anti-MRSA compound production was optimized by Solid State Fermentation (SSF) and the purification of the active molecule was carried out by TLC and RP-HPLC. The inhibitory concentration and LC50 were calculated using Statistical software SPSS. The Biomedical studies including the cardiac assay and organ toxicity assessment were carried out in Zebrafish. Results The bioactive anti-MRSA small molecule A2 was purified by TLC with Rf value of 0.37 with 1.389 retention time at RP-HPLC. The Inhibitory Concentration of the purified molecule A2 was 30 µg/mL but, the inhibitory concentration of the MRSA in the infected embryo was 32-34 µg/mL for TLC purified molecule A2 with LC50 mean value was 61.504 µg/mL. Zebrafish toxicity was assessed in 48-60 µg/mL by observing the physiological deformities and the heart beat rates (HBR) of embryos for anti MRSA molecule showed the mean of 41.33-41.67 HBR/15 seconds for 40 µg/mL and control was 42.33-42.67 for 15 seconds which significantly showed that the anti-MRSA molecule A2 did not affected the HBR. Conclusions Anti-MRSA molecule from Streptomyces sp PVRK-1 was isolated and biomedical studies in Zebrafish model assessed that the molecule was non toxic at the minimal inhibitory concentration of MRSA. PMID:23569790

  7. Asthma, Allergy and Eczema among Adults in Multifamily Houses in Stockholm (3-HE Study) - Associations with Building Characteristics, Home Environment and Energy Use for Heating

    PubMed Central

    Norbäck, Dan; Lampa, Erik; Engvall, Karin

    2014-01-01

    Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings) were invited (one subject/dwelling) and 7,554 participated (73%). Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR?=?1.74) and mould odour (OR?=?1.79). Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR?=?1.45) and was associated with redecoration (OR?=?1.48) and mould odour (OR?=?2.35). Pollen allergy was less common in buildings using more energy for heating (OR?=?0.75) and was associated with humid air (OR?=?1.76) and mould odour (OR?=?2.36). Eczema was more common in larger buildings (OR 1.07) and less common in buildings using more energy for heating (OR?=?0.85) and was associated with water damage (OR?=?1.47), humid air (OR?=?1.73) and mould odour (OR?=?2.01). Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR?=?0.49; 95% CI 0.29–0.82). Pollen allergy was less common if the building maintenance was outsourced (OR?=?0.67; 95% CI 0.51–0.88). Eczema was more common when management accessibility was only at the division level (OR?=?1.49; 95% CI 1.06–2.11). In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness. Energy saving may have consequences for allergy and eczema. More epidemiological studies are needed on building management organization. PMID:25479551

  8. Ceftobiprole: a review of a broad-spectrum and anti-MRSA cephalosporin.

    PubMed

    Zhanel, George G; Lam, Ashley; Schweizer, Frank; Thomson, Kristjan; Walkty, Andrew; Rubinstein, Ethan; Gin, Alfred S; Hoban, Daryl J; Noreddin, Ayman M; Karlowsky, James A

    2008-01-01

    Ceftobiprole, an investigational cephalosporin, is currently in phase III clinical development. Ceftobiprole is a broad-spectrum cephalosporin with demonstrated in vitro activity against Gram-positive cocci, including meticillin-resistant Staphylococcus aureus (MRSA) and meticillin-resistant S. epidermidis, penicillin-resistant S. pneumoniae, Enterococcus faecalis, Gram-negative bacilli including AmpC-producing Escherichia coli and Pseudomonas aeruginosa, but excluding extended-spectrum beta-lactamase-producing strains. Like cefotaxime, ceftriaxone, ceftazidime, and cefepime, ceftobiprole demonstrates limited activity against anaerobes such as Bacteroides fragilis and non-fragilis Bacteroides spp. In single-step and serial passage in vitro resistance development studies, ceftobiprole demonstrated a low propensity to select for resistant subpopulations. Ceftobiprole, like cefepime, is a weak inducer and a poor substrate for AmpC beta-lactamases.Ceftobiprole medocaril, the prodrug of ceftobiprole, is converted by plasma esterases to ceftobiprole in <30 minutes. Peak serum concentrations of ceftobiprole observed at the end of a single 30-minute infusion were 35.5 mug/mL for a 500-mg dose and 59.6 mug/mL for a 750-mg dose. The volume of distribution of ceftobiprole is 0.26 L/kg ( approximately 18 L), protein binding is 16%, and its serum half-life is approximately 3.5 hours. Ceftobiprole is renally excreted ( approximately 70% in the active form) and systemic clearance correlates with creatinine clearance, meaning that dosage adjustment is required in patients with renal dysfunction. Ceftobiprole has a modest post-antibiotic effect (PAE) of approximately 0.5 hours for MRSA and a longer PAE of approximately 2 hours for penicillin-resistant pneumococci. Ceftobiprole, when administered intravenously at 500 mg once every 8 hours (2-hour infusion), has a >90% probability of achieving f T(>MIC) (free drug concentration exceeds the minimum inhibitory concentration [MIC]) for 40% and 60%, respectively, of the dosing interval for isolates with ceftobiprole MIC < or =4 and < or =2 mg/L, respectively.Currently, only limited clinical trial data are published for ceftobiprole. In a phase III trial, 784 patients with Gram-positive skin infections were randomized to treatment with either ceftobiprole 500 mg or vancomycin 1 g, each administered twice daily for 7-14 days; 93.3% of patients were clinically cured with ceftobiprole compared with 93.5% receiving vancomycin, and the eradication rate for MRSA infections was 91.8% for ceftobiprole compared with 90% for vancomycin. A phase III, randomized, double-blind, multicenter trial compared ceftobiprole 500 mg every 8 hours with vancomycin 1 g every 12 hours plus ceftazidime 1 g every 8 hours in patients with complicated skin and skin structure infections. Of the 828 patients enrolled, 31% had diabetic foot infections, 30% had abscesses, and 22% had wounds. No difference in clinical cure was reported in the clinically evaluable, intent-to-treat and microbiologically evaluable populations with cure rates of 90.5%, 81.9%, and 90.8%, respectively, in the ceftobiprole-treated patients and 90.2%, 80.8%, and 90.5%, respectively, in the vancomycin plus ceftazidime-treated group. Microbiologic eradication of Gram-positive cocci meticillin-susceptible S. aureus (MSSA) [ceftobiprole 91% vs vancomycin plus ceftazidime 92%] and MRSA (ceftobiprole 87% vs vancomycin plus ceftazidime 80%), as well as Gram-negative bacilli, E. coli (ceftobiprole 89% vs vancomycin plus ceftazidime 92%), and P. aeruginosa (ceftobiprole 87% vs vancomycin plus ceftazidime 100%), was not significantly different between groups. Similar cures rates in the microbiologically evaluable population occurred in both groups for Panton-Valentine leukocidin (PVL)-positive MSSA and PVL-positive MRSA.Currently, ceftobiprole has completed phase III trials for complicated skin and skin structure infections due to MRSA and nosocomial pneumonia due to suspected or proven MRSA; phase III trials are also ongoing in community-acquired

  9. MRSA Carriage in Community Outpatients: A Cross-Sectional Prevalence Study in a High-Density Livestock Farming Area along the Dutch-German Border

    PubMed Central

    Paget, John; Aangenend, Helen; Kühn, Malte; Hautvast, Jeannine; van Oorschot, Desiree; Olde Loohuis, Alphons; van der Velden, Koos; Friedrich, Alexander W.; Voss, Andreas; Köck, Robin

    2015-01-01

    Objectives MRSA poses a considerable public health threat to the community. The objectives of this study were to assess the prevalence of MRSA carriage and determine factors that were associated with MRSA carriage among outpatients who had used antibiotics in the previous three months and who lived in a high-density livestock farming area along the Dutch-German border. Methods Cross-sectional prevalence study carried out between November 2011 and June 2012. Nasal swabs and questionnaires were collected in patients (>4 years) who had used antibiotics in the previous three months from twelve Dutch General Practitioners (GPs), seven German GPs and two German outpatient urologists. To assess nasal carriage, swabs were analyzed using selective MRSA agars after broth enrichment. MRSA positive samples were spa typed. Results Data were collected from 513 GP outpatients in the Netherlands, 261 GP outpatients in Germany and 200 urologist outpatients in Germany. The overall prevalence of MRSA carriage was 0.8%, 1.1% and 2.0%, respectively. In the GP outpatient populations, the prevalence was similar in both countries (0.8% and 1.1%, respectively, p = 0.879), all spa types were indicative for livestock-associated MRSA (4xt011 in the Netherlands; 2xt034 and t011 in Germany) and being a farmer, living on or near (<5km) to a farm were associated with MRSA carriage. In the urologist outpatient population, the prevalence was higher (2.0%), all spa types were indicative for healthcare-associated MRSA (t068, t032, t003, t10231) and being a farmer, living on or near to a farm were factors not associated with MRSA carriage. Conclusions The prevalence of MRSA carriage in these community outpatient populations along the Dutch-German border was low. There were striking similarities in livestock-associated MRSA carriage and clonal spread in the outpatient populations seeing their GP in both countries. In contrast, urologist outpatients in Germany were colonized with spa types indicative of healthcare-associated MRSA. PMID:26619190

  10. Comparative Evaluation of Three Chromogenic Media Combined with Broth Enrichment and the Real-Time PCR-Based Xpert MRSA Assay for Screening of Methicillin-Resistant Staphylococcus aureus in Nasal Swabs

    PubMed Central

    Lee, Seungok; Park, Kang-Gyun; Jekarl, Dong Wook; Chae, Hyojin; Yoo, Jin-Kyung; Seo, Sin Won; Choi, Jung Eun; Lim, Jung Hye; Heo, Seon Mi; Seo, Ju Hee

    2013-01-01

    Background We evaluated the performance of three chromogenic media (Brilliance agar I [Oxoid, UK], Brilliance agar II [Oxoid], and ChromID MRSA [Biomérieux, France]) combined with broth enrichment and the Xpert MRSA assay for screening of methicillin-resistant Staphylococcus aureus (MRSA). Methods We obtained 401 pairs of duplicate nasal swabs from 321 patients. One swab was suspended overnight in tryptic soy broth; 50-µL aliquots of suspension were inoculated on the three chromogenic media. Brilliance agar I and II were examined after 24 hr, and ChromID MRSA, after 24 and 48 hr. The paired swab was processed directly using real-time PCR-based Xpert MRSA assay. Results True positives, designated as MRSA growth in any of the culture media, were detected with the prevalence of 17% in our institution. We report the sensitivity, specificity, positive predictive value, and negative predictive value of MRSA growth as follows: 92.3%, 94.0%, 75.9%, and 98.4% in Brilliance agar I (24 hr); 92.7%, 97.9%, 90.0%, and 98.5% in Brilliance agar II (24 hr); 95.6%, 95.8%, 82.3%, and 99.1% in ChromID MRSA (24 hr); 100%, 92.5%, 73.1%, and 100% in ChromID MRSA (48 hr); 92.6%, 96.7%, 85.1%, and 98.5% in Xpert MRSA assay. The agreement between the enriched culture and Xpert MRSA assay was 96.0%. Conclusions Three chromogenic culture media combined with enrichment and Xpert MRSA assay demonstrated similar capabilities in MRSA detection. The Xpert MRSA assay yielded results comparable to those of culture methods, saving 48-72 hr, thus facilitating earlier detection of MRSA in healthcare settings. PMID:23826561

  11. Efficacy of Caltropis procera and Ficus sycomorus extracts in treating MRSA (methicillin-resistant Staphylococcus aureus)-keratitis in rabbit

    PubMed Central

    Sayed, Waiel F.; Salem, Wesam M. A.; Haridy, Mohie A. M.; Hassan, Ne'mat H.

    2015-01-01

    MRSA-induced keratitis in rabbit was used to evaluate the therapeutic effect of F. sycomorus leaves and C. procera latex extracts. Within the 6 rabbit groups tested, group 1 received sterilized saline, while other groups (2 to 6) received 100 ?l of intrastromal injections of 1.5×103 colony forming unit (cfu) ml-1 of methicillin-resistant Staphylococcus aureus (MRSA). After 12 hours, groups 3 to 6 also received chloramphenicol, aqueous extract of C. procera latex, aqueous and alcoholic extracts of F. sycomorus leaves, respectively 3 times daily for 12 successive days. The tested extracts inhibited MRSA growth in vitro (i.e. on culture medium). Colony counts in cornea discs from groups 3 to 6 were significantly reduced (P ? 0.001) compared to group 2 (untreated). Clinical signs of keratitis were observed on group 2 until the end of experiment. In groups 3 to 6, gradual recovery was observed and signs disappeared by the 12th DPI (days post inoculation). Only mild symptoms persisted in group 5 (aqueous extract of leaves). In group 3 and 5, cornea, iris, ciliary body and conjunctiva showed mild leukocytic infiltration and depigmentation of melanin cells while recovery of cornea and iris was observed in groups 4 and 6. In conclusion, the used extracts have potential therapeutic effects on MRSA-induced keratitis in rabbit. PMID:26648824

  12. Antimicrobial activities of bacteriocins E50-52 and B602 against MRSA and other nosocomial infections

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to determine the antimicrobial activities of previously published bacteriocins E50-52 and B602 against methicillin resistant Staphylococcus aureus (MRSA) and other prominent nosocomial bacterial infections. methods: Several Russian hospitals were enlisted into the study from 2003 ...

  13. Chloramphenicol encapsulated in poly-?-caprolactone–pluronic composite: nanoparticles for treatment of MRSA-infected burn wounds

    PubMed Central

    Kalita, Sanjeeb; Devi, Banasmita; Kandimalla, Raghuram; Sharma, Kaustav Kalyan; Sharma, Arup; Kalita, Kasturi; Kataki, Amal Chandra; Kotoky, Jibon

    2015-01-01

    The emergence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased precipitously over the past several decades, with far-reaching health care and societal costs. MRSA infections in the context of burn wounds lead to invasive disease that could potentially cause mortality. Chloramphenicol is a well-known broad-spectrum bacteriostatic antibiotic that has been used since 1949, but due to its hydrophobicity, poor penetration in skin, fast degradation, and toxicity, its application has been hindered. Furthermore, it has been demonstrated that old antibiotics such as chloramphenicol remained active against a large number of currently prevalent resistant bacterial isolates due to their low-level use in the past. Recently, the novel nanoparticulate drug-delivery system has been used and reported to be exceptionally useful for topical therapeutics, due to its distinctive physical characteristics such as a high surface-to-volume ratio and minuscule size. It helps to achieve better hydrophilicity, bioavailability, and controlled delivery with enhanced therapeutic index, which has resulted in decreased toxicity levels compared to the crude drug. Here, we report a novel chloramphenicol loaded with poly(?-caprolactone) (PCL)-pluronic composite nanoparticles (CAM-PCL-P NPs), physicochemical characterizations, and its bioactivity evaluation in a MRSA-infected burn-wound animal model. CAM-PCL-P NPs could encapsulate 98.3% of the drug in the nanoparticles and release 81% of the encapsulated drug over 36 days with a time to 50% drug release of 72 hours (51%). Nanoparticle suspensions maintained the initial properties with respect to size and encapsulation efficiency, even after 6 months of storage at 4°C and 25°C, respectively (P>0.05). Significant reduction in the level of toxicity was observed for CAM-PCL-P NPs compared with that of free drug as confirmed from hemolytic activity against human blood erythrocytes and cytotoxicity assay against an MCF-7 breast cancer cell line. In vitro antibacterial activities were performed by zone of inhibition, minimum inhibitory concentrations, minimum bacterial concentration, and time-kill assays, which showed that CAM-PCL-P NPs exhibited significantly enhanced anti-MRSA activity against ten clinical isolates of MRSA strains. The augmented activity of CAM-PCL-P NPs was further tested on a MRSA-infected burn-wound animal model and achieved quicker efficacy in MRSA clearance and improved the survival rate compared with free-chloramphenicol treatment. Thus, we propose CAM-PCL-P NPs as a promising novel antimicrobial candidate that may have a good potential for preclinical applications. PMID:25931822

  14. Daptomycin versus vancomycin for osteoarticular infections due to methicillin-resistant Staphylococcus aureus (MRSA): a nested case-control study.

    PubMed

    Liang, S Y; Khair, H N; McDonald, J R; Babcock, H M; Marschall, J

    2014-04-01

    Vancomycin is the standard antibiotic for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. While daptomycin is approved for MRSA bacteremia, its effectiveness in osteoarticular infections (OAIs) has not been established. A 1:2 nested case-control study of adult patients with MRSA OAIs admitted to an academic center from 2005 to 2010 was carried out. Clinical outcomes and drug toxicity in patients treated with daptomycin versus vancomycin were compared. Twenty patients with MRSA OAIs treated with daptomycin were matched to 40 patients treated with vancomycin. The median age of the patients was 52 years (range, 25-90), and 40 (67%) were male. Most patients had osteomyelitis (82%), predominantly from a contiguous source (87%). Forty percent were diabetics. Diabetic patients were more likely to receive vancomycin than daptomycin [20 (50%) vs. 4 (20%); p = 0.03]. Vancomycin was more often combined with antibiotics other than daptomycin [22 (55%) vs. 5 (25%); p = 0.03]. The median total antibiotic treatment duration was 48 (daptomycin) vs. 46 days (vancomycin) (p = 0.5). Ninety percent of daptomycin-treated patients had previously received vancomycin for a median of 14.5 days (range, 2-36). Clinical success rates were similar between daptomycin and vancomycin at 3 months [15 (75%) vs. 27 (68%); p = 0.8] and 6 months [14 (70%) vs. 23 (58%); p = 0.5], even after propensity score-based adjustment for antibiotic assignment. The frequency of adverse events was similar between treatment groups [1 (5%) vs. 7 (18%); p = 0.2]. Daptomycin and vancomycin achieved similar rates of clinical success and drug tolerability. Daptomycin is a reasonable alternative for treating MRSA OAIs, particularly in patients where therapy with vancomycin has not been well tolerated. PMID:24186726

  15. Comparative activity of oritavancin against meticillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates from Geneva University Hospital.

    PubMed

    Vaudaux, Pierre; Huggler, Elzbieta; Arhin, Francis F; Moeck, Gregory; Renzoni, Adriana; Lew, Daniel P

    2009-12-01

    In this study, we assessed by broth microdilution the in vitro activity of oritavancin, a semisynthetic lipoglycopeptide currently under development, against selected meticillin-resistant Staphylococcus aureus (MRSA) bloodstream isolates (n=56) from Geneva University Hospital, Switzerland, displaying a wide range of vancomycin minimum inhibitory concentrations (MICs) (0.25-4 microg/mL). The MRSA resistance phenotype was confirmed by broth microdilution (oxacillin MIC > or = 4 microg/mL) for all isolates; 89% and 100% of the tested isolates were also resistant to erythromycin and ciprofloxacin, respectively. For 53 MRSA isolates for which vancomycin MICs were in the susceptible range (0.5-2.0 microg/mL), the oritavancin MICs ranged from 0.03 microg/mL to 0.5 microg/mL. For these 53 vancomycin-susceptible isolates, the cumulative distribution of oritavancin MICs was markedly different from those of vancomycin, teicoplanin, daptomycin and linezolid MICs, yielding an oritavancin MIC for 90% of the organisms (MIC(90)) (0.25 microg/mL) that was four times lower than the MIC(90) values (1 microg/mL) of comparators. For three MRSA isolates with a vancomycin-intermediate phenotype (vancomycin MIC=4 microg/mL), oritavancin MICs (0.5-1.0 microg/mL) were 2-4-fold lower than vancomycin, teicoplanin or daptomycin MICs, but were equivalent to linezolid MICs. Pairwise comparison for each bloodstream isolate showed that oritavancin was > or =4-fold more active than vancomycin, teicoplanin and daptomycin, against 86%, 75% and 59% of all MRSA isolates, respectively. PMID:19744838

  16. Antibacterial Evaluation of Synthetic Thiazole Compounds In Vitro and In Vivo in a Methicillin-Resistant Staphylococcus aureus (MRSA) Skin Infection Mouse Model

    PubMed Central

    Mohammad, Haroon; Cushman, Mark; Seleem, Mohamed N.

    2015-01-01

    The emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA), including strains resistant to current antibiotics, has contributed to an increase in the number of skin infections reported in humans in recent years. New therapeutic options are needed to counter this public health challenge. The aim of the present study was to examine the potential of thiazole compounds synthesized by our research group to be used topically to treat MRSA skin and wound infections. The broth microdilution method confirmed that the lead thiazole compound and four analogues are capable of inhibiting MRSA growth at concentrations as low as 1.3 ?g/mL. Additionally, three compounds exhibited a synergistic relationship when combined with the topical antibiotic mupirocin against MRSA in vitro via the checkerboard assay. Thus the thiazole compounds have potential to be used alone or in combination with mupirocin against MRSA. When tested against human keratinocytes, four derivatives of the lead compound demonstrated an improved toxicity profile (were found to be non-toxic up to a concentration of 20 ?g/mL). Utilizing a murine skin infection model, we confirmed that the lead compound and three analogues exhibited potent antimicrobial activity in vivo, with similar capability as the antibiotic mupirocin, as they reduced the burden of MRSA present in skin wounds by more than 90%. Taken altogether, the present study provides important evidence that these thiazole compounds warrant further investigation for development as novel topical antimicrobials to treat MRSA skin infections. PMID:26536129

  17. Isolation of Methicillin-Resistant Staphylococcus aureus (MRSA) from HIV Patients Referring to HIV Referral Center, Shiraz, Iran, 2011-2012

    PubMed Central

    Hassanzadeh, Parvin; Hassanzadeh, Yashgin; Mardaneh, Jalal; Rezai, Esmaeel; Motamedifar, Mohammad

    2015-01-01

    Extension of drug resistant Staphylococcus aureus strains is one of the problems of modern society. Presence of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected individuals is an important cause of severe infections. Therefore, the main goal of this study was to determine the prevalence rate of MRSA carriage rate among HIV patients referring to the Shiraz HIV referral center (Shiraz, Iran) during 2011-2012. Nasal swabs were obtained from HIV positive patients and were cultured on differential and selective media to isolate Staphylococcus aureus, which was confirmed by standard biochemical tests. For isolation of MRSA isolates, bacterial suspensions were cultured on Muller-Hinton Agar containing NaCl and Oxacillin. Finally, data were analyzed by the SPSS software. Of 180 HIV patients, MRSA was isolated from nasal cavity of 23 (12.8%) patients. Most of the isolates were recovered from male subjects who were under 40 years old. No variables such as skin disease, history of hospitalization or infectious disease had significant association with the MRSA colonization rate. The presence of MRSA isolates in the nasal cavity of HIV patients in such a rate warns us about the potential spreading of MRSA among HIV patients in our society and emphasizes on establishing better prevention strategies. PMID:26538782

  18. Isolation of Methicillin-Resistant Staphylococcus aureus (MRSA) from HIV Patients Referring to HIV Referral Center, Shiraz, Iran, 2011-2012.

    PubMed

    Hassanzadeh, Parvin; Hassanzadeh, Yashgin; Mardaneh, Jalal; Rezai, Esmaeel; Motamedifar, Mohammad

    2015-11-01

    Extension of drug resistant Staphylococcus aureus strains is one of the problems of modern society. Presence of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected individuals is an important cause of severe infections. Therefore, the main goal of this study was to determine the prevalence rate of MRSA carriage rate among HIV patients referring to the Shiraz HIV referral center (Shiraz, Iran) during 2011-2012. Nasal swabs were obtained from HIV positive patients and were cultured on differential and selective media to isolate Staphylococcus aureus, which was confirmed by standard biochemical tests. For isolation of MRSA isolates, bacterial suspensions were cultured on Muller-Hinton Agar containing NaCl and Oxacillin. Finally, data were analyzed by the SPSS software. Of 180 HIV patients, MRSA was isolated from nasal cavity of 23 (12.8%) patients. Most of the isolates were recovered from male subjects who were under 40 years old. No variables such as skin disease, history of hospitalization or infectious disease had significant association with the MRSA colonization rate. The presence of MRSA isolates in the nasal cavity of HIV patients in such a rate warns us about the potential spreading of MRSA among HIV patients in our society and emphasizes on establishing better prevention strategies. PMID:26538782

  19. MRSA-Infected External Iliac Artery Pseudoaneurysm Treated with Endovascular Stenting

    SciTech Connect

    Clarke, M.G.; Thomas, H.G. Chester, J.F.

    2005-04-15

    A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacements at aged 23 and six years later had the right knee prosthesis removed for infection, with subsequent osteomyelitis of the femoral shaft and right total hip prosthesis disruption. Peripheral arteriography was performed in view of persistent bleeding from the sinus, which revealed a 6 cm false aneurysm filling from and compressing the right external iliac artery (EIA). A PTFE-covered, balloon expandable JOSTENT was deployed in the right EIA, successfully excluding the false aneurysm and preventing further bleeding from the sinus. No graft infection was reported at 12 months. This case illustrates the potential use of endovascular stent-grafting in the treatment of an infected pseudoaneurysm.

  20. Use of Longitudinal Dose–Response Modeling to Support the Efficacy and Tolerability of Alitretinoin in Severe Refractory Chronic Hand Eczema (CHE)

    PubMed Central

    Schmith, GD; Singh, R; Gomeni, R; Graff, O; Hamedani, AG; Troughton, JS; Learned, SM

    2015-01-01

    Longitudinal dose–response analyses of alitretinoin (an investigational agent in the US) were conducted to supplement results from phase III studies in severe, refractory chronic hand eczema, with objectives to address several outstanding development issues (e.g., optimal dose, possible factors affecting efficacy and/or tolerability). Models were fitted to the physicians' global assessment score and triglycerides over time. Five hundred trials were simulated to evaluate the relevance of findings. Analyses clarified that the optimal dose of alitretinoin was 30 mg once daily, where response rates were ?10% over placebo at 12 weeks and increased by 5–7% over placebo for every 4 weeks thereafter, for up to 24 weeks. Elderly subjects had higher magnitudes of efficacy and an increased probability of high triglycerides. Results from analyses sufficiently addressed the development issues, thereby adding to the weight of evidence supporting the efficacy and safety of alitretinoin in the treatment of severe, refractory chronic hand eczema. PMID:26225249

  1. Quantifying Type-Specific Reproduction Numbers for Nosocomial Pathogens: Evidence for Heightened Transmission of an Asian Sequence Type 239 MRSA Clone

    PubMed Central

    Cooper, Ben S.; Kypraios, Theodore; Batra, Rahul; Wyncoll, Duncan; Tosas, Olga; Edgeworth, Jonathan D.

    2012-01-01

    An important determinant of a pathogen's success is the rate at which it is transmitted from infected to susceptible hosts. Although there are anecdotal reports that methicillin-resistant Staphylococcus aureus (MRSA) clones vary in their transmissibility in hospital settings, attempts to quantify such variation are lacking for common subtypes, as are methods for addressing this question using routinely-collected MRSA screening data in endemic settings. Here we present a method to quantify the time-varying transmissibility of different subtypes of common bacterial nosocomial pathogens using routine surveillance data. The method adapts approaches for estimating reproduction numbers based on the probabilistic reconstruction of epidemic trees, but uses relative hazards rather than serial intervals to assign probabilities to different sources for observed transmission events. The method is applied to data collected as part of a retrospective observational study of a concurrent MRSA outbreak in the United Kingdom with dominant endemic MRSA clones (ST22 and ST36) and an Asian ST239 MRSA strain (ST239-TW) in two linked adult intensive care units, and compared with an approach based on a fully parametric transmission model. The results provide support for the hypothesis that the clones responded differently to an infection control measure based on the use of topical antiseptics, which was more effective at reducing transmission of endemic clones. They also suggest that in one of the two ICUs patients colonized or infected with the ST239-TW MRSA clone had consistently higher risks of transmitting MRSA to patients free of MRSA. These findings represent some of the first quantitative evidence of enhanced transmissibility of a pandemic MRSA lineage, and highlight the potential value of tailoring hospital infection control measures to specific pathogen subtypes. PMID:22511854

  2. Association of prevalence of rhinitis, atopic eczema, rhinoconjunctivitis and wheezing with mortality from infectious diseases and with antibiotic susceptibility at a country level

    PubMed Central

    Fsadni, Peter; Fava, Stephen; Montefort, Stephen

    2015-01-01

    Background It was previously reported that there is a positive correlation between incidence of type 1 diabetes and prevalence of asthma and atopic eczema. A negative correlation between the prevalence of type 1 diabetes and mortality from infectious diseases as well as a positive correlation with antibiotic susceptibility at a country level have also been reported. Objective The aim of this study was to investigate the association between country prevalence of rhinitis, atopic eczema, rhinoconjunctivitis, and wheezing with mortality from infectious diseases and also with antibiotic susceptibility at a country level. Methods Data for prevalence of rhinitis, eczema, rhinoconjunctivitis, and wheezing was obtained from the International Study of Asthma and Allergies in Childhood study (ISAAC). ISAAC Phase one was a multicentre multicountry cross sectional study involving over 700,000 children in 2 age groups of school children, 13-14 years old (adolescents) and 6-7 years old (children) in 156 centres from 56 countries. Mortality from infectious diseases was taken from World Health Organisation data. The Alexander project was used to identify antibiotic susceptibilities to common bacteria. Results There were significant positive correlations between atopic eczema and mortality from all infectious diseases studied, diarrhoeal illness, tropical infections, and childhood infections. A negative correlation exists between the prevalence of rhinitis and Streptococcus pneumoniae susceptibility to penicillin and to erythromycin, rhinitis and Haemophilus influenzae susceptibility to ampicillin and between rhinoconjunctivitis and H. influenzae susceptibility to ampicillin. Conclusion Th1/Th2 responses might influence the pathogenesis of infectious disease mortality, while antibiotic overprescription could explain the negative association between atopy and antibiotic susceptibility. PMID:26240791

  3. Skin Barrier Function and Staphylococcus aureus Colonization in Vestibulum Nasi and Fauces in Healthy Infants and Infants with Eczema: A Population-Based Cohort Study

    PubMed Central

    Berents, Teresa Løvold; Carlsen, Karin Cecilie Lødrup; Mowinckel, Petter; Skjerven, Håvard Ove; Kvenshagen, Bente; Rolfsjord, Leif Bjarte; Bradley, Maria; Lieden, Agne; Carlsen, Kai-Håkon; Gaustad, Peter; Gjersvik, Petter

    2015-01-01

    Atopic eczema (AE) is associated with Staphylococcus aureus (S. aureus) colonization and skin barrier dysfunction, often measured by increased transepidermal water loss (TEWL). In the present study, the primary aim was to see whether S. aureus colonization in the vestibulum nasi and/or fauces was associated with increased TEWL in infants with healthy skin and infants with eczema. Secondarily, we aimed to investigate whether TEWL measurements on non-lesional skin on the lateral upper arm is equivalent to volar forearm in infants. In 167 of 240 infants, recruited from the general population, TEWL measurements on the lateral upper arm and volar forearm, using a DermaLab USB, fulfilled our environmental requirements. The mean of three TEWL measurements from each site was used for analysis. The infants were diagnosed with no eczema (n = 110), possible AE (n = 28) or AE (n = 29). DNA samples were analysed for mutations in the filaggrin gene (FLG). Bacterial cultures were reported positive with the identification of at least one culture with S. aureus from vestibulum nasi and/or fauces. S. aureus colonization, found in 89 infants (53%), was not associated with increased TEWL (i.e. TEWL in the upper quartile), neither on the lateral upper arm or volar forearm (p = 0.08 and p = 0.98, respectively), nor with AE (p = 0.10) or FLG mutation (p = 0.17). TEWL was significantly higher on both measuring sites in infants with AE compared to infants with possible AE and no eczema. FLG mutation was significantly associated with increased TEWL, with a 47% difference in TEWL. We conclude that S. aureus in vestibulum nasi and/or fauces was not associated with TEWL, whereas TEWL measurements on the lateral upper arm and volar forearm appear equally appropriate in infants. PMID:26070153

  4. Inhibition of NK cell activity by IL-17 allows vaccinia virus to induce severe skin lesions in a mouse model of eczema vaccinatum

    PubMed Central

    Tomimori, Yoshiaki; Yumoto, Kenji; Hasegawa, Shunji; Ando, Tomoaki; Tagaya, Yutaka; Crotty, Shane; Kawakami, Toshiaki

    2009-01-01

    Threats of bioterrorism have renewed efforts to better understand poxvirus pathogenesis and to develop a safer vaccine against smallpox. Individuals with atopic dermatitis are excluded from smallpox vaccination because of their propensity to develop eczema vaccinatum, a disseminated vaccinia virus (VACV) infection. To study the underlying mechanism of the vulnerability of atopic dermatitis patients to VACV infection, we developed a mouse model of eczema vaccinatum. Virus infection of eczematous skin induced severe primary erosive skin lesions, but not in the skin of healthy mice. Eczematous mice exhibited lower natural killer (NK) cell activity but similar cytotoxic T lymphocyte activity and humoral immune responses. The role of NK cells in controlling VACV-induced skin lesions was demonstrated by experiments depleting or transferring NK cells. The proinflammatory cytokine interleukin (IL)-17 reduced NK cell activity in mice with preexisting dermatitis. Given low NK cell activities and increased IL-17 expression in atopic dermatitis patients, these results can explain the increased susceptibility of atopic dermatitis patients to eczema vaccinatum. PMID:19468065

  5. The epidemiology and experience of atopic eczema during childhood: a discussion paper on the implications of current knowledge for health care, public health policy and research.

    PubMed

    Fennessy, M; Coupland, S; Popay, J; Naysmith, K

    2000-08-01

    Atopic eczema is a chronic skin condition affecting between 5% and 20% of children aged up to 11 years at one time or other. Research suggests that prevalence is increasing and various environmental factors have been implicated in the aetiology. While often seen to be a minor problem, research suggests that it can cause considerable disruption to the lives of children and their carers and involves significant cost for the family and health care systems. The current consensus is that the majority of cases of atopic eczema are most appropriately managed within primary care. However, management of the condition is problematic because diagnosis is often difficult. Consultations tend to focus on the physical aspects of the problems neglecting the psychosocial, while treatment remains mainly palliative and can be as diverse as the condition itself. More appropriate and effective primary care management and support for children with atopic eczema and their carers will only be developed if health professionals become more aware of the social context of the disease and the impact on the lives of those affected. Public health responses focusing on primary prevention are also needed. This paper reviews a diverse literature on the epidemiology of the condition, the way in which it affects the lives of children and their carers and the factors that shape their help seeking decisions. The aim is to contribute to a more substantial knowledge base for public health and primary care developments and to point to areas for future research PMID:10890869

  6. Development of Eczema Vaccinatum in Atopic Mouse Models and Efficacy of MVA Vaccination against Lethal Poxviral Infection

    PubMed Central

    Knitlova, Jarmila; Hajkova, Vera; Voska, Ludek; Elsterova, Jana; Obrova, Barbora; Melkova, Zora

    2014-01-01

    Smallpox vaccine based on live, replicating vaccinia virus (VACV) is associated with several potentially serious and deadly complications. Consequently, a new generation of vaccine based on non-replicating Modified vaccinia virus Ankara (MVA) has been under clinical development. MVA seems to induce good immune responses in blood tests, but it is impossible to test its efficacy in vivo in human. One of the serious complications of the replicating vaccine is eczema vaccinatum (EV) occurring in individuals with atopic dermatitis (AD), thus excluding them from all preventive vaccination schemes. In this study, we first characterized and compared development of eczema vaccinatum in different mouse strains. Nc/Nga, Balb/c and C57Bl/6J mice were epicutaneously sensitized with ovalbumin (OVA) or saline control to induce signs of atopic dermatitis and subsequently trans-dermally (t.d.) immunized with VACV strain Western Reserve (WR). Large primary lesions occurred in both mock- and OVA-sensitized Nc/Nga mice, while they remained small in Balb/c and C57Bl/6J mice. Satellite lesions developed in both mock- and OVA-sensitized Nc/Nga and in OVA-sensitized Balb/c mice with the rate 40–50%. Presence of mastocytes and eosinophils was the highest in Nc/Nga mice. Consequently, we have chosen Nc/Nga mice as a model of AD/EV and tested efficacy of MVA and Dryvax vaccinations against a lethal intra-nasal (i.n.) challenge with WR, the surrogate of smallpox. Inoculation of MVA intra-muscularly (i.m.) or t.d. resulted in no lesions, while inoculation of Dryvax t.d. yielded large primary and many satellite lesions similar to WR. Eighty three and 92% of mice vaccinated with a single dose of MVA i.m. or t.d., respectively, survived a lethal i.n. challenge with WR without any serious illness, while all Dryvax-vaccinated animals survived. This is the first formal prove of protective immunity against a lethal poxvirus challenge induced by vaccination with MVA in an atopic organism. PMID:25486419

  7. Treatment of localized abscesses induced by methicillin-resistant Staphylococcus aureus (MRSA) using MRgFUS: First in vivo results

    NASA Astrophysics Data System (ADS)

    Rieck, Birgit; Curiel, Laura; Mougenot, Charles; Zhang, Kunyan; Pichardo, Samuel

    2012-11-01

    Background. In the present work we study the therapeutic effect of focused ultrasound on localized abscess induced by methicillin-resistant Staphylococcus aureus (MRSA). MRSA is a major nosocomial pathogen in health-care facilities. The people, particularly those who are immunocompromised are prone to develop infectious sites that often are non-responsive to regular treatments. Because of its capability to induce a rise of temperature at a very precise location, the use of focused ultrasound represents a considerable opportunity to propose a new therapy for MRSA-related infections. Methods. A 50?L subcutaneous injection of MRSA strain USA 400 bacteria at a concentration of 7×103/?L was made on the left thigh of BALB/c mice and an abscess of 6±2 mm-length formed after 48hrs. A transducer operating at 3 MHz with a focal length of 50mm and diameter of 32mm was used to treat the abscess. The focal point was positioned 2mm under the skin at the abscess center. Forty-eight hours after injection 4 ultrasound exposures of 9s-each were applied to each abscess under Magnetic Resonance-guidance. Each exposure was followed by a 1 min pause. Real-time estimation of change of temperature was done using a communication toolbox (matMRI) developed in our laboratory. Three experimental groups of 6 animals each were tested: moderate temperature (MT), high temperature (HT) and control. MT and HT groups reached, respectively, 55°C and 65°C at end of exposure. Effectiveness of the treatment was assessed by culturing bacteria of the treated abscess 1 and 4 days after treatment. Spleen samples were cultured to test for septicemia. Results. Macroscopic evaluation of treated abscess indicated a diminution of external size of abscess 1d after treatment. Treatment did not cause open wounds. Bacteria counting 1 day after treatment was 0.7±1.1 × 105, 0.5±0.7 × 105 and 1.1±2.3 × 105 CFU/?l for MT, HT and control groups, respectively; for the 4-day end point, the count was 0.6±0.6 × 104, 0.09±0.2×104 and 1.0±1.3 × 104. Absence of bacteria in spleen samples indicated that the therapy did not trigger septicemia. Conclusions. Focused ultrasound induces a therapeutic effect in abscesses induced by MRSA. This effect is observed as a reduction of the number bacteria in the abscess. These initial results indicate that focused ultrasound is a viable option for the treatment of MRSA-related infections.

  8. Noninvasive measuring methods for the investigation of irritant patch test reactions. A study of patients with hand eczema, atopic dermatitis and controls.

    PubMed

    Agner, T

    1992-01-01

    The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and atopic dermatits were studied and compared. In healthy volunteers increased baseline TEWL and increased light reflection from the skin, interpreted as "fair" skin, was found to be associated with increased susceptibility to SLS. Hand eczema patients were found to have fairer and thinner skin than matched controls. Increased susceptibility to SLS was found only in patients with acute eczema. Patients with atopic dermatitis had increased baseline TEWL as well as increased skin susceptibility as compared to controls. Skin susceptibility is thus influenced by individual- as well as environment-related factors. Knowledge of determinants of skin susceptibility may be useful for the identification of high-risk subjects for development of irritant contact dermatitis, and may help to prevent the formation of the disease. PMID:1636360

  9. The Prevalence, Risk Factors and Changes in Symptoms of Self Reported Asthma, Rhinitis and Eczema Among Pregnant Women in Ogbomoso, Nigeria

    PubMed Central

    Adeyemi, Adewale Samson; Adebayo, Philip Babatunde; Tanimowo, Moses O.; Ayodele, Olugbenga Edward

    2015-01-01

    Background Allergic disorders have become a major public health concern worldwide. No Nigerian study has examined the epidemiology of allergic diseases among women. Aim To document the prevalence, risk factors and the changes in the symptoms of allergic disorders during pregnancy. Settings and Design Cross-sectional study conducted at the booking and antenatal clinics of LAUTECH Teaching Hospital and Millennium Development Goals (MDG) Clinic of the Comprehensive Health Center, Oja Igbo, Ogbomoso, Nigeria. Materials and Methods Study enrolled 432 women from two public hospitals. Sociodemographic and clinical history were obtained and allergic disorders were diagnosed using ISAAC questionnaires. Results The prevalence of wheezing, eczema and rhinitis in pregnancy are 7.5%, 4.0% and 5.8% respectively. The prevalence of wheezing and eczema was slightly higher among the pregnant in past 12 months. Wheeze worsened in 70% (18/26), improved in 15% (2/26), and stable in 15% (2/26). Eczema worsened in 50% (7/14), improved in 7.1% (1/14) and stable in 42.9% (6/14), while allergic rhinitis worsened in 50% (11/22), improved in 22.7% (5/22) and stabilized in 27.3 % (6/22). In multivariate analysis, the risk of allergic diseases in pregnancy was increase 2 times by low income earning (CI: 1.2 – 2.1, p = 0.002), low level education (OR = 0.6, CI: 0.3 – 0.9, p = 0.011) and by family history of asthma, OR-4.3, CI – 1.3 – 13.9, p = 0.015. Family history of asthma increase the chances of asthma by 18.7 times, CI-2.3 – 152.2, p = 0.006, while the odd of eczema was increased 9.1 times (CI-2.7 – 30.6, p<0.001) and 2.4 times (CI: 1.2 – 4.7, p = 0.008) by second hand home smoking and low-family income respectively. The risk of allergic rhinitis were raised 1.8 times by low family income (CI 1.1 – 2.8, p = 0.013) and 3.9 times by family history of rhinitis (OR = 3.9, CI 1.2 – 12.7, p = 0.024). Conclusion Prevalence of wheezing and eczema are higher in pregnancy probably due to exacerbation induced by pregnancy. Social and genetic factors are important risk factors for allergic disorders in pregnancy. PMID:26500933

  10. Aryl-Alkyl-Lysines: Agents That Kill Planktonic Cells, Persister Cells, Biofilms of MRSA and Protect Mice from Skin-Infection

    PubMed Central

    Ghosh, Chandradhish; Manjunath, Goutham B.; Konai, Mohini M.; Uppu, Divakara S. S. M.; Hoque, Jiaul; Paramanandham, Krishnamoorthy; Shome, Bibek R.; Haldar, Jayanta

    2015-01-01

    Development of synthetic strategies to combat Staphylococcal infections, especially those caused by methicillin resistant Staphyloccus aureus (MRSA), needs immediate attention. In this manuscript we report the ability of aryl-alkyl-lysines, simple membrane active small molecules, to treat infections caused by planktonic cells, persister cells and biofilms of MRSA. A representative compound, NCK-10, did not induce development of resistance in planktonic cells in multiple passages and retained activity in varying environments of pH and salinity. At low concentrations the compound was able to depolarize and permeabilize the membranes of S. aureus persister cells rapidly. Treatment with the compound not only eradicated pre-formed MRSA biofilms, but also brought down viable counts in bacterial biofilms. In a murine model of MRSA skin infection, the compound was more effective than fusidic acid in bringing down the bacterial burden. Overall, this class of molecules bears potential as antibacterial agents against skin-infections. PMID:26669634

  11. Supporting Self-Care for Families of Children With Eczema With a Web-Based Intervention Plus Health Care Professional Support: Pilot Randomized Controlled Trial

    PubMed Central

    Muller, Ingrid; Yardley, Lucy; Burgess, Hana; Selinger, Hannah; Stuart, Beth L; Little, Paul

    2014-01-01

    Background Childhood eczema, or childhood atopic dermatitis, causes significant distress to children and their families through sleep disturbance and itch. The main cause of treatment failure is nonuse of prescribed treatments. Objective The objective of this study was to develop and test a Web-based intervention to support families of children with eczema, and to explore whether support from a health care professional (HCP) is necessary to engage participants with the intervention. Methods We followed the PRECEDE-PROCEED model: regular emollient use was the target behavior we were seeking to promote and we identified potential techniques to influence this. LifeGuide software was used to write the intervention website. Carers of children with eczema were invited through primary care mail-out and randomized to 3 groups: (1) website only, (2) website plus HCP support, or (3) usual care. Patient-Oriented Eczema Measure (POEM) scores were measured online by carer report at baseline and at 12 weeks. Qualitative interviews were carried out with 13 HCPs (primarily practice nurses) and 26 participants to explore their experiences of taking part in the study. Results A total of 143 carers were recruited through 31 practices. We found a decrease of ?2 in follow-up compared with baseline POEM score in 23 of 42 (55%) participants in the website only group, 16 of 49 (33%) in the usual care group, and 18 of 47 (38%) in the website plus HCP group. Website use data showed that 75 of 93 (81%) participants allocated to the website groups completed the core modules, but less than half used other key components (videos: 35%; regular text reminders: 39%). There were no consistent differences in website use between the website only or the website plus HCP groups. Qualitative feedback showed that most HCPs had initial concerns about providing support for eczema self-care because this was not a condition that they felt expert in. However, HCPs reported productive consultations and that they found it helpful to use the website in consultations, while observing that some participants seemed to need more support than others. Qualitative interviews with participants suggested that HCP support was valued highly only by a minority, generally those who were less confident in their management of eczema or less confident using the Internet. Conclusions Our pilot trial demonstrated the potential for greater improvements in POEM scores in both website intervention groups and that a full-scale trial is feasible. Such a trial would quantify the effectiveness and cost-effectiveness of this intervention to determine whether it should be widely promoted to families of children with newly diagnosed eczema. In this study population, HCP support was not strongly valued by participants and did not lead to better outcomes or website use than use of the Web-based intervention alone. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 98560867; http://www.controlled-trials.com/ISRCTN98560867 (Archived by WebCite at http://www.webcitation.org/6NcxvMtgN). PMID:24594972

  12. Methicillin-resistant Staphylococcus aureus (MRSA) is associated with low within-herd prevalence of intra-mammary infections in dairy cows: Genotyping of isolates.

    PubMed

    Luini, M; Cremonesi, P; Magro, G; Bianchini, V; Minozzi, G; Castiglioni, B; Piccinini, R

    2015-08-01

    Staphylococcus aureus is one of the most common mastitis-causing pathogens worldwide. In the last decade, livestock-associated methicillin-resistant S. aureus (LA-MRSA) infections have been described in several species, included the bovines. Hence, this paper investigates the diffusion of MRSA within Italian dairy herds; the strains were further characterized using a DNA microarray, which detects 330 different sequences, including the methicillin-resistance genes mecA and mecC and SCCmec typing. The analysis of overall patterns allows the assignment to Clonal Complexes (CC). Overall 163 S. aureus isolates, collected from quarter milk samples in 61 herds, were tested. MRSA strains were further processed using spa typing. Fifteen strains (9.2%), isolated in 9 herds (14.75%), carried mecA, but none harboured mecC. MRSA detection was significantly associated (P<0.011) with a within-herd prevalence of S. aureus intra-mammary infections (IMI) ?5%. Ten MRSA strains were assigned to CC398, the remaining ones to CC97 (n=2), CC1 (n=2) or CC8 (n=1). In 3 herds, MRSA and MSSA co-existed: CC97-MRSA with CC398-MSSA, CC1-MRSA with CC8-MSSA and CC398-MRSA with CC126-MSSA. The results of spa typing showed an overall similar profile of the strains belonging to the same CC: t127-CC1, t1730-CC97, t899 in 8 out of 10 CC398. In the remaining 2 isolates a new spa type, t14644, was identified. The single CC8 was a t3092. The SCCmec cassettes were classified as type IV, type V or type IV/V composite. All or most strains harboured the genes encoding the ?-lactamase operon and the tetracycline resistance. Streptogramin resistance gene was related to CC398. Enterotoxin and leukocidin genes were carried only by CC1, CC8 and CC97-MRSA. The persistence of MRSA clones characterized by broader host range, in epidemiologically unrelated areas and in dairy herds with low prevalence of S. aureus IMI, might enhance the risk for adaptation to human species. PMID:26009302

  13. Birch pollen influence the severity of atopic eczema – prospective clinical cohort pilot study and ex vivo penetration study

    PubMed Central

    Fölster-Holst, Regina; Galecka, Jagoda; Weißmantel, Sigo; Dickschat, Ute; Rippke, Frank; Bohnsack, Kerstin; Werfel, Thomas; Wichmann, Katja; Buchner, Matthias; Schwarz, Thomas; Vogt, Annika; Lademann, Jürgen; Meinke, Martina C

    2015-01-01

    There is little clinical evidence for a correlation between the severity of atopic eczema (AE) and pollen exposition. To obtain more data, we performed a clinical cohort pilot study about the influence of pollen on AE between sensitized and nonsensitized subjects and an experimental study addressing the cutaneous penetration of pollen into the skin. Fifty-five patients were monitored during birch pollen season. To study the cutaneous penetration, grass pollen allergens were applied on excised skin and the uptake in CD1c-expressing dendritic cells was investigated. The correlation between environmental pollen load and severity of the Scoring Atopic Dermatitis (SCORAD) score and pruritus was observed, regardless of the status of sensitization. The sensitized group recovered significantly worse after the birch pollen season. Remarkably higher amounts of pollen allergens taken up by CD1c cells were detected in epidermal cells derived from skin explants with a disturbed epidermal barrier. These findings suggest an exacerbating role of pollen in AE utilizing the epidermal route. PMID:26604810

  14. How Often Do Comparative Randomised Controlled Trials in the Field of Eczema Fail to Directly Compare the Treatments Being Tested?

    PubMed

    Ratib, Sonia; Wilkes, Sally R; Nankervis, Helen; Thomas, Kim S; Williams, Hywel C

    2015-01-01

    The objective of the study was to identify all parallel design randomised controlled trials (RCTs) comparing treatments for eczema in recent dermatology literature that have failed to report a between-group analysis. The GREAT database (www.greatdatabase.org.uk) was searched to identify parallel group RCTs comparing two or more interventions published in the English language in the last decade, 2004 to 2013. The primary outcome was the number of studies that had not reported a between-group analysis for any of the outcomes. Where possible we re-analysed the data to determine whether a between-group analysis would have given a different conclusion to that reported. Out of a total of 304 RCTs in the study period, 173 (56.9%) met the inclusion criteria. Of the 173 eligible studies, 12 (6.9%) had not conducted a between-group analysis for any of the reported outcomes. There was no clear improvement over time. Five of the eight studies that were re-analysed yielded non-significant between-group differences yet reported significant within-group comparisons. All but one of the 12 studies implied that the experimental intervention was successful despite not undertaking any between-group comparisons. Although the proportion of all RCTs that fail to report an appropriate between-group analysis is small, the fact that any scientist who purports to compare one treatment against another then chooses to omit the key comparison statistic is worrying. PMID:26239561

  15. What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 2. Treatment and prevention.

    PubMed

    Madhok, V; Futamura, M; Thomas, K S; Barbarot, S

    2015-06-01

    This review provides a summary of key findings from 22 systematic reviews on atopic eczema (AE) published over the 2-year period from January 2012 to 31 December 2013, focusing on prevention and treatment of AE. For an update of systematic reviews on the epidemiology, mechanisms of disease and methodological issues, see Part 1 of this update. Based on current systematic review evidence, the most promising intervention for the prevention of AE is the use of probiotics (and possibly prebiotics) during the late stages of pregnancy and early life. Exposure to household pets, especially dogs, may also be protective, but exclusive breastfeeding for up to 7 months does not confer benefit. The role of vitamin D in preventing AE is currently unclear. Very few of the systematic reviews provided additional evidence for the use of specific treatments for AE. Further research is required to establish the role of desensitization, Chinese herbal medicines, homeopathy and specialist clothing. Nevertheless, there is now clear evidence that evening primrose oil and borage oil are not effective for the treatment of AE. There have been no randomized controlled trials on the use of H1 anti-histamines as monotherapy for the treatment of AE. PMID:25622761

  16. Climate and prevalence of atopic eczema in 6- to 7-year-old school children in Spain. ISAAC phase III.

    PubMed

    Suárez-Varela, María Morales; García-Marcos Alvarez, Luís; Kogan, Michael D; González, Agustín Llopis; Gimeno, Antonio Martínez; Aguinaga Ontoso, Inés; Díaz, Carlos González; Pena, Alberto Arnedo; Aurrecoechea, Begoña Domínguez; Monge, Rosa María Busquets; Quiros, Alfredo Blanco; Garrido, José Batlles; Canflanca, Iñaqui Miner; Varela, Angel López-Silvarrey

    2008-11-01

    Atopic eczema (AE) is a chronic skin disease. Recent reports indicate that the worldwide prevalence of AE is increasing and that various environmental factors are implicated in its aetiology. Climatic conditions have been related with AE prevalence, and Spain has varying climatic conditions. The aim of this study is to document the possible climatic influence on the prevalence of AE in schoolchildren aged 6-7 years in three different climatic regions in Spain. We conducted a cross-sectional population-based survey of 28,394 schoolchildren aged 6-7 years from 10 Spanish centres in three different climatic regions. The mean participation rate was 76.5%. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Spanish Academy of Dermatology criteria used in Spain to diagnose AE. The data, including annual temperature, precipitation, relative humidity and the annual number of sunny hours per climatic region, were obtained from the Spanish National Institute of Meteorology. Different AE prevalences were found in all three climatic regions studied: Atlantic, 32.9; Mediterranean 28.3; and Continental 31.2 per 100 children studied (p < 0.005). AE was positively associated with precipitation and humidity, and was negatively associated with temperature and the number of sunny hours. The results show that AE is significantly dependent on meteorological conditions. PMID:18779981

  17. 'Perfect skin', the media and patients with skin disease: a qualitative study of patients with acne, psoriasis and atopic eczema.

    PubMed

    Magin, Parker; Adams, Jon; Heading, Gaynor; Pond, Dimity

    2011-01-01

    The relationship of skin disease with societal ideals of beauty, and the role of the media in this relationship, has not previously been researched. The overall objective of this study was to explore the psychological effects of skin disease. The theme of the ideal of perfect skin and the role of the media in generating this ideal arose via an inductive study methodology and was explored in the context of respondents' psychological morbidity. A qualitative study, 62 semi-structured interviews were conducted with respondents with acne, eczema or psoriasis recruited from both general practice and specialist dermatology practice in an Australian regional city. Interviews were audiotaped, transcribed and subjected to thematic analysis employing a process of constant comparison in which data collection and analysis were cumulative and concurrent. The themes of perfect skin, societal ideals and media influence emerged from this iterative process. Respondents identified a societal ideal of flawless skin, largely mediated by media portrayals of perfection. Failure to meet this ideal precipitated psychological morbidity in female, but not male, respondents. An appreciation of the pervasive pressures of society and media upon females with skin disease may inform management strategies, particularly psychological management strategies, in patients with skin disease. PMID:21645475

  18. Comparison of spa Types, SCCmec Types and Antimicrobial Resistance Profiles of MRSA Isolated from Turkeys at Farm, Slaughter and from Retail Meat Indicates Transmission along the Production Chain

    PubMed Central

    Vossenkuhl, Birgit; Brandt, Jörgen; Fetsch, Alexandra; Käsbohrer, Annemarie; Kraushaar, Britta; Alt, Katja; Tenhagen, Bernd-Alois

    2014-01-01

    The prevalence of MRSA in the turkey meat production chain in Germany was estimated within the national monitoring for zoonotic agents in 2010. In total 22/112 (19.6%) dust samples from turkey farms, 235/359 (65.5%) swabs from turkey carcasses after slaughter and 147/460 (32.0%) turkey meat samples at retail were tested positive for MRSA. The specific distributions of spa types, SCCmec types and antimicrobial resistance profiles of MRSA isolated from these three different origins were compared using chi square statistics and the proportional similarity index (Czekanowski index). No significant differences between spa types, SCCmec types and antimicrobial resistance profiles of MRSA from different steps of the German turkey meat production chain were observed using Chi-Square test statistics. The Czekanowski index which can obtain values between 0 (no similarity) and 1 (perfect agreement) was consistently high (0.79–0.86) for the distribution of spa types and SCCmec types between the different processing stages indicating high degrees of similarity. The comparison of antimicrobial resistance profiles between the different process steps revealed the lowest Czekanowski index values (0.42–0.56). However, the Czekanowski index values were substantially higher than the index when isolates from the turkey meat production chain were compared to isolates from wild boar meat (0.13–0.19), an example of a separated population of MRSA used as control group. This result indicates that the proposed statistical method is valid to detect existing differences in the distribution of the tested characteristics of MRSA. The degree of similarity in the distribution of spa types, SCCmec types and antimicrobial resistance profiles between MRSA isolates from different process stages of turkey meat production may reflect MRSA transmission along the chain. PMID:24788143

  19. Effects of Reducing Antimicrobial Use and Applying a Cleaning and Disinfection Program in Veal Calf Farming: Experiences from an Intervention Study to Control Livestock-Associated MRSA

    PubMed Central

    Bos, Marian E. H.; Verstappen, Koen M.; Van Cleef, Brigitte A. G. L.; Kluytmans, Jan A. J. W.; Wagenaar, Jaap A.; Heederik, Dick J. J.

    2015-01-01

    With the ultimate aim of containing the emergence of resistant bacteria, a Dutch policy was set in place in 2010 promoting a reduction of antimicrobial use (AMU) in food-producing animals. In this context, a study evaluated strategies to curb livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA). Fifty-one veal calf farms were assigned to one of 3 study arms: RAB farms reducing antimicrobials by protocol; RAB-CD farms reducing antimicrobials by protocol and applying a cleaning and disinfection program; and Control farms without interventions. MRSA carriage was tested in week 0 and week 12 of 2 consecutive production cycles in farmers, family members and veal calves. Interventions were validated and a cyclic rise in MRSA-prevalence in animals was shown with a more moderate increase in RAB farms. Prevalence in humans declined parallel over time in the study arms but RAB farms were at the lowest MRSA levels from the beginning of the study. In RAB-CD farms, human and animal prevalence did not differ from Control farms and MRSA air loads were significantly higher than in the other study arms. Mimicking the national trend, an overall AMU decrease (daily dosages per animal per cycle (DDDA/C)) was observed over 4 pre-study and the 2 study cycles; this trend did not have a significant effect on a set of evaluated farm technical parameters. AMU was positively associated with MRSA across study arms (ORs per 10 DDDA/C increase = 1.26 for both humans (p = 0.07) and animals (p = 0.12 in first cycle)). These results suggest that AMU reduction might be a good strategy for curbing MRSA in veal calf farming, however the specific cleaning and disinfecting program in RAB-CD farms was not effective. The drop in MRSA prevalence in people during the study could be attributed to the observed long-term AMU decreasing trend. PMID:26305895

  20. Validation of a phage-open reading frame typing kit for rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) transmission in a tertiary hospital.

    PubMed

    Takahashi, Hiroki; Seki, Masafumi; Yamamoto, Norihisa; Hamaguchi, Shigeto; Ojima, Masahiro; Hirose, Tomoya; Yoshiya, Kazuhisa; Toyokawa, Masahiro; Nishi, Isao; Ogura, Hiroshi; Shimazu, Takeshi; Tomono, Kazunori

    2015-01-01

    Surveillance is very important to prevent the nosocomial spread of methicillin-resistant Staphylococcus aureus (MRSA), and infection sources and routes have historically been identified using molecular and epidemiological genotyping with pulsed-field gel electrophoresis. However, phage-open reading frame typing (POT) has recently been developed. Here, we investigated whether POT would be useful to survey MRSA outbreaks and transmission. We therefore applied POT to 91 MRSA isolates detected in cultures from inpatients at our hospital between May and October 2014. Among the 91 isolates, 12 POT types comprising 38 isolated MRSA strains were considered as overlapping. Five of them were detected in different wards, whereas the remaining seven were found in the same ward, including the emergency department. Three of seven POT number 93-155-111 strains were detected in the surgical ward, and all of four POT number 93-157-61 strains were detected in the cardiosurgical ward. These data suggested that transmission of the MRSA strains with the same POT-types from the same wards was nosocomial, and that POT accurately and rapidly identified MRSA strains, which allowed effective control of infection and transmission. PMID:25999746

  1. The Combination of Catechin and Epicatechin Gallate from Fructus Crataegi Potentiates ?-Lactam Antibiotics Against Methicillin-Resistant Staphylococcus aureus (MRSA) in Vitro and in Vivo

    PubMed Central

    Qin, Rongxin; Xiao, Kangkang; Li, Bin; Jiang, Weiwei; Peng, Wei; Zheng, Jiang; Zhou, Hong

    2013-01-01

    Fructus crataegi (hawthorn) is the common name of all plant species in the genus Crataegus of the Rosaceae family. In the present study, three monomers of (+)-catechin (C), (?)-epicatechin gallate (ECg) and (?)-epigallocatechin (EGC) were isolated from the hawthorn under the guide of antibacterial sensitization activity. The bioactivity of the composite fraction in enhancing the antibacterial effect of oxacillin against methicillin-resistant Staphylococcus aureus (MRSA) was greater than that of the individual monomer of the hawthorn extract in vitro. Two-fold dilution and checkerboard methods were used to analyze antibacterial activity and screen for the combination and proportion of monomers with the best bioactivity. The result showed that C (128 mg/L) combined with ECg (16 mg/L) had the greatest effect and the combination also reduced the bacterial load in blood of septic mice challenged with a sublethal dose of MRSA, increased daunomycin accumulation within MRSA and down-regulated the mRNA expression of norA, norC and abcA, three important efflux pumps of MRSA. In summary, C and ECg enhanced the antibacterial effect of ?-lactam antibiotics against MRSA in vitro and in vivo, which might be related to the increased accumulation of antibiotics within MRSA via suppression of important efflux pumps’ gene expression. PMID:23325048

  2. Dynamics of Biofilm Formation and the Interaction between Candida albicans and Methicillin-Susceptible (MSSA) and -Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Zago, Chaiene Evelin; Silva, Sónia; Sanitá, Paula Volpato; Barbugli, Paula Aboud; Dias, Carla Maria Improta; Lordello, Virgínia Barreto; Vergani, Carlos Eduardo

    2015-01-01

    Polymicrobial biofilms are an understudied and a clinically relevant problem. This study evaluates the interaction between C. albicans, and methicillin- susceptible (MSSA) and resistant (MRSA) S. aureus growing in single- and dual-species biofilms. Single and dual species adhesion (90 min) and biofilms (12, 24, and 48 h) were evaluated by complementary methods: counting colony-forming units (CFU mL-1), XTT-reduction, and crystal violet staining (CV). The secretion of hydrolytic enzymes by the 48 h biofilms was also evaluated using fluorimetric kits. Scanning electron microscopy (SEM) was used to assess biofilm structure. The results from quantification assays were compared using two-way ANOVAs with Tukey post-hoc tests, while data from enzymatic activities were analyzed by one-way Welch-ANOVA followed by Games-Howell post hoc test (? = 0.05). C. albicans, MSSA and MRSA were able to adhere and to form biofilm in both single or mixed cultures. In general, all microorganisms in both growth conditions showed a gradual increase in the number of cells and metabolic activity over time, reaching peak values between 12 h and 48 h (?<0.05). C. albicans single- and dual-biofilms had significantly higher total biomass values (?<0.05) than single biofilms of bacteria. Except for single MRSA biofilms, all microorganisms in both growth conditions secreted proteinase and phospholipase-C. SEM images revealed extensive adherence of bacteria to hyphal elements of C. albicans. C. albicans, MSSA, and MRSA can co-exist in biofilms without antagonism and in an apparent synergistic effect, with bacteria cells preferentially associated to C. albicans hyphal forms. PMID:25875834

  3. Noninvasive In Vivo Imaging to Evaluate Immune Responses and Antimicrobial Therapy against Staphylococcus aureus and USA300 MRSA Skin Infections

    PubMed Central

    Cho, John S.; Zussman, Jamie; Donegan, Niles P.; Irene Ramos, Romela; Garcia, Nairy C.; Uslan, Daniel Z.; Iwakura, Yoichiro; Simon, Scott I.; Cheung, Ambrose L.; Modlin, Robert L.; Kim, Jenny; Miller, Lloyd S.

    2011-01-01

    Staphylococcus aureus skin infections represent a significant public health threat because of the emergence of antibiotic-resistant strains such as methicillin-resistant S. aureus (MRSA). As greater understanding of protective immune responses and more effective antimicrobial therapies are needed, a S. aureus skin wound infection model was developed in which full-thickness scalpel cuts on the backs of mice were infected with a bioluminescent S. aureus (methicillin sensitive) or USA300 community-acquired MRSA strain and in vivo imaging was used to noninvasively monitor the bacterial burden. In addition, the infection-induced inflammatory response was quantified using in vivo fluorescence imaging of LysEGFP mice. Using this model, we found that both IL-1? and IL-1? contributed to host defense during a wound infection, whereas IL-1? was more critical during an intradermal S. aureus infection. Furthermore, treatment of a USA300 MRSA skin infection with retapamulin ointment resulted in up to 85-fold reduction in bacterial burden and a 53% decrease in infection-induced inflammation. In contrast, mupirocin ointment had minimal clinical activity against this USA300 strain, resulting in only a 2-fold reduction in bacterial burden. Taken together, this S. aureus wound infection model provides a valuable preclinical screening method to investigate cutaneous immune responses and the efficacy of topical antimicrobial therapies. PMID:21191403

  4. Minor C-geranylated flavanones from Paulownia tomentosa fruits with MRSA antibacterial activity.

    PubMed

    Navrátilová, Alice; Schneiderová, Kristýna; Veselá, Daniela; Hanáková, Zuzana; Fontana, Anna; Dall'Acqua, Stefano; Cva?ka, Josef; Innocenti, Gabbriella; Novotná, Jana; Urbanová, Marie; Pelletier, Jerry; ?ížek, Alois; Žemli?ková, Helena; Šmejkal, Karel

    2013-05-01

    Exhaustive chromatographic separation of the chloroform portion of the ethanolic extract obtained from Paulownia tomentosa (Thunb). Steud. (Paulowniaceae) fruits has led to isolation of ten C-6 geranylated flavanones tomentodiplacone C-I and mimulone C-E, featured by 3'-methoxy and 4'-hydroxy or 4'-hydroxy substitution of the B-ring of the flavonoid, respectively. The structures of these compounds were determined by using mass spectrometry (including HRMS) and 1D and 2D NMR spectroscopy. The absolute configurations of the compounds at C-2 were determined using circular dichroism. The obtained compounds showed the presence of a geranyl moiety functionalized by a carbonyl, hydroxyl or methoxyl group, or by formation of tetrahydrofuran or fused-pyrane ring, respectively. All of the flavanones described were isolated for the first time from a natural source. The antibacterial activities of selected compounds isolated along with the previously isolated geranylated flavanones were evaluated against a common panel of microbes and MRSA strains. The selected isolated compounds were tested for their ability to affect eukaryotic translation initiation via dual-luciferase reporter assay (firefly and renilla). PMID:23453910

  5. Antimicrobial Activity of Isothiocyanates from Cruciferous Plants against Methicillin-Resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Dias, Carla; Aires, Alfredo; Saavedra, Maria José

    2014-01-01

    Purified isothiocyanates from cruciferous plants (Brassicacea, Syn. Cruciferae) plants were evaluated against 15 isolates of methicillin-resistant S. aureus isolated from diabetic foot-ulcer patients aiming the study of the potential usage of allyl-isothiocyanate, benzyl-isothiocyanate and 2-phenylethyl-isothiocyanate against this important bacteria. Disc diffusion and minimum inhibitory concentration methods were used to access the antimicrobial activity. The index (Ia) and rate (Ra) of the antibacterial activity for each compound were calculated. The results showed a highly dose-dependent compound and chemical structure antibacterial effectiveness. The results showed a strong relation between the chemical structure of isothiocyanates and its antibacterial effectiveness. The benzyl-isothiocyanate was the most effective with a minimum inhibitory concentration varying between 2.9 and 110 µg· mL?1 with an antibacterial activity rate up to 87%. Moreover, their antibacterial activity was mainly bactericidal. This study provides scientific evidence that isothiocyanates have an interesting biological value and must be considered as an important tool to be used against MRSA. PMID:25353177

  6. Halogenated quinolines discovered through reductive amination with potent eradication activities against MRSA, MRSE and VRE biofilms.

    PubMed

    Basak, Akash; Abouelhassan, Yasmeen; Huigens Iii, Robert W

    2015-10-14

    Small molecules capable of eradicating non-replicating bacterial biofilms are of great importance to human health as conventional antibiotics are ineffective against these surface-attached bacterial communities. Here, we report the discovery of several halogenated quinolines (HQs) identified through a reductive amination reaction that demonstrated potent eradication of MRSA (; MBEC = 125 ?M), MRSE (; MBEC = 3.0 ?M) and VRE (, and ; MBEC = 1.0 ?M) biofilms. HQs were evaluated using the Calgary Biofilm Device (CBD) and demonstrated near equipotent killing activities against planktonic and biofilm cells based on MBC and MBEC values. When tested against red blood cells, these HQ analogues demonstrated low haemolytic activity (3 to 21% at 200 ?M) thus we conclude that these HQ analogues do not operate primarily through the destruction of bacterial membranes, typical of other biofilm-eradicating agents (i.e., antimicrobial peptides). HQ antibacterial agents are potent biofilm-eradicating compounds and could lead to useful treatments for biofilm-associated bacterial infections. PMID:26414088

  7. Hospital-wide infection control practice and Meticillin-resistant Staphylococcus aureus (MRSA) in the intensive care unit (ICU): an observational study

    PubMed Central

    Workman, Rella

    2014-01-01

    Summary Objectives To estimate trends in infection/colonisation with meticillin-resistant Staphylococcus aureus (MRSA) in an intensive care unit (ICU). Design Observational study of results of ICU admission and weekly screens for MRSA. Setting and Participants All ICU admissions in 2001–2012. Interventions ICU admissions were screened for MRSA throughout. In late 2006, screening was extended to the whole hospital and extra measures taken in ICU. Main outcome measures Prevalence of MRSA in ICU admissions and number acquiring MRSA therein. Results In all, 366 of 6565 admissions to ICU were MRSA positive, including 270 of 4466 coming from within the hospital in which prevalence increased with time prior to transfer to ICU. Prevalence in this group was 9.4% (8.2–10.6) in 2001–2006, decreasing to 3.4% (2.3–4.5) in 2007–2009 and 1.3% (0.6–2.0) in 2010–2012, p?5 days on wards before ICU admission: 18.9% (15.6–22.2) in 2001–2006, 7.1% (4.0–10.2) in 2007–2009 and 1.6% (0.1–3.1) in 2010–2012, p?MRSA within ICU, the relative risk being greater when known positives present: 4.34 (3.98–4.70), p?MRSA bacteraemias, 38 were in 2001–2006. The risk of bacteraemia in those acquiring MRSA decreased from 25% (18.1–31.9) in 2001–2006 to 6.1% (0–12.8) thereafter, p?=?0.022. Conclusions Following better hospital-wide infection control, fewer MRSA-positive patients were admitted to ICU with a parallel decrease in acquisition therein. Better practice there reduced the risk of bacteraemia. PMID:25383196

  8. Trends in antibiotic susceptibility patterns and epidemiology of MRSA isolates from several hospitals in Riyadh, Saudi Arabia

    PubMed Central

    Baddour, Manal M; Abuelkheir, Manal M; Fatani, Amal J

    2006-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA), is associated with high morbidity and mortality rates with rapid development of resistance. Methods A total of 512 MRSA isolates were procured from 6 major hospitals in Riyadh, Saudi Arabia and antibiotic susceptibilities and MICs were documented against several antibiotics and vancomycin. SPSS version 10 was used for statistical analysis. Results The prevalence of MRSA in the study hospitals ranged from 12% to 49.4%. Mean patient age was 44 years with males constituting 64.4% and females 35.6%. Approximately 41.5% of the isolates came from patients in the extreme age groups. MIC for vancomycin was in the susceptible range for all isolates ranging from 0.25 to 3 ug/ml. The overall susceptibility of MRSA to the various antibiotics tested was: fusidic acid 4.3%, sulfamethoxazole/trimethoprim 33.8%, gentamicin 39.6%, mupirocin 77.0%, gatifloxacin 78.9%, chloramphenicl 80.7%, linezolid 95.1%, quinupristin/dalfopristin 100%. Some differences were noted in the resistance of isolates among the participating hospitals reflecting antibiotic usage. On the whole, inpatient isolates (accounting for 77.5% of the isolates) were more resistant than outpatient isolates (22.5%) except for linezolid. Quinupristin-dalfopristin and linezolid are the most effective antibiotics tested against inpatient isolates while quinupristin-dalfopristin and gatifloxacin seem to be the most effective against outpatient isolates. Approximately one forth of the isolates are no longer susceptible to mupirocin used for eradication of the carrier state reflecting resistance developing after widespread use. Trends over time show a tendency towards decreased susceptibility to gatifloxacin and linezolid with increasing susceptibility to gentamicin and sulfamethoxazole/trimethoprim. Conclusion Quinupristin/dalfopristin and linezolid are two valuable additions to our antimicrobial armamentarium, but resistance has already been described. To preserve their value, their use should be limited to those rare cases where they are clearly needed. Fusidic acid, the local antibiotic, gentamicin and trimethoprim/sulfamethoxazole should not be relied upon for treatment of MRSA infections, at least empirically as the percentage of susceptible isolates is very low. PMID:17140452

  9. Genetic characterization of human coxsackievirus A6 variants associated with atypical hand, foot and mouth disease: a potential role of recombination in emergence and pathogenicity

    PubMed Central

    Gaunt, Eleanor; Harvala, Heli; Österback, Riikka; Sreenu, Vattipally B.; Thomson, Emma; Waris, Matti

    2015-01-01

    Human coxsackievirus A6 (CVA6) is an enterically transmitted enterovirus. Until recently, CVA6 infections were considered as being of minor clinical significance, and only rarely aetiologically linked with hand, foot and mouth disease (HFMD) associated with other species A enteroviruses (particularly EV71 and CVA16). From 2008 onwards, however, CVA6 infections have been associated with several outbreaks worldwide of atypical HFMD (aHFMD) accompanied by a varicelliform rash. We recently reported CVA6-associated eczema herpeticum occurring predominantly in children and young adults in Edinburgh in January and February 2014. To investigate genetic determinants of novel clinical phenotypes of CVA6, we genetically characterized and analysed CVA6 variants associated with eczema herpeticum in Edinburgh in 2014 and those with aHFMD in CAV isolates collected from 2008. A total of eight recombinant forms (RFs) have circulated worldwide over the past 10 years, with the particularly recent appearance of RF-H associated with eczema herpeticum cases in Edinburgh in 2014. Comparison of phylogenies and divergence of complete genome sequences of CVA6 identified recombination breakpoints in 2A–2C, within VP3, and between 5? untranslated region and VP1. A Bayesian temporal reconstruction of CVA6 evolution since 2004 provided estimates of dates and the actual recombination events that generated more recently appearing recombination groups (RF-E, -F, -G and -H). Associations were observed between recombination groups and clinical presentations of herpangina, aHFMD and eczema herpeticum, but not with VP1 or other structural genes. These observations provided evidence that NS gene regions may potentially contribute to clinical phenotypes and outcomes of CVA6 infection. PMID:25614593

  10. High Incidence of Oxacillin-Susceptible mecA-Positive Staphylococcus aureus (OS-MRSA) Associated with Bovine Mastitis in China

    PubMed Central

    Pu, WanXia; Su, Yang; Li, JianXi; Li, ChunHui; Yang, ZhiQiang; Deng, HaiPing; Ni, ChunXia

    2014-01-01

    Staphylococcus aureus is a main cause of bovine mastitis and a major pathogen affecting human health. The emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA) has become a significant concern for both animal health and public health. This study investigated the incidence of MRSA in milk samples collected from dairy cows with clinical mastitis and characterized the MRSA isolates using antimicrobial susceptibility tests and genetic typing methods. In total, 103 S. aureus isolates were obtained from dairy farms in 4 different provinces in China, including Gansu, Shanghai, Sichuan, and Guizhou. Antimicrobial susceptibility testing of these isolates revealed that the resistance rates to penicillin and sulfamethoxazole were high, while the resistance rates to ciprofloxacin and vancomycin were low. Among the 103 isolates, 49 (47.6%) were found to be mecA-positive, indicating the high incidence of MRSA. However, 37 of the 49 mecA-positive isolates were susceptible to oxacillin as determined by antimicrobial susceptibility assays and were thus classified as oxacillin-susceptible mecA-positive S. aureus (OS-MRSA). These isolates could be misclassified as methicillin susceptible Staphylococcus aureus (MSSA) if genetic detection of mecA was not performed. Molecular characterization of selected mecA-positive isolates showed that they were all negative with Panton-Valentine leukocidin (PVL), but belonged to different spa types and SCCmec types. These results indicate that OS-MRSA is common in bovine mastitis in China and underscore the need for genetic methods (in addition to phenotypic tests) to accurately identify MRSA. PMID:24523877

  11. Hands4U: A multifaceted strategy to implement guideline-based recommendations to prevent hand eczema in health care workers: design of a randomised controlled trial and (cost) effectiveness evaluation

    PubMed Central

    2011-01-01

    Background Workers in wet work occupations have a risk for developing hand eczema. Prevention strategies exist, but compliance to the proposed recommendations is poor. Therefore, a multifaceted implementation strategy (MIS) is developed to implement these recommendations to reduce hand eczema among health care workers performing wet work. Methods/Design This study is a randomised controlled trial in three university hospitals in the Netherlands. Randomisation to the control or intervention group is performed at department level. The control group receives a leaflet containing the recommendations only. The intervention group receives the MIS which consists of five parts: 1) within a department, a participatory working group is formed to identify problems with the implementation of the recommendations, to find solutions for it and implement these solutions; 2) role models will help their colleagues in performing the desired behaviour; 3) education to all workers will enhance knowledge about (the prevention of) hand eczema; 4) reminders will be placed at the department reminding workers to use the recommendations; 5) workers receive the same leaflet as the control group containing the recommendations. Data are collected by questionnaires at baseline and after 3, 6, 9 and 12 months. The primary outcome measure is self-reported hand eczema. The most important secondary outcome measures are symptoms of hand eczema; actual use of the recommendations; sick leave; work productivity; and health care costs. Analyses will be performed according to the intention to treat principle. Cost-effectiveness of the MIS will be evaluated from both the societal and the employer's perspective. Discussion The prevention of hand eczema is important for the hospital environment. If the MIS has proven to be effective, a major improvement in the health of health care workers can be obtained. Results are expected in 2014. Trial registration number NTR2812 PMID:21867490

  12. Community-Associated Methicillin-Resistant Staphylococcus aureus Clonal Complex 80 Type IV (CC80-MRSA-IV) Isolated from the Middle East: A Heterogeneous Expanding Clonal Lineage

    PubMed Central

    Harastani, Houda H.; Tokajian, Sima T.

    2014-01-01

    Background The emergence of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) has caused a change in MRSA epidemiology worldwide. In the Middle East, the persistent spread of CA-MRSA isolates that were associated with multilocus sequence type (MLST) clonal complex 80 and with staphylococcal cassette chromosome mec (SCCmec) type IV (CC80-MRSA-IV), calls for novel approaches for infection control that would limit its spread. Methodology/Principal Findings In this study, the epidemiology of CC80-MRSA-IV was investigated in Jordan and Lebanon retrospectively covering the period from 2000 to 2011. Ninety-four S. aureus isolates, 63 (67%) collected from Lebanon and 31 (33%) collected from Jordan were included in this study. More than half of the isolates (56%) were associated with skin and soft tissue infections (SSTIs), and 73 (78%) were Panton-Valentine Leukocidin (PVL) positive. Majority of the isolates (84%) carried the gene for exofoliative toxin d (etd), 19% had the Toxic Shock Syndrome Toxin-1 gene (tst), and seven isolates from Jordan had a rare combination being positive for both tst and PVL genes. spa typing showed the prevalence of type t044 (85%) and pulsed-field gel electrophoresis (PFGE) recognized 21 different patterns. Antimicrobial susceptibility testing showed the prevalence (36%) of a unique resistant profile, which included resistance to streptomycin, kanamycin, and fusidic acid (SKF profile). Conclusions The genetic diversity among the CC80 isolates observed in this study poses an additional challenge to infection control of CA-MRSA epidemics. CA-MRSA related to ST80 in the Middle East was distinguished in this study from the ones described in other countries. Genetic diversity observed, which may be due to mutations and differences in the antibiotic regimens between countries may have led to the development of heterogeneous strains. Hence, it is difficult to maintain “the European CA-MRSA clone” as a uniform clone and it is better to designate as CC80-MRSA-IV isolates. PMID:25078407

  13. Large screening of CA-MRSA among Staphylococcus aureus colonizing healthy young children living in two areas (urban and rural) of Portugal

    PubMed Central

    2010-01-01

    Background The incidence of pediatric infections due to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), including children with no identifiable risk factors, has increased worldwide in the last decade. This suggests that healthy children may constitute a reservoir of MRSA in the community. In this study, nested within a larger one on nasopharyngeal ecology, we aimed to: (i) evaluate the prevalence of MRSA colonizing young children in Portugal; and (ii) compare results with those obtained in a study conducted a decade ago, when this prevalence was <0.5%. Methods In the years 2006, 2007, and 2009, nasopharyngeal samples were obtained from 2,100 children aged up to 6 years attending day-care centers. S. aureus were isolated by routine procedures and strains were tested for susceptibility against a panel of 12 antimicrobial agents. MRSA isolates were further characterized by SmaI-PFGE profiling, MLST, spa typing, SCCmec typing, and presence of virulence factors. Results Seventeen percent of the children carried S. aureus. Among the 365 isolates, non-susceptibility rates were 88% to penicillin, 14% to erythromycin, 6% to clindamycin, 2% to tetracycline, and <1% to oxacillin, rifampicin, ciprofloxacin, and SXT. Three MRSA strains were isolated. These had properties of CA-MRSA, such as low-level resistance to oxacillin and limited resistance to non-beta-lactams. Two CA-MRSA were related to USA700 (ST72-IV): one was ST72-IVc, spa type t148; the other was ST939-IVa (ST939 is a single locus variant (SLV) of ST72), spa type t324. The third strain was related to USA300 (ST8-IV) being characterized by ST931 (SLV of ST8)-VI, spa type t008. The three MRSA strains were PVL-negative, but all carried LukE-LukD leukocidin, hemolysins gamma, gamma variant and beta, and staphylococcal enterotoxin sel. Conclusions Our results, based on analysis of S. aureus isolated from nasopharyngeal samples, suggest that in Portugal the prevalence of CA-MRSA carriage in healthy young children remains extremely low favoring the exclusion of this group as a reservoir of such isolates. PMID:20438633

  14. Driving Forces of Mechanisms Regulating Oxacillin-Resistance Phenotypes of MRSA: Truly Oxacillin-Susceptible mecA-Positive Staphylococcus aureus Clinical Isolates also Exist.

    PubMed

    Pournaras, Spyros; Sabat, Artur J; Grundmann, Hajo; Hendrix, Ron; Tsakris, Athanasios; Friedrich, Alexander W

    2015-01-01

    As MRSA are considered Staphylococcus aureus isolates with oxacillin minimum inhibitory concentration (MIC) of ?4 mg/L or harboring the mecA gene. However, the presence of mecA does not necessarily lead to oxacillin resistance and mecA gene-carrying isolates may have oxacillin MIC within the susceptible range (?2 mg/L). During the last few years it has become apparent that oxacillin-susceptible (OS) mecA-positive S. aureus isolates (commonly called OS-MRSA) are rather commonly detected worldwide and may remain undiagnosed using phenotypic susceptibility testing methods. This review will summarize the current reports on OS-MRSA isolations and the underlying mechanisms regulating the expression of oxacillin resistance and also oxacillin susceptibility in mecA-positive S. aureus isolates. As MRSA commonly cause severe infections against which effective therapies are limited, understanding of these mechanisms could enable the identification of new targets for the treatment or reversion of the MRSA phenotype. PMID:25760336

  15. Daptomycin plus fosfomycin versus daptomycin monotherapy in treating MRSA: protocol of a multicentre, randomised, phase III trial

    PubMed Central

    Shaw, E; Miró, J M; Puig-Asensio, M; Pigrau, C; Barcenilla, F; Murillas, J; Garcia-Pardo, G; Espejo, E; Padilla, B; Garcia-Reyne, A; Pasquau, J; Rodriguez-Baño, J; López-Contreras, J; Montero, M; de la Calle, C; Pintado, V; Calbo, E; Gasch, O; Montejo, M; Salavert, M; Garcia-Pais, M J; Carratalà, J; Pujol, M

    2015-01-01

    Introduction Despite the availability of new antibiotics such as daptomycin, methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia continues to be associated with high clinical failure rates. Combination therapy has been proposed as an alternative to improve outcomes but there is a lack of clinical studies. The study aims to demonstrate that combination of daptomycin plus fosfomycin achieves higher clinical success rates in the treatment of MRSA bacteraemia than daptomycin alone. Methods and analysis A multicentre open-label, randomised phase III study. Adult patients hospitalised with MRSA bacteraemia will be randomly assigned (1:1) to group 1: daptomycin 10?mg/kg/24?h intravenous; or group 2: daptomycin 10?mg/kg/24?h intravenous plus fosfomycin 2?gr/6?g intravenous. The main outcome will be treatment response at week 6 after stopping therapy (test-of-cure (TOC) visit). This is a composite variable with two values: Treatment success: resolution of clinical signs and symptoms (clinical success) and negative blood cultures (microbiological success) at the TOC visit. Treatment failure: if any of the following conditions apply: (1) lack of clinical improvement at 72?h or more after starting therapy; (2) persistent bacteraemia (positive blood cultures on day 7); (3) therapy is discontinued early due to adverse effects or for some other reason based on clinical judgement; (4) relapse of MRSA bacteraemia before the TOC visit; (5) death for any reason before the TOC visit. Assuming a 60% cure rate with daptomycin and a 20% difference in cure rates between the two groups, 103 patients will be needed for each group (?:0.05, ß: 0.2). Statistical analysis will be based on intention to treat, as well as per protocol and safety analysis. Ethics and dissemination The protocol was approved by the Spanish Medicines and Healthcare Products Regulatory Agency (AEMPS). The sponsor commits itself to publishing the data in first quartile peer-review journals within 12?months of the completion of the study. Trial registration number NCT01898338. PMID:25762232

  16. Identification and crude protein extract of endophytic bacteria strain KLXD06 antagonistic against MRSA isolated from Hemsleya sinesis.

    PubMed

    Tang, Mei; Gong, Mingfu; Xu, Chenghao; Wu, Sanlin; Liu, Fang

    2014-07-01

    Hemsleya sinesis Cogn has a variety of medicinal value. Strain KLXD06 is an endophytic bacteria isolated from H. sinesis exhibited significant inhibitory activity against methicillin-resistant Staphylococcus aureus (MRSA). This strain was identified by methods including 16S rDNA sequence homology and phylogenetic analysis morphological, biochemical and physiological characteristics analysis. Ccrude protein from KLXD06 was extracted by ammon ium sulfate salting-out. The results showed that strain KLXD06 was identified as Serratia marcescens. Antibacterial crude protein from KLXD06 was extracted by ammon ium sulfate salting-out, has a thermal stability. PMID:25016271

  17. Epidemiology and Pathogenesis of C. difficile and MRSA in the Light of Current NHS Control Policies: A Policy review.

    PubMed

    Agha, Maliha

    2012-01-01

    Healthcare associated infections (HCAIs) cause significant morbidity and mortality, and are estimated to cost the United Kingdom National Health Service £1 billion annually. The current health care infection rates suggest that the level of performance to avoid HCAIs is not maintained consistently. Increasing screening, improving local accountability and performance management, careful use of antibiotics in the management of emergency patients, health economy wide approaches, and improved hand washing will be effective in lowering the rate of HCAIs. This paper reviews current NHS Control Policies in place for Methicillin Resistant Staphylococcus Aureus (MRSA) and C. difficile. PMID:26257907

  18. Isolation, Virulence, and Antimicrobial Resistance of Methicillin-Resistant Staphylococcus aureus (MRSA) and Methicillin Sensitive Staphylococcus aureus (MSSA) Strains from Oklahoma Retail Poultry Meats

    PubMed Central

    Abdalrahman, Lubna S.; Stanley, Adriana; Wells, Harrington; Fakhr, Mohamed K.

    2015-01-01

    Staphylococcus aureus is one the top five pathogens causing domestically acquired foodborne illness in the U.S. Only a few studies are available related to the prevalence of S. aureus and MRSA in the U.S. retail poultry industry. The objectives of this study were to determine the prevalence of S. aureus (MSSA and MRSA) in retail chicken and turkey meats sold in Tulsa, Oklahoma and to characterize the recovered strains for their antimicrobial resistance and possession of toxin genes. A total of 167 (114 chicken and 53 turkey) retail poultry samples were used in this study. The chicken samples included 61 organic samples while the rest of the poultry samples were conventional. The overall prevalence of S. aureus was 57/106 (53.8%) in the conventional poultry samples and 25/61 (41%) in the organic ones. Prevalence in the turkey samples (64.2%) was higher than in the chicken ones (42.1%). Prevalence of S. aureus did not vary much between conventional (43.4%) and organic chicken samples (41%). Two chicken samples 2/114 (1.8%) were positive for MRSA. PFGE identified the two MRSA isolates as belonging to PFGE type USA300 (from conventional chicken) and USA 500 (from organic chicken) which are community acquired CA-MRSA suggesting a human based source of contamination. MLST and spa typing also supported this conclusion. A total of 168 Staphylococcus aureus isolates (101 chicken isolates and 67 turkey isolates) were screened for their antimicrobial susceptibility against 16 antimicrobials and their possession of 18 different toxin genes. Multidrug resistance was higher in the turkey isolates compared to the chicken ones and the percentage of resistance to most of the antimicrobials tested was also higher among the turkey isolates. The hemolysin hla and hld genes, enterotoxins seg and sei, and leucocidins lukE-lukD were more prevalent in the chicken isolates. The PVL gene lukS-lukF was detected only in chicken isolates including the MRSA ones. In conclusion, S. aureus is highly prevalent in poultry retail meats sold in Oklahoma with a very low presence of human-originated MRSA. Multidrug resistance is not only prevalent in the MRSA isolates, but also in many MSSA poultry strains, particularly turkey. PMID:26035662

  19. Tilapia Piscidin 4 (TP4) Stimulates Cell Proliferation and Wound Closure in MRSA-Infected Wounds in Mice

    PubMed Central

    Huang, Hang-Ning; Chan, Yi-Lin; Wu, Chang-Jer; Chen, Jyh-Yih

    2015-01-01

    Antimicrobial peptides (AMPs) are endogenous antibiotics that directly affect microorganisms, and also have a variety of receptor-mediated functions. One such AMP, Tilapia piscidin 4 (TP4), was isolated from Nile tilapia (Oreochromis niloticus); TP4 has antibacterial effects and regulates the innate immune system. The aim of the present study was to characterize the role of TP4 in the regulation of wound closure in mice and proliferation of a keratinocyte cell line (HaCaT) and fibroblast cell line (Hs-68). In vitro, TP4 stimulated cell proliferation and activated collagen I, collagen III, and keratinocyte growth factor (KGF) gene expression in Hs-68 cells, which induces keratin production by HaCaT cells. This effect was detectable at TP4 concentrations of 6.25 µg/mL in both cell lines. In vivo, TP4 was found to be highly effective at combating peritonitis and wound infection caused by MRSA in mouse models, without inducing adverse behavioral effects or liver or kidney toxicity. Taken together, our results indicate that TP4 enhances the survival rate of mice infected with the bacterial pathogen MRSA through both antimicrobial and wound closure activities mediated by epidermal growth factor (EGF), transforming growth factor (TGF), and vascular endothelial growth factor (VEGF). The peptide is likely involved in antibacterial processes and regulation of tissue homeostasis in infected wounds in mice. Overall, these results suggest that TP4 may be suitable for development as a novel topical agent for wound dressing. PMID:25955756

  20. Use of tilapia piscidin 3 (TP3) to protect against MRSA infection in mice with skin injuries

    PubMed Central

    Huang, Han-Ning; Chan, Yi-Lin; Hui, Cho-Fat; Wu, Jen-Leih; Wu, Chang-Jer; Chen, Jyh-Yih

    2015-01-01

    Antimicrobial peptides (AMPs), represent promising agents for new therapeutic approaches of infected wound treatment, on account of their antimicrobial and wound closure activities, and low potential for inducing resistance. However, therapeutic applications of these AMPs are limited by their toxicity and low stability in vivo. Previously, we reported that the 23 amino-acid designer peptide TP3 possessed antimicrobial activities. Here, we analyzed the wound closure activities of TP3 both and in vivo. TP3 at doses of up to 40 ?g/ml did not affect the viability of baby hamster kidney cells. Furthermore, TP3 was found to be highly effective at combating peritonitis and wound infection caused by MRSA in mouse models, without inducing adverse behavioral effects or liver or kidney toxicity. TP3 treatment increased survival by 100% at 8 days after infection, and accelerated the progression of proliferation, remodeling, and maturation of infected wounds. Taken together, our results indicate that TP3 enhances the rate of survival of mice infected with the bacterial pathogen MRSA through both antimicrobial and immunomodulatory effects. Overall, these results suggest that TP3 may be suitable for development as a novel topical agent for treatment of infected wounds. PMID:25992774

  1. Bio-inspired synthesis yields a tricyclic indoline that selectively resensitizes methicillin-resistant Staphylococcus aureus (MRSA) to ?-lactam antibiotics

    PubMed Central

    Podoll, Jessica D.; Liu, Yongxiang; Chang, Le; Walls, Shane; Wang, Wei; Wang, Xiang

    2013-01-01

    The continuous emergence of resistant bacteria has become a major worldwide health threat. The current development of new antibacterials has lagged far behind. To discover reagents to fight against resistant bacteria, we initiated a chemical approach by synthesizing and screening a small molecule library, reminiscent of the polycyclic indole alkaloids. Indole alkaloids are a class of structurally diverse natural products, many of which were isolated from plants that have been used as traditional medicine for millennia. Specifically, we adapted an evolutionarily conserved biosynthetic strategy and developed a concise and unified diversity synthesis pathway. Using this pathway, we synthesized 120 polycyclic indolines that contain 26 distinct skeletons and a wide variety of functional groups. A tricyclic indoline, Of1, was discovered to selectively potentiate the activity of ?-lactam antibiotics in multidrug-resistant methicillin-resistant Staphylococcus aureus (MRSA), but not in methicillin-sensitive S. aureus. In addition, we found that Of1 itself does not have antiproliferative activity but can resensitize several MRSA strains to the ?-lactam antibiotics that are widely used in the clinic, such as an extended-spectrum ?-lactam antibiotic amoxicillin/clavulanic acid and a first-generation cephalosporin cefazolin. These data suggest that Of1 is a unique selective resistance-modifying agent for ?-lactam antibiotics, and it may be further developed to fight against resistant bacteria in the clinic. PMID:24019472

  2. Tilapia Piscidin 4 (TP4) Stimulates Cell Proliferation and Wound Closure in MRSA-Infected Wounds in Mice.

    PubMed

    Huang, Hang-Ning; Chan, Yi-Lin; Wu, Chang-Jer; Chen, Jyh-Yih

    2015-05-01

    Antimicrobial peptides (AMPs) are endogenous antibiotics that directly affect microorganisms, and also have a variety of receptor-mediated functions. One such AMP, Tilapia piscidin 4 (TP4), was isolated from Nile tilapia (Oreochromis niloticus); TP4 has antibacterial effects and regulates the innate immune system. The aim of the present study was to characterize the role of TP4 in the regulation of wound closure in mice and proliferation of a keratinocyte cell line (HaCaT) and fibroblast cell line (Hs-68). In vitro, TP4 stimulated cell proliferation and activated collagen I, collagen III, and keratinocyte growth factor (KGF) gene expression in Hs-68 cells, which induces keratin production by HaCaT cells. This effect was detectable at TP4 concentrations of 6.25 µg/mL in both cell lines. In vivo, TP4 was found to be highly effective at combating peritonitis and wound infection caused by MRSA in mouse models, without inducing adverse behavioral effects or liver or kidney toxicity. Taken together, our results indicate that TP4 enhances the survival rate of mice infected with the bacterial pathogen MRSA through both antimicrobial and wound closure activities mediated by epidermal growth factor (EGF), transforming growth factor (TGF), and vascular endothelial growth factor (VEGF). The peptide is likely involved in antibacterial processes and regulation of tissue homeostasis in infected wounds in mice. Overall, these results suggest that TP4 may be suitable for development as a novel topical agent for wound dressing. PMID:25955756

  3. Synergistic antibacterial and antibiotic effects of bisbenzylisoquinoline alkaloids on clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Zuo, Guo-Ying; Li, Yang; Wang, Tao; Han, Jun; Wang, Gen-Chun; Zhang, Yun-Ling; Pan, Wei-Dong

    2011-01-01

    The antibacterial activity of two bisbenzylisoquinoline alkaloids, tetrandrine (Tet) and demethyltetrandrine (d-Tet), alone and in combination with the antibiotics ampicillin (AMP), azithromycin (AZM), cefazolin (CFZ) and levofloxacin (LEV) against 10 clinical isolates of staphylococcal chromosomal cassette mec (SCCmec) III type methicillin-resistant Staphylococcus aureus (MRSA) was studied. Susceptibility to each agent alone was tested using a broth microdilution method. The chequerboard and time-kill tests were used for the combined evaluations. The minimal inhibitory concentrations/minimal bactericidal concentrations (MICs/MBCs, ?g/mL) ranges alone were 64-128/256-1,024 for both Tet and d-Tet. Significant synergies against 90% of the isolates were observed for the Tet/CFZ combination, with their MICs being reduced by 75-94% [fractional inhibitory concentration indices (FICIs) ranged from 0.188 to 0.625], respectively. An additive bactericidal result was also observed for the Tet (d-Tet)/CFZ combination in the time-kill experiments. These results demonstrated that Tet and d-Tet enhanced the in vitro inhibitory efficacy of CFZ. Their potential for combinatory therapy of patients infected with MRSA warrants further pharmacological investigation. PMID:22117171

  4. A fatty acid from the diatom Phaeodactylum tricornutum is antibacterial against diverse bacteria including multi-resistant Staphylococcus aureus (MRSA).

    PubMed

    Desbois, Andrew P; Mearns-Spragg, Andrew; Smith, Valerie J

    2009-01-01

    Pathogenic bacteria, such as multidrug-resistant Staphylococcus aureus (MRSA), which are not susceptible to most conventional antibiotics, are causing increased concern in healthcare institutions worldwide. The discovery of novel antibacterial compounds for biomedical exploitation is one avenue that is being pursued to combat these problematic bacteria. Marine eukaryotic microalgae are known to produce numerous useful products but have attracted little attention in the search for novel antibiotic compounds. Cell lysates of the marine diatom, Phaeodactylum tricornutum Bohlin, have been reported to display antibacterial activity in vitro, but the compounds responsible have not been fully identified. In this paper, using column chromatography and reversed-phase high-performance liquid chromatography, we report the isolation of an antibacterial fatty acid. Mass spectrometry and (1)H-nuclear magnetic resonance spectroscopy revealed it to be the polyunsaturated fatty acid, eicosapentaenoic acid (EPA). We show that EPA is active against a range of both Gram-positive and Gram-negative bacteria, including MRSA, at micromolar concentrations. These data indicate that it could find application in the topical and systemic treatment of drug-resistant bacterial infections. PMID:18575935

  5. Eczema (Atopic Dermatitis) Complications

    MedlinePLUS

    ... eventually develop infection, which worsens the atopic dermatitis. Viral Infections People with atopic dermatitis are highly vulnerable to certain viral infections of the skin. For example, if infected with ...

  6. Nummular Dermatitis (Discoid Eczema)

    MedlinePLUS

    ... and benefits Practice and Advocacy Residents & Fellows Media Relations Toolkit Leadership Institute Volunteer and mentor opportunities Member directory AAD store International resources My account Patient education resources Awards, grants, ...

  7. Eczema and Atopic Dermatitis

    MedlinePLUS

    ... Use a small amount of soap. Keep the water temperature cool or warm, not hot. Soaking in the tub for a short time can be good for your skin because the skin's outer layer can absorb water and become less dry. Soak for 15 to ...

  8. Eczema (For Parents)

    MedlinePLUS

    ... or coarsely woven materials) certain skin care products, perfumes, and colognes (particularly those that contain alcohol) tobacco ... patch of suspected allergen, such as dyes or fragrances, on the skin) scratch/prick tests (placing suspected ...

  9. Comparative Prevalence of Immune Evasion Complex Genes Associated with ?-Hemolysin Converting Bacteriophages in MRSA ST5 Isolates from Swine, Swine Facilities, Humans with Swine Contact, and Humans with No Swine Contact

    PubMed Central

    Hau, Samantha J.; Sun, Jisun; Davies, Peter R.; Frana, Timothy S.; Nicholson, Tracy L.

    2015-01-01

    Livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA) draws concern from the public health community because in some countries these organisms may represent the largest reservoir of MRSA outside hospital settings. Recent studies indicate LA-MRSA strains from swine are more genetically diverse than the first reported sequence type ST398. In the US, a diverse population of LA-MRSA is found including organisms of the ST398, ST9, and ST5 lineages. Occurrence of ST5 MRSA in swine is of particular concern since ST5 is among the most prevalent lineages causing clinical infections in humans. The prominence of ST5 in clinical disease is believed to result from acquisition of bacteriophages containing virulence or host-adapted genes including the immune-evasion cluster (IEC) genes carried by ?-hemolysin converting bacteriophages, whose absence in LA-MRSA ST398 is thought to contribute to reduced rates of human infection and transmission associated with this lineage. The goal of this study was to investigate the prevalence of IEC genes associated with ?-hemolysin converting bacteriophages in MRSA ST5 isolates obtained from agricultural sources, including swine, swine facilities, and humans with short- or long-term swine exposure. To gain a broader perspective, the prevalence of these genes in LA-MRSA ST5 strains was compared to the prevalence in clinical MRSA ST5 strains from humans with no known exposure to swine. IEC genes were not present in any of the tested MRSA ST5 strains from agricultural sources and the ?-hemolysin gene was intact in these strains, indicating the bacteriophage’s absence. In contrast, the prevalence of the ?-hemolysin converting bacteriophage in MRSA ST5 strains from humans with no exposure to swine was 90.4%. The absence of ?-hemolysin converting bacteriophage in LA-MRSA ST5 isolates is consistent with previous reports evaluating ST398 strains and provides genetic evidence indicating LA-MRSA ST5 isolates may harbor a reduced capacity to cause severe disease in immunocompetent humans. PMID:26554919

  10. Population-Based Estimates of Methicillin-Resistant "Staphylococcus aureus" (MRSA) Infections among High School Athletes--Nebraska, 2006-2008

    ERIC Educational Resources Information Center

    Buss, Bryan F.; Mueller, Shawn W.; Theis, Max; Keyser, Alison; Safranek, Thomas J.

    2009-01-01

    Methicillin-resistant "Staphylococcus aureus" (MRSA) is an emerging cause of skin and soft-tissue infections among athletes. To determine statewide incidence among high school athletes, we surveyed all 312 Nebraska high schools regarding sport programs offered, program-specific participation numbers, number of athletes with physician-diagnosed…

  11. Surveillance of physician-diagnosed skin and soft tissue infections consistent with methicillin-resistant Staphylococcus aureus (MRSA) among Nebraska high school athletes, 2008-2012.

    PubMed

    Buss, Bryan F; Connolly, Susan

    2014-02-01

    Though historically confined to hospital settings, methicillin-resistant Staphylococcus aureus (MRSA) has received increasing attention in the wider community, particularly among athletes. A 2007-2008 investigation in Nebraska concluded that MRSA skin infections were an emerging problem among the state's student athletes. Statewide surveillance was subsequently conducted during 4 school years (2008-2012) to estimate incidence of skin and soft tissue infections (SSTI) consistent with MRSA among student athletes. High school athletic officials completed Internet-based surveys following winter and fall sport seasons. Over 3 school years, incidence estimates per 10,000 athletes decreased substantially from 20.9 (2008-2009) to 11.3 (2010-2011) among football players and from 60.8 (2008-2009) to 28.1 (2010-2011) among wrestlers. Following the 2011-2012 sport seasons, however, incidence estimates increased to 16.6 per 10,000 football players and 43.3 per 10,000 wrestlers. School nurses should support school officials to prioritize prevention and control efforts for SSTI, including MRSA. PMID:23727844

  12. Development and Deployment of a Health Information Exchange to Understand the Transmission of MRSA across Hospitals via Molecular Genotyping and Social Networking Analysis

    ERIC Educational Resources Information Center

    Khan, Yosef M.

    2012-01-01

    Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a hardy and extremely virulent multidrug resistant organism that has been a major cause of hospital acquired infections ever since its discovery in the 1960's. It has severe consequences such as causing increased hospital length of stay, economic burden, morbidity, and…

  13. Maternal fish and shellfish consumption and wheeze, eczema and food allergy at age two: a prospective cohort study in Brittany, France

    PubMed Central

    2013-01-01

    Background Environmental exposures, including dietary contaminants, may influence the developing immune system. This study assesses the association between maternal pre-parturition consumption of seafood and wheeze, eczema, and food allergy in preschool children. Fish and shellfish were studied separately as they differ according to their levels of omega-3 polyunsaturated fatty acids (which have anti-allergic properties) and their levels of contaminants. Methods The PELAGIE cohort included 3421 women recruited at the beginning of pregnancy. Maternal fish and shellfish intake was measured at inclusion by a food frequency questionnaire. Wheeze, eczema, and food allergy were evaluated by a questionnaire completed by the mother when the child was 2 years old (n?=?1500). Examination of the associations between seafood intake and outcomes took major confounders into account. Complementary sensitivity analyses with multiple imputation enabled us to handle missing data, due mostly to attrition. Results Moderate maternal pre-parturition fish intake (1 to 4 times a month) was, at borderline significance, associated with a lower risk of wheeze (adjusted OR?=?0.69 (0.45-1.05)) before age 2, compared with low intake (< once/month). This result was not, however, consistent: after multiple imputation, the adjusted OR was 0.86 (0.63-1.17). Shellfish intake at least once a month was associated with a higher risk of food allergy before age 2 (adjusted OR?=?1.62 (1.11-2.37)) compared to low or no intake (< once/month). Multiple imputation confirmed this association (adjusted OR?=?1.52 (1.05-2.21)). Conclusions This study suggests that maternal pre-parturition shellfish consumption may increase the risk of food allergy. Further large-scale epidemiologic studies are needed to corroborate these results, identify the contaminants or components of shellfish responsible for the effects observed, determine the persistence of the associations seen at age 2, and investigate potential associations with health effects observable at later ages, such as allergic asthma. PMID:24295221

  14. Methicillin-Resistant Staphylococcus aureus (MRSA) Contamination in Bedside Surfaces of a Hospital Ward and the Potential Effectiveness of Enhanced Disinfection with an Antimicrobial Polymer Surfactant

    PubMed Central

    Yuen, John W. M.; Chung, Terence W. K.; Loke, Alice Y.

    2015-01-01

    The aim in this study was to assess the effectiveness of a quaternary ammonium chloride (QAC) surfactant in reducing surface staphylococcal contamination in a routinely operating medical ward occupied by patients who had tested positive for methicillin-resistant Staphylococcus aureus (MRSA). The QAC being tested is an antibacterial film that is sprayed onto a surface and can remain active for up to 8 h. A field experimental study was designed with the QAC plus daily hypochlorite cleaning as the experimental group and hypochlorite cleaning alone as the control group. The method of swabbing on moistened surfaces was used for sampling. It was found that 83% and 77% of the bedside surfaces of MRSA-positive and MRSA-negative patients respectively were contaminated with staphylococci at 08:00 hours, and that the staphylococcal concentrations increased by 80% at 1200 h over a 4-hour period with routine ward and clinical activities. Irrespective of the MRSA status of the patients, high-touch surfaces around the bed-units within the studied medical ward were heavily contaminated (ranged 1 to 276 cfu/cm2 amongst the sites with positive culture) with staphylococcal bacteria including MRSA, despite the implementation of daily hypochlorite wiping. However, the contamination rate dropped significantly from 78% to 11% after the application of the QAC polymer. In the experimental group, the mean staphylococcal concentration of bedside surfaces was significantly (p < 0.0001) reduced from 4.4 ± 8.7 cfu/cm2 at 08:00 hours to 0.07 ± 0.26 cfu/cm2 at 12:00 hours by the QAC polymer. The results of this study support the view that, in addition to hypochlorite wiping, the tested QAC surfactant is a potential environmental decontamination strategy for preventing the transmission of clinically important pathogens in medical wards. PMID:25768241

  15. MRSA Clonal Complex 22 Strains Harboring Toxic Shock Syndrome Toxin (TSST-1) Are Endemic in the Primary Hospital in Gaza, Palestine

    PubMed Central

    Chen, Liang; Abdelateef, Nahed; Elamreen, Farid Abu; Ginocchio, Christine C.; Pierard, Denis; Becker, Karsten; Kreiswirth, Barry N.

    2015-01-01

    Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in both community and healthcare-related settings worldwide. Current knowledge regarding the epidemiology of S. aureus and MRSA in Gaza is based on a single community-based carriage study. Here we describe a cross-sectional analysis of 215 clinical isolates collected from Al-Shifa Hospital in Gaza during 2008 and 2012. Methods All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using VITEK2 and MicroScan. Results MRSA represented 56.3% of all S. aureus strains, and increased in frequency from 2008 (54.8%) to 2012 (58.4%). Aside from beta-lactams, resistance was observed to tetracycline, erythromycin, clindamycin, gentamicin, and fluoroquinolones. Molecular typing identified 35 spa types representing 17 MLST clonal complexes (CC), with spa 998 (Ridom t223, CC22) and spa 70 (Ridom t044, CC80) being the most prevalent. SCCmec types I, III, IV, V and VI were identified among MRSA isolates, while type II was not detected. PVL genes (lukF/S-PV) were detected in 40.0% of all isolates, while the TSST-1 gene (tst) was detected in 27.4% of all isolates, with surprisingly high frequency within CC22 (70.4%). Both PVL and TSST-1 genes were found in several isolates from 2012. Conclusions Molecular typing of clinical isolates from Gaza hospitals revealed unusually high prevalence of TSST-1 genes among CC22 MRSA, which is noteworthy given a recent community study describing widespread carriage of a CC22 MRSA clone known as the ‘Gaza strain’. While the latter did not address TSST-1, tst-positive spa 998 (Ridom t223) has been detected in several neighboring countries, and described as endemic in an Italian NICU, suggesting international spread of a ‘Middle Eastern variant’ of pandemic CC22 strain EMRSA-15. PMID:25781188

  16. Phenotypic and genomic comparisons of highly vancomycin-resistant Staphylococcus aureus strains developed from multiple clinical MRSA strains by in vitro mutagenesis

    PubMed Central

    Ishii, Kenichi; Tabuchi, Fumiaki; Matsuo, Miki; Tatsuno, Keita; Sato, Tomoaki; Okazaki, Mitsuhiro; Hamamoto, Hiroshi; Matsumoto, Yasuhiko; Kaito, Chikara; Aoyagi, Tetsuji; Hiramatsu, Keiichi; Kaku, Mitsuo; Moriya, Kyoji; Sekimizu, Kazuhisa

    2015-01-01

    The development of vancomycin (VCM) resistance in Staphylococcus aureus threatens global health. Studies of the VCM-resistance mechanism and alternative therapeutic strategies are urgently needed. We mutagenized S. aureus laboratory strains and methicillin-resistant S. aureus (MRSA) with ethyl methanesulfonate, and isolated mutants that exhibited high resistance to VCM (minimum inhibitory concentration?=?32??g/ml). These VCM-resistant strains were sensitive to linezolid and rifampicin, and partly to arbekacin and daptomycin. Beta-lactams had synergistic effects with VCM against these mutants. VCM-resistant strains exhibited a 2-fold increase in the cell wall thickness. Several genes were commonly mutated among the highly VCM-resistant mutants. These findings suggest that MRSA has a potential to develop high VCM resistance with cell wall thickening by the accumulation of mutations. PMID:26603341

  17. Is Xpert MRSA/SA SSTI real-time PCR a reliable tool for fast detection of methicillin-resistant coagulase-negative staphylococci in periprosthetic joint infections?

    PubMed

    Lourtet-Hascoëtt, J; Bicart-See, A; Félicé, M P; Giordano, G; Bonnet, E

    2015-09-01

    Periprosthetic joint infections (PJIs) are frequently caused by methicillin-resistant coagulase-negative staphylococci (CoNS). Cultures remain the gold standard but often require a few days. Thus, a rapid test could be interesting to guide antibiotic strategy earlier. The purpose of this study was to evaluate the performances of RT-PCR Xpert® MRSA/SA technique for the detection of methicillin-resistant CoNS (MRCoNS) from deep samples in patients with PJIs. RT-PCR was tested on 72 samples. Sensitivity, specificity, positive predictive value, and negative predictive value of RT-PCR method were 0.36, 0.98, 0.90, and 0.74, respectively. Although RT-PCR may allow early microbial diagnosis of PJI due to Staphylococcus aureus (MSSA and MRSA), the low sensitivity and the high cost of this method to detect MRCoNS could limit its use in this field. PMID:26052062

  18. Phenotypic and genomic comparisons of highly vancomycin-resistant Staphylococcus aureus strains developed from multiple clinical MRSA strains by in vitro mutagenesis.

    PubMed

    Ishii, Kenichi; Tabuchi, Fumiaki; Matsuo, Miki; Tatsuno, Keita; Sato, Tomoaki; Okazaki, Mitsuhiro; Hamamoto, Hiroshi; Matsumoto, Yasuhiko; Kaito, Chikara; Aoyagi, Tetsuji; Hiramatsu, Keiichi; Kaku, Mitsuo; Moriya, Kyoji; Sekimizu, Kazuhisa

    2015-01-01

    The development of vancomycin (VCM) resistance in Staphylococcus aureus threatens global health. Studies of the VCM-resistance mechanism and alternative therapeutic strategies are urgently needed. We mutagenized S. aureus laboratory strains and methicillin-resistant S. aureus (MRSA) with ethyl methanesulfonate, and isolated mutants that exhibited high resistance to VCM (minimum inhibitory concentration?=?32??g/ml). These VCM-resistant strains were sensitive to linezolid and rifampicin, and partly to arbekacin and daptomycin. Beta-lactams had synergistic effects with VCM against these mutants. VCM-resistant strains exhibited a 2-fold increase in the cell wall thickness. Several genes were commonly mutated among the highly VCM-resistant mutants. These findings suggest that MRSA has a potential to develop high VCM resistance with cell wall thickening by the accumulation of mutations. PMID:26603341

  19. Anatomical patterns of colonization of pets with staphylococcal species in homes of people with methicillin-resistant Staphylococcus aureus (MRSA) skin or soft tissue infection (SSTI).

    PubMed

    Iverson, S A; Brazil, A M; Ferguson, J M; Nelson, K; Lautenbach, E; Rankin, S C; Morris, D O; Davis, M F

    2015-03-23

    Methicillin-resistant strains of Staphylococcus aureus (MRSA), Staphylococcus pseudintermedius (MRSP), and other pathogenic staphylococci can cause infections in companion animals and humans. Identification of colonized animals is fundamental to research and practice needs, but harmonized methods have not yet been established. To establish the optimal anatomic site for the recovery of methicillin-resistant coagulase positive staphylococci (CPS), survey data and swabs were collected from 196 pets (dogs, cats, reptiles, birds, fish and pocket pets) that lived in households with an MRSA-infected person. Using broth-enrichment culture and PCR for speciation, S. aureus was identified in 27 of 179 (15%) pets sampled at baseline and 19 of 125 (15%) pets sampled at a three-month follow-up home visit. S. pseudintermedius was isolated from 33 of 179 (18%) pets sampled at baseline and 21 of 125 (17%) of pets sampled at follow-up. The baseline MRSA and MRSP prevalence was 8% and 1% respectively from 145 mammalian pets. The follow-up MRSA and MRSP prevalence was 7% and <1% respectively from 95 mammalian pets. The mouth was the most sensitive single site sampled for isolation of S. aureus and S. pseudintermedius in mammals. In a subset of pets, from which all available isolates were identified, dual carriage of S. aureus and S. pseudintermedius was 22% at baseline and 11% at follow-up. These results identify the mouth as the most sensitive site to screen for pathogenic staphylococci and suggest that it should be included in sampling protocols. PMID:25623014

  20. Proteomic and genomic analysis of methicillin-resistant Staphylococcus aureus (MRSA) exposed to manuka honey in vitro demonstrated down-regulation of virulence markers

    PubMed Central

    Jenkins, Rowena; Burton, Neil; Cooper, Rose

    2014-01-01

    Objectives Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen. Its resistance to multiple antibiotics and its prevalence in healthcare establishments make it a serious threat to human health that requires novel interventions. Manuka honey is a broad-spectrum antimicrobial agent that is gaining acceptance in the topical treatment of wounds. Because its mode of action is only partially understood, proteomic and genomic analysis was used to investigate the effects of manuka honey on MRSA at a molecular level. Methods Two-dimensional gel electrophoresis with dual-channel imaging was combined with matrix-assisted laser desorption ionization–time of flight mass spectrometry to determine the identities of differentially expressed proteins. The expression of the corresponding genes was investigated by quantitative PCR. Microarray analysis provided an overview of alterations in gene expression across the MRSA genome. Results Genes with increased expression following exposure to manuka honey were associated with glycolysis, transport and biosynthesis of amino acids, proteins and purines. Those with decreased expression were involved in the tricarboxylic acid cycle, cell division, quorum sensing and virulence. The greatest reductions were seen in genes conferring virulence (sec3, fnb, hlgA, lip and hla) and coincided with a down-regulation of global regulators, such as agr, sae and sarV. A model to illustrate these multiple effects was constructed and implicated glucose, which is one of the major sugars contained in honey. Conclusions A decreased expression of virulence genes in MRSA will impact on its pathogenicity and needs to be investigated in vivo. PMID:24176984

  1. Discovery of an ultra-short linear antibacterial tetrapeptide with anti-MRSA activity from a structure-activity relationship study.

    PubMed

    Lau, Qiu Ying; Ng, Fui Mee; Cheong, Jin Wei Darryl; Yap, Yi Yong Alvin; Tan, Yoke Yan Fion; Jureen, Roland; Hill, Jeffrey; Chia, Cheng San Brian

    2015-11-13

    The overuse and misuse of antibiotics has resulted in the emergence of drug-resistant pathogenic bacteria, including meticillin-resistant Staphylococcus aureus (MRSA), the primary pathogen responsible for human skin and soft-tissue infections. Antibacterial peptides are known to kill bacteria by rapidly disrupting their membranes and are deemed plausible alternatives to conventional antibiotics. One advantage of their membrane-targeting mode of action is that bacteria are unlikely to develop resistance as changing their cell membrane structure and morphology would likely involve extensive genetic mutations. However, major concerns in using peptides as antibacterial drugs include their instability towards plasma proteases, toxicity towards human cells due to their membrane-targeting mode of action and high manufacturing cost. These concerns can be mitigated by developing peptides as topical agents, by the judicial selection of amino acids and developing very short peptides respectively. In this preliminary report, we reveal a linear, non-hemolytic tetrapeptide with rapid bactericidal activity against MRSA developed from a structure-activity relationship study based on the antimicrobial hexapeptide WRWRWR-NH2. Our finding opens promising avenues for the development of ultra-short antibacterials to treat multidrug-resistant MRSA skin and soft tissue infections. PMID:26489599

  2. Detection of mecA and enterotoxin genes in Staphylococcus aureus isolates associated with bovine mastitis and characterization of Staphylococcal cassette chromosome mec (SCCmec) in MRSA strains.

    PubMed Central

    Havaei, Seyed Asghar; Assadbeigi, Behnaz; Esfahani, Bahram Nasr; Hoseini, Nafiseh Sadat; Rezaei, Nahid; Havaei, Seyed Rouhollah

    2015-01-01

    Background and Objectives: Staphylococcus aureus is one of the main causatives of bovine mastitis. Resistance of some strains to methicillin, can complicate the treatment of its infections. On the other hand, enterotoxin production is also important. Therefore, the aim of our study was to investigate the methicillin resistance and enterotoxin production in S. aureus isolates caused bovine mastitis. Materials and Methods: Four hundred and fifty milk samples were collected. After isolation of Staphylococcus aureus, MRSA strains were detected by cefoxitin disc diffusion and oxacillin agar screening methods. DNA was extracted by phenol – chloroform method and PCR was applied for mecA, sea and seb genes. SCCmec types of mecA gene were identified using multiplex-PCR. Results: Fifty-four (12%) S. aureus were isolated. Out of these, 10 and 9 MRSA strains identified by cefoxitin disc diffusion and oxacillin agar screening methods, respectively. All 10 MRSA isolates identified by cefoxitin disc diffusion, were positive for mecA gene and all of them belonged to SCCmec type IV. The sea genes were detected in 19 isolates and only two isolates were positive for seb genes. One isolate possessed both sea and seb genes. Conclusion: Findings of this study indicated that results of cefoxitin disc diffusion test is in concordance with the PCR for mecA gene and has a higher sensitivity compared to oxacillin agar screening method. Finally, Our findings suggest that enterotoxin A is the dominant type.

  3. SPR-DNA array for detection of methicillin-resistant Staphylococcus aureus (MRSA) in combination with loop-mediated isothermal amplification.

    PubMed

    Nawattanapaiboon, Kawin; Kiatpathomchai, Wansika; Santanirand, Pitak; Vongsakulyanon, Apirom; Amarit, Ratthasart; Somboonkaew, Armote; Sutapun, Boonsong; Srikhirin, Toemsak

    2015-12-15

    In this study, we evaluated surface plasmon resonance imaging (SPR imaging) as a DNA biosensor for the detection of methicillin-resistant Staphylococcus aureus (MRSA) which is one of the most common causes of nosocomial infections. The DNA sample were collected from clinical specimens, including sputum and blood hemoculture were undergone LAMP amplification for 0.18 kbp and 0.23 kbp DNA fragments of femB and mecA genes, respectively. The self-assembled monolayer surface (SAMs) was used for immobilized streptavidin-biotinylated probes on the sensor surface for the detection of LAMP amplicons from MRSA. Both LAMP amplicons were simultaneously hybridized with ssDNA probes immobilized onto a bio-functionalized surface to detect specific targets in the multiplex DNA array platform. In addition, the sensor surface could be regenerated allowing at least five cycles of use with a shortened assay time. The detection limit of LAMP-SPR sensing was 10 copies/µl and LAMP-SPR sensing system showed a good selectivity toward the MRSA. PMID:26159153

  4. Frequency of biocide-resistant genes and susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA).

    PubMed

    Liu, Qingzhong; Zhao, Huanqiang; Han, Lizhong; Shu, Wen; Wu, Qiong; Ni, Yuxing

    2015-08-01

    The aim of this study was to determine the prevalence of biocide-resistant determinants and the susceptibility to chlorhexidine in high-level mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MuH MRSA). Fifty-three MuH MRSA isolates were analyzed for plasmid-borne genes (qacA/B, smr, qacG, qacH, and qacJ) by polymerase chain reaction (PCR); for chromosome-mediated genes (norA, norB, norC, mepA, mdeA, sepA, and sdrM) by PCR and quantitative reverse transcription-PCR (qRT-PCR); and for susceptibility to chlorhexidine by MIC and minimum bactericidal concentration (MBC). Furthermore, disinfectant efficacy was tested in the presence of 3.0% bovine serum albumin (BSA) in MBC detection. The plasmid-borne genes qacA/B (83.0%) and smr (77.4%) and overexpressions of chromosome-mediated genes norA (49.0%) and norB (28.8%) were predominantly found in isolates studied, and 90.6% of the isolates revealed tolerance to chlorhexidine. In the presence of BSA, the average MBC of chlorhexidine for these isolates rose to 256 ?g/mL. Altogether, our results suggest that surveillance of sensitivity to biocides among MuH MRSA isolates is essential for hospital infection control. PMID:26008124

  5. Residential Culturable Fungi, (1–3, 1–6)-?-D-glucan, and Ergosterol Concentrations in Dust Are Not Associated with Asthma, Rhinitis or Eczema Diagnoses in Children

    PubMed Central

    Choi, Hyunok; Byrne, Sam; Larsen, Lisbeth Suldrup; Sigsgaard, Torben; Thorne, Peter S.; Larsson, Lennart; Sebastian, Aleksandra; Bornehag, Carl-Gustaf

    2014-01-01

    Background Qualitative reporting of home indoor moisture problems predicts respiratory diseases. However, causal agents underlying such qualitative markers remain unknown. Methods In the homes of 198 multiple allergic case children and 202 controls in Sweden, we cultivated culturable fungi by directly plating dust, and quantified(1–3, 1–6)-?-D-glucan, and ergosterol in dust samples from the child’s bedroom. We examined the relationship between these fungal agents and degree of parent or inspector reported home indoor dampness, and microbiological laboratory’s mold index. We also compared the concentrations of these agents between multiple allergic cases and healthy controls, as well as IgE-sensitization among cases. Results The concentrations of culturable fungal agents were comparable between houses with parent and inspector reported mold issues and those without. There were no differences in concentrations of the individual or the total summed culturable fungi, (1–3, 1–6)-?-D-glucan, and ergosterol between the controls and the multiple allergic case children, or individual diagnosis of asthma, rhinitis or eczema. Conclusion Culturable fungi, (1–3, 1–6)-?-D-glucan, and ergosterol in dust were not associated with qualitative markers of indoor dampness or mold or indoor humidity. Furthermore, these agents in dust samples were not associated with any health outcomes in the children. PMID:24016225

  6. Climate and prevalence of atopic eczema in 6- to 7-year-old school children in Spain. ISAAC PhASE III

    NASA Astrophysics Data System (ADS)

    Suárez-Varela, María Morales; García-Marcos Alvarez, Luís; Kogan, Michael D.; González, Agustín Llopis; Gimeno, Antonio Martínez; Ontoso, Inés Aguinaga; Díaz, Carlos González; Pena, Alberto Arnedo; Aurrecoechea, Begoña Domínguez; Monge, Rosa María Busquets; Quiros, Alfredo Blanco; Garrido, José Batlles; Canflanca, Iñaqui Miner; Varela, Ángel López-Silvarrey

    2008-11-01

    Atopic eczema (AE) is a chronic skin disease. Recent reports indicate that the worldwide prevalence of AE is increasing and that various environmental factors are implicated in its aetiology. Climatic conditions have been related with AE prevalence, and Spain has varying climatic conditions. The aim of this study is to document the possible climatic influence on the prevalence of AE in schoolchildren aged 6-7 years in three different climatic regions in Spain. We conducted a cross-sectional population-based survey of 28,394 schoolchildren aged 6-7 years from 10 Spanish centres in three different climatic regions. The mean participation rate was 76.5%. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Spanish Academy of Dermatology criteria used in Spain to diagnose AE. The data, including annual temperature, precipitation, relative humidity and the annual number of sunny hours per climatic region, were obtained from the Spanish National Institute of Meteorology. Different AE prevalences were found in all three climatic regions studied: Atlantic, 32.9; Mediterranean 28.3; and Continental 31.2 per 100 children studied ( p < 0.005). AE was positively associated with precipitation and humidity, and was negatively associated with temperature and the number of sunny hours. The results show that AE is significantly dependent on meteorological conditions.

  7. Caco-2 cells cytotoxicity of nifuroxazide derivatives with potential activity against Methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Fernandes, Mariane B; Gonçalves, José E; Scotti, Marcus T; de Oliveira, Alex A; Tavares, Leoberto C; Storpirtis, Sílvia

    2012-04-01

    It is important to determine the toxicity of compounds and co-solvents that are used in cell monolayer permeability studies to increase confidence in the results obtained from these in vitro experiments. This study was designed to evaluate the cytotoxicity of new nifuroxazide derivatives with potential activity against Methicillin-resistant Staphylococcus aureus (MRSA) in Caco-2 cells to select analogues for further in vitro permeability analyses. In this study, nitrofurantoin and nifuroxazide, in addition to 6 furanic and 6 thiophenic nifuroxazide derivatives were tested at 2, 4, 6, 8 and 10 ?g/mL. In vitro cytotoxicity assays were performed according to the MTT (methyl tetrazolium) assay protocol described in ISO 10993-5. The viability of treated Caco-2 cells was greater than 83% for all tested nitrofurantoin concentrations, while those treated with nifuroxazide at 2, 4 and 6 ?g/mL had viabilities greater than 70%. Treatment with the nifuroxazide analogues resulted in viability values greater than 70% at 2 and 4 ?g/mL with the exception of the thiophenic methyl-substituted derivative, which resulted in cell viabilities below 70% at all tested concentrations. Caco-2 cells demonstrated reasonable viability for all nifuroxazide derivatives, except the thiophenic methyl-substituted compound. The former were selected for further permeability studies using Caco-2 cells. PMID:22285235

  8. Turning the tide or riding the waves? Impacts of antibiotic stewardship and infection control on MRSA strain dynamics in a Scottish region over 16?years: non-linear time series analysis

    PubMed Central

    Lawes, Timothy; López-Lozano, José-María; Nebot, César; Macartney, Gillian; Subbarao-Sharma, Rashmi; Dare, Ceri R J; Edwards, Giles F S; Gould, Ian M

    2015-01-01

    Objectives To explore temporal associations between planned antibiotic stewardship and infection control interventions and the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA). Design Retrospective ecological study and time-series analysis integrating typing data from the Scottish MRSA reference laboratory. Setting Regional hospital and primary care in a Scottish Health Board. Participants General adult (N=1?051?993) or intensive care (18?235) admissions and primary care registrations (460?000 inhabitants) between January 1997 and December 2012. Interventions Hand-hygiene campaign; MRSA admission screening; antibiotic stewardship limiting use of macrolides and ‘4Cs’ (cephalosporins, coamoxiclav, clindamycin and fluoroquinolones). Outcome measures Prevalence density of MRSA clonal complexes CC22, CC30 and CC5/Other in hospital (isolates/1000 occupied bed days, OBDs) and community (isolates/10?000 inhabitant-days). Results 67% of all clinical MRSA isolates (10?707/15?947) were typed. Regional MRSA population structure was dominated by hospital epidemic strains CC30, CC22 and CC45. Following declines in overall MRSA prevalence density, CC5 and other strains of community origin became increasingly important. Reductions in use of ‘4Cs’ and macrolides anticipated declines in sublineages with higher levels of associated resistances. In multivariate time-series models (R2=0.63–0.94) introduction of the hand-hygiene campaign, reductions in mean length of stay (when >4?days) and bed occupancy (when >74 to 78%) predicted declines in CC22 and CC30, but not CC5/other strains. Lower importation pressures, expanded MRSA admission screening, and reductions in macrolide and third generation cephalosporin use (thresholds for association: 135–141, and 48–81 defined daily doses/1000 OBDs, respectively) were followed by declines in all clonal complexes. Strain-specific associations with fluoroquinolones and clindamycin reflected resistance phenotypes of clonal complexes. Conclusions Infection control measures and changes in population antibiotic use were important predictors of MRSA strain dynamics in our region. Strategies to control MRSA should consider thresholds for effects and strain-specific impacts. PMID:25814495

  9. In vitro pharmacodynamics of human simulated exposures of ceftaroline and daptomycin against MRSA, hVISA, and VISA with and without prior vancomycin exposure.

    PubMed

    Bhalodi, Amira A; Hagihara, Mao; Nicolau, David P; Kuti, Joseph L

    2014-01-01

    The effects of prior vancomycin exposure on ceftaroline and daptomycin therapy against methicillin-resistant Staphylococcus aureus (MRSA) have not been widely studied. Humanized free-drug exposures of vancomycin at 1 g every 12 h (q12h), ceftaroline at 600 mg q12h, and daptomycin at 10 mg/kg of body weight q24h were simulated in a 96-h in vitro pharmacodynamic model against three MRSA isolates, including one heteroresistant vancomycin-intermediate S. aureus (hVISA) isolate and one VISA isolate. A total of five regimens were tested: vancomycin, ceftaroline, and daptomycin alone for the entire 96 h, and then sequential therapy with vancomycin for 48 h followed by ceftaroline or daptomycin for 48 h. Microbiological responses were measured by the changes in log10 CFU during 96 h from baseline. Control isolates grew to 9.16 ± 0.32, 9.13 ± 0.14, and 8.69 ± 0.28 log10 CFU for MRSA, hVISA, and VISA, respectively. Vancomycin initially achieved ?3 log10 CFU reductions against the MRSA and hVISA isolates, followed by regrowth beginning at 48 h; minimal activity was observed against VISA. The change in 96-h log10 CFU was largest for sequential therapy with vancomycin followed by ceftaroline (-5.22 ± 1.2, P = 0.010 versus ceftaroline) and for sequential therapy with vancomycin followed by ceftaroline (-3.60 ± 0.6, P = 0.037 versus daptomycin), compared with daptomycin (-2.24 ± 1.0), vancomycin (-1.40 ± 1.8), and sequential therapy with vancomycin followed by daptomycin (-1.32 ± 1.0, P > 0.5 for the last three regimens). Prior exposure of vancomycin at 1 g q12h reduced the initial microbiological response of daptomycin, particularly for hVISA and VISA isolates, but did not affect the response of ceftaroline. In the scenario of poor vancomycin response for high-inoculum MRSA infection, a ceftaroline-containing regimen may be preferred. PMID:24217694

  10. Decolonisation of MRSA, S. aureus and E. coli by Cold-Atmospheric Plasma Using a Porcine Skin Model In Vitro

    PubMed Central

    Maisch, Tim; Shimizu, Tetsuji; Li, Yang-Fang; Heinlin, Julia; Karrer, Sigrid; Morfill, Gregor; Zimmermann, Julia L.

    2012-01-01

    In the last twenty years new antibacterial agents approved by the U.S. FDA decreased whereas in parallel the resistance situation of multi-resistant bacteria increased. Thus, community and nosocomial acquired infections of resistant bacteria led to a decrease in the efficacy of standard therapy, prolonging treatment time and increasing healthcare costs. Therefore, the aim of this work was to demonstrate the applicability of cold atmospheric plasma for decolonisation of Gram-positive (Methicillin-resistant Staphylococcus aureus (MRSA), Methicillin-sensitive Staphylococcus aureus) and Gram-negative bacteria (E. coli) using an ex vivo pig skin model. Freshly excised skin samples were taken from six month old female pigs (breed: Pietrain). After application of pure bacteria on the surface of the explants these were treated with cold atmospheric plasma for up to 15 min. Two different plasma devices were evaluated. A decolonisation efficacy of 3 log10 steps was achieved already after 6 min of plasma treatment. Longer plasma treatment times achieved a killing rate of 5 log10 steps independently from the applied bacteria strains. Histological evaluations of untreated and treated skin areas upon cold atmospheric plasma treatment within 24 h showed no morphological changes as well as no significant degree of necrosis or apoptosis determined by the TUNEL-assay indicating that the porcine skin is still vital. This study demonstrates for the first time that cold atmospheric plasma is able to very efficiently kill bacteria applied to an intact skin surface using an ex vivo porcine skin model. The results emphasize the potential of cold atmospheric plasma as a new possible treatment option for decolonisation of human skin from bacteria in patients in the future without harming the surrounding tissue. PMID:22558091

  11. Fatty Acyl Incorporation in the Biosynthesis of WAP-8294A, a Group of Potent Anti-MRSA Cyclic Lipodepsipeptides

    PubMed Central

    Chen, Haotong; Olson, Andrew S.; Su, Wei; Dussault, Patrick H.; Du, Liangcheng

    2015-01-01

    WAP-8294A is a family of at least 20 cyclic lipodepsipeptides exhibiting potent anti-MRSA activity. These compounds differ mainly in the hydroxylated fatty acyl chain; WAP-8294A2, the most potent member of the family that reached clinical trials, is based on (R)-3-hydroxy-7-methyloctanoic acid. It is unclear how the acyl group is incorporated because no acyl-CoA ligase (ACL) gene is present in the WAP-8294A gene cluster in Lysobacter enzymogenes OH11. Here, we identified seven putative ACL genes in the OH11 genome and showed that the yield of WAP-8294A2 was impacted by multiple ACL genes with the ACL6 gene having the most significant effect. We then investigated several (R)-3-hydroxy fatty acids and their acyl SNAC (N-acetylcysteamine) thioesters as substrates for the ACLs. Feeding (R)-3-hydroxy-7-methyloctanoate-SNAC to the ACL6 gene deletion mutant restored the production of WAP-8294A2. Finally, we heterologously expressed the seven ACL genes in E. coli and purified six of the proteins. While these enzymes exhibit a varied level of activity in vitro, ACL6 showed the highest catalytic efficiency in converting (R)-3-hydroxy-7-methyloctanoic acid to its CoA thioester when incubated with coenzyme A and ATP. These results provided both in vivo and in vitro evidence to support the fact that ACL6 is the main player for fatty acyl activation and incorporation in WAP-8294A2 biosynthesis. The results also suggest that the molecular basis for the acyl chain diversity in the WAP-8294A family is the presence of functionally overlapping ACLs.

  12. N-palmitoylethanolamine and N-acetylethanolamine are effective in asteatotic eczema: results of a randomized, double-blind, controlled study in 60 patients

    PubMed Central

    Yuan, Chao; Wang, Xue-Min; Guichard, Alexandre; Tan, Yi-Mei; Qian, Chun-Yan; Yang, Li-Jie; Humbert, Philippe

    2014-01-01

    Background Asteatotic eczema (AE) is characterized by itchy, dry, rough, and scaling skin. The treatments for AE are mainly emollients, usually containing urea, lactic acid, or a lactate salt. N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA) are both endogenous lipids used as novel therapeutic tools in the treatment of many skin diseases. The purpose of this study was to compare a PEA/AEA emollient with a traditional emollient in the treatment of AE. Methods A monocentric, randomized, double-blind, comparative trial was conducted in 60 AE patients to evaluate and compare the efficacy of the two emollients. The level of skin dryness among the subjects ranged from mild to moderate. The subjects’ skin barrier function and the current perception threshold were tested for 28 days by clinical scoring and bioengineering technology. Results The results showed that, although some aspects were improved in both groups, the group using the emollient containing PEA/AEA presented a better skin surface change in capacitance. However, the most impressive finding was the ability of the PEA/AEA emollient to increase the 5 Hz current perception threshold to a normal level after 7 days, with a significant difference between values at baseline and after 14 days. A current perception threshold of 5 Hz was positively and significantly correlated with skin surface hydration and negatively correlated with transepidermal water loss in the PEA/AEA emollient group. Conclusion Compared with traditional emollients, regular application of a topical PEA/AEA emollient could improve both passive and active skin functions simultaneously. PMID:25071367

  13. Cow's milk and ovalbumin-specific IgG and IgA in children with eczema: low ?-lactoglobulin-specific IgG4 levels are associated with cow's milk allergy.

    PubMed

    Savilahti, Emma M; Viljanen, Mirva; Kuitunen, Mikael; Savilahti, Erkki

    2012-09-01

    Tolerance to allergens may partly depend on allergen-specific IgG and IgG subclasses and IgA antibodies. We investigated whether specific IgG and IgG subclasses and IgA antibodies to ?-lactoglobulin, ?-casein, and ovalbumin differed between infants who had verified cow's milk allergy (CMA) and infants with cow's milk (CM)-associated eczema, but negative CM oral challenge. The study population comprised 95 infants with clinical eczema that was by history associated with the consumption of CM. After an elimination period, a double-blind, placebo-controlled (DBPC) CM oral challenge confirmed CMA in 45 infants. Skin prick tests (SPT) were performed with CM and hen's egg. Serum levels of IgE antibodies to CM and hen's egg were measured with UniCAP (Phadia, Uppsala, Sweden), and levels of IgA, IgG, IgG1, and IgG4 antibodies to ?-lactoglobulin, ?-casein, and ovalbumin were measured with enzyme-linked immunosorbent assay. We observed that infants with CMA had lower IgG4 levels to ?-lactoglobulin than infants with negative DBPC CM challenge (p = 0.004). Positive CM SPT was associated with lower IgG4 levels to ?-casein (p = 0.04). The relation of CM IgE to ?-lactoglobulin and ?-casein IgG4 was higher in CMA than in infants with negative challenge (p < 0.002 and 0.0001). Positive egg SPT was associated with elevated levels of specific IgG to ovalbumin, ?-lactoglobulin, and ?-casein as well as IgA to ?-casein (p < 0.04). Our study thus shows that low ?-lactoglobulin-specific serum IgG4 levels may differentiate eczematous infants with CMA from infants who have eczema with only suspected association with CM. PMID:22435658

  14. Mycelium of fungi isolated from mouldy foods inhibits Staphylococcus aureus including MRSA – A rationale for the re-introduction of mycotherapy?

    PubMed Central

    Alnaimat, Sulaiman; Alharbi, Naiyf S.; Alharbi, Sulaiman Ali; Salmen, Saleh H.; Chinnathambi, Arunachalam; Al-Johny, Bassam O.; Wainwright, M.

    2015-01-01

    Fungal mycelium capable of producing antibacterial agents was isolated from samples of apple, beetroot, lemon and orange; the mycelium of all isolates produced penicillin, while the apple and beetroot samples also produced the antibacterial mycotoxin patulin. The known penicillin-producing fungi were shown to produce penicillin, but not patulin. The mycelial discs of all of fruit and vegetable isolates, as well as the two known penicillin producing fungi, inhibited Staphylococcus aureus, and mycelium of all isolates inhibited MRSA, in contrast, only one of the two known penicillin-producers did so. The results are discussed in relation to the possibility of using the mycelium of Penicillium species in mycotherapy. PMID:26288565

  15. Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections: A South Texas Ambulatory Research Network (STARNet) study

    PubMed Central

    Labreche, Matthew J.; Lee, Grace C.; Attridge, Russell T.; Mortensen, Eric M.; Koeller, Jim; Du, Liem C.; Nyren, Natalie R.; Treviño, Lucina B.; Treviño, Sylvia B.; Peña, Joel; Mann, Michael W.; Muñoz, Abilio; Marcos, Yolanda; Rocha, Guillermo; Koretsky, Stella; Esparza, Sandra; Finnie, Mitchell; Dallas, Steven D.; Parchman, Michael L.; Frei, Christopher R.

    2013-01-01

    Objective To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs). Methods This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have “moderate or complicated” SSTIs if they had a lesion ? 5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. Results Overall, treatment failure occurred in 21% of patients (n=21/98) at a mean additional cost of $1,933.71 per patient. Treatment failure occurred in 27% of patients in the moderate or complicated group and 11% of patients in the mild or uncomplicated group (p = 0.08). In a subgroup analysis of patients who received I&D, patients with moderate or complicated SSTIs had higher rates of treatment failure than patients with mild or uncomplicated SSTIs (36% vs. 10%; p = 0.04). Conclusions One in five patients presenting to a primary care clinic for a MRSA SSTI will likely require additional interventions as a result of treatment failure at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting. PMID:24004702

  16. Investigation into the potential of sub-lethal photodynamic antimicrobial chemotherapy (PACT) to reduce susceptibility of meticillin-resistant Staphylococcus aureus (MRSA) to antibiotics

    NASA Astrophysics Data System (ADS)

    Cassidy, C. M.; Donnelly, R. F.; Tunney, M. M.

    2009-06-01

    In PACT, a combination of a sensitising drug and visible light cause the selective destruction of microbial cells via singlet oxygen production. As singlet oxygen is a non-specific oxidizing agent and is only present during illumination, development of resistance to this treatment is thought to be unlikely. However, in response to oxidative stress, bacteria can up-regulate oxidative stress genes and associated antibiotic resistance genes. The up-regulation of these genes and potential transfer of genetic material may result in a resistant bacterial population. This study determined whether treatment of clinically isolated meticillin resistant Staphylococcus aureus (MRSA) strains with sub-lethal doses of methylene blue (MB) and meso-tetra (N-methyl-4-pyridyl) porphine tetra tosylate (TMP)-PACT resulted in reduced susceptibility to antibiotics and previously lethal PACT. Exposure of strains to sub-lethal doses of photosensitizer in combination with light had no effect on susceptibility to previously lethal photosensitization. Furthermore, exposure to sub-lethal concentrations of both photosensitizers caused no significant changes in the minimum inhibitory concentration (MIC) for each strain tested. Any differences in susceptibility were not significant as they did not cross breakpoints between resistant and susceptible for any organism or antibiotic tested. Therefore, PACT remains an attractive alternative option for treatment of MRSA infections.

  17. Pet Care: MRSA FAQ

    MedlinePLUS

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  18. Photos of MRSA Infections

    MedlinePLUS

    ... Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333 800-CDC-INFO (800-232-4636) TTY: ( ... Disease Control and Prevention 1600 Clifton Road Atlanta, GA 30329-4027, USA 800-CDC-INFO (800-232- ...

  19. Eczema (Atopic Dermatitis) in Infants

    MedlinePLUS

    ... clothing Tobacco smoke and chemicals Some soaps and detergents Who's At Risk Infants are more likely to ... bathing. Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress. Fragrance- ...

  20. Eczema (Atopic Dermatitis) in Adults

    MedlinePLUS

    ... condition primarily affecting allergy-prone people. Heat, humidity, detergents/soaps, abrasive clothing (eg, very scratchy wools), chemicals, ... bathing. Attempt to minimize exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress. Fragrance- ...

  1. Eczema (Atopic Dermatitis) in Children

    MedlinePLUS

    ... primarily affecting people who have allergies. Heat, humidity, detergents/soaps, abrasive clothing (eg, very scratchy wools), chemicals, ... bathing. Try to reduce exposure to heat, humidity, detergents/soaps, abrasive clothing, chemicals, smoke, and stress. Use ...

  2. Expression, purification, crystallization and preliminary X-ray diffraction studies of triosephosphate isomerase from methicillin-resistant Staphylococcus aureus (MRSA252)

    PubMed Central

    Mukherjee, Somnath; Dutta, Debajyoti; Saha, Baisakhee; Das, Amit Kumar

    2009-01-01

    Triosephosphate isomerase from methicillin-resistant Staphylococcus aureus (MRSA252) was cloned in pQE30 vector, overexpressed in Escherichia coli M15 (pREP4) cells and purified to homogeneity. The protein was crystallized from 1.6?M trisodium citrate dihydrate pH 6.5 using the hanging-drop vapour-diffusion method. The crystals belonged to space group P43212, with unit-cell parameters a = b = 79.15, c = 174.27?Å. X-ray diffraction data were collected and processed to a maximum resolution of 1.9?Å. The presence of two molecules in the asymmetric unit gave a Matthews coefficient (V M) of 2.64?Å3?Da?1, with a solvent content of 53.63%. PMID:19342791

  3. Imidazolidine-4-one derivatives in the search for novel chemosensitizers of Staphylococcus aureus MRSA: synthesis, biological evaluation and molecular modeling studies.

    PubMed

    Matys, Anna; Podlewska, Sabina; Witek, Karolina; Witek, Jagna; Bojarski, Andrzej J; Schabikowski, Jakub; Otr?bska-Machaj, Ewa; Latacz, Gniewomir; Szyma?ska, Ewa; Kie?-Kononowicz, Katarzyna; Molnar, Joseph; Amaral, Leonard; Handzlik, Jadwiga

    2015-08-28

    A series of amine derivatives of 5-aromatic imidazolidine-4-ones (7-19), representing three subgroups: piperazine derivatives of 5-arylideneimidazolones (7-13), piperazine derivatives of 5-arylideneimidazolidine-2,4-dione (14-16) and primary amines of 5-naphthyl-5-methylimidazolidine-2,4-diones (17-19), was evaluated for their ability to improve antibiotics effectiveness in two strains of Gram-positive Staphylococcus aureus: ATCC 25923 (a reference strain) and MRSA (methicillin resistant S. aureus) HEMSA 5 (a resistant clinical isolate). The latter compounds (17-19) were obtained by 4-step synthesis using Bucherer-Bergs condensation, two-phase bromoalkylation and Gabriel reactions. The naphthalen derivative: (Z)-5-(naphthalen-2-ylmethylene)-2-(piperazin-1-yl)-3H-imidazol-4(5H)-one (10) was the most potent in combination with ?-lactam antibiotics and ciprofloxacin against the resistant strain. The high potency to increase efficacy of oxacillin was noted for (Z)-5-(anthracen-10-ylmethylene)-2-(piperazin-1-yl)-3H-imidazol-4(5H)one (12) too. In order to explain the mechanism of action of the compounds 10 and 12, docking studies with the use of crystal structures of a penicillin binding protein (PBP2a) and MecR1 were carried out. Their outcomes suggested that the most probable mechanism of action of the active compounds is the interaction with MecR1. Molecular dynamic experiments performed for the active compounds and compound 13 (structurally similar to 12) supported this hypothesis and provided possible explanation of activity dependencies of the tested compounds in terms of the restoration of antibiotic efficacy in S. aureus MRSA HEMSA 5. PMID:26160112

  4. Comparison of ESBL – And AmpC Producing Enterobacteriaceae and Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated from Migratory and Resident Population of Rooks (Corvus frugilegus) in Austria

    PubMed Central

    Mehinagic, Kemal; Rosengarten, Renate; Hoelzl, Franz; Knauer, Felix; Walzer, Chris

    2013-01-01

    In order to test whether rooks (Corvus frugilegus) represent good indicators for the potential circulation of antibiotics in their native habitat, two populations with different migratory behavior were tested for the presence of beta-lactamase producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (MRSA). In all, 54 and 102 samples of fresh feces of a migratory and a resident population were investigated. A total of 24 and 3 cefotaxime-resistant enterobacterial isolates were obtained from the migratory and resident population, respectively. In these isolates CTX-M-1 (n?=?15), CTX-M-3 (n?=?3), and CTX-M-15 (n?=?3) genes were detected. TEM-1 and OXA-1 were associated with CTX-M in 3 and 2 isolates, respectively. In two E. coli isolates CMY-2 could be detected, where from one isolate displayed an overexpression of chromosomal AmpC as well. Among E. coli isolates the most common phylogenetic group was A (n?=?11) and ST1683 (n?=?5). In one E. coli of B2-ST131 the rfbO25b locus was detected. Three Enterobacter isolates were stably derepressed AmpC-producers. In five samples of the migratory population, PVL positive MRSA could be isolated. Two isolates were typed SCCmec IVa, spa type t127, and ST1. Three isolates carried a SCCmec type IVc, with spa type t852 and ST22. The highly significant difference of the occurrence of antibiotic resistance between the migratory population from eastern Europe compared to resident population in our study indicates that rooks may be good indicator species for the evaluation of environmental contamination with antibiotic resistant bacteria, especially due to their ecology, foraging behavior and differing migratory behavior. PMID:24391878

  5. [Molecular epidemiology of the Methicillin-resistant Staphylococcus aureus(MRSA) by the internal transcribed spacer PCR (ITS-PCR) method and the phage open reading frame typing (POT) method].

    PubMed

    Senda, Yasuko; Takemori, Yukiko; Iwata, Yasunori; Fujita, Shinichi; Sakai, Yoshio; Wada, Takashi

    2014-05-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is the most common causative bacteria of hospital acquired infection, and should be rapidly identified for infection control. For this purpose, in our hospital, the PCR electrophoresis patterns of spacer regions (ITS: internal transcribed spacers) (ITS-PCR) are combined with a toxigenicity assay to establish a strain identification method for outbreak surveillance. In the present study, the usefulness of this method was evaluated in comparison with the POT (phage-open reading frame typing) method. One hundred MRSA strains isolated from inpatients in our hospital between April 2011 and March 2012 were classified into 25 patterns using the ITS-PCR method combined with a toxigenicity assay. The strains could be classified into 46 patterns using the POT method. ITS-PCR type 22 strain producing enterotoxin C and toxic shock syndrome toxin-1 could be further classified into 7 patterns using the POT method. In the outbreak of the type 22 strain, cross-infection could be excluded by additional analysis using the POT method, providing more precise information on strain identification. We identified that some strains of the same POT type consisted of different ITS-PCR types or toxigenicities. Therefore, these results suggest that the combination of ITS-PCR method plus toxigenicity assay with POT method may be a useful technique of MRSA typing. PMID:25051655

  6. [Reduction of livestock-associated methicillin-resistant staphylococcus aureus (LA-MRSA) in the exhaust air of two piggeries by a bio-trickling filter and a biological three-step air cleaning system].

    PubMed

    Clauss, Marcus; Schulz, Jochen; Stratmann-Selke, Janin; Decius, Maja; Hartung, Jörg

    2013-01-01

    "Livestock-associated" Methicillin-resistent Staphylococcus aureus (LA-MRSA) are frequently found in the air of piggeries, are emitted into the ambient air of the piggeries and may also drift into residential areas or surrounding animal husbandries.. In order to reduce emissions from animal houses such as odour, gases and dust different biological air cleaning systems are commercially available. In this study the retention efficiencies for the culturable LA-MRSA of a bio-trickling filter and a combined three step system, both installed at two different piggeries, were investigated. Raw gas concentrations for LA-MRSA of 2.1 x 10(2) cfu/m3 (biotrickling filter) and 3.9 x 10(2) cfu/m3 (three step system) were found. The clean gas concentrations were in each case approximately one power of ten lower. Both systems were able to reduce the number of investigated bacteria in the air of piggeries on average about 90%. The investigated systems can contribute to protect nearby residents. However, considerable fluctuations of the emissions can occur. PMID:23540196

  7. The herbal-derived honokiol and magnolol enhances immune response to infection with methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA).

    PubMed

    Choi, Eun-Jin; Kim, Hyung-Ip; Kim, Ji-Ae; Jun, Soo Youn; Kang, Sang Hyeon; Park, Dong June; Son, Seok-Jun; Kim, Younghoon; Shin, Ok Sarah

    2015-05-01

    The emergence of antibiotic resistant strains such as methicillin-resistant Staphylococcus aureus (MRSA) reminds us an urgent need to develop a new immune-modulating agent for preventing S. aureus infection. In this study, we found that herbal medicines, honokiol and magnolol, caused a significant cellular immune modulatory effect during S. aureus infection. In mouse macrophages, these compounds drove upregulation of an antioxidant effect in response to S. aureus, resulting in a dampened total cellular reactive oxygen species (ROS) production and decreased production of inflammatory cytokines/chemokines, whereas honokiol induced increased types I and III interferon messenger RNA (mRNA) expression levels in response to MSSA infection. Moreover, the internalization of S. aureus by human alveolar epithelial cells was inhibited by these compounds. Furthermore, honokiol and magnolol treatment promoted a delay in killing during MSSA infection in Caenorhabditis elegans, suggesting antimicrobial function in vivo. In conclusion, honokiol and magnolol may be considered as attractive immune-modulating treatment for S. aureus infection. PMID:25586586

  8. A new anti-MRSA antibiotic complex, WAP-8294A II. Structure characterization of minor components by ESI LCMS and MS/MS.

    PubMed

    Kato, Azusa; Hirata, Haruhisa; Ohashi, Yoshitami; Fujii, Kiyonaga; Mori, Kenji; Harada, Ken-ichi

    2011-05-01

    The anti-MRSA antibiotic, WAP-8294A, was isolated from the fermentation broth of Lysobacter sp. The major component, WAP-8294A2, is composed of 1 mol of Gly, L-Leu, L-Glu, D-Asn, D-Trp, D-threo-?-hydroxyasparagine, N-Me-D-Phe and N-Me-L-Val, and 2?mol of L-Ser, D-Orn and D-3-hydroxy-7-Me-octanoic acid. The structure of the WAP-8294A2 was mainly determined as a cyclic depsipeptide by 2D NMR experiments. However, it was difficult to use the NMR experiment to determine the minor components, A1, A4 and Ax13, isolated in small amounts. In the present study, ESI MS/MS was applied to the structure elucidation of these minor components. The structures of these minor components were determined on the basis of the fragmentation pattern of the product ions of WAP-8294A2 in the ESI MS/MS. As a result, it was confirmed that A1 and A4 had the same amino acid sequence as A2, while A1 and A4 had the 3-OH-octanoic acid and 3-OH-8-Me-nonanoic acid, respectively, in the place of the 3-OH-7-Me-octanoic acid in A2. In the structure of Ax13, it was found that Gly of A2 was changed to ?-Ala of Ax13. PMID:21326252

  9. High prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carrying the mecC gene in a semi-extensive red deer (Cervus elaphus hispanicus) farm in Southern Spain.

    PubMed

    Gómez, Paula; Lozano, Carmen; González-Barrio, David; Zarazaga, Myriam; Ruiz-Fons, Francisco; Torres, Carmen

    2015-06-12

    The objective was to determine the prevalence of Staphylococcus aureus nasal carriage in red deer of a semi-extensive farm and in humans in contact with the estate animals, and to characterize obtained isolates. Nasal swabs of 65 deer and 15 humans were seeded on mannitol-salt-agar and oxacillin-resistance-screening-agar-base. Isolates were identified by microbiological and molecular methods. Antimicrobial susceptibility profile was determined for 16 antibiotics by disk-diffusion and the presence of eight antibiotic resistance genes, seven virulence genes and genes of immune-evasion-cluster (IEC) was analyzed by PCR. S. aureus was typed by PFGE-SmaI, spa, agr, SCCmec and MLST. Isolates were detected in 16 deer (24.6%). Eleven S. aureus isolates were methicillin-resistant (MRSA), and five were methicillin-susceptible (MSSA). All MRSA harbored mecC gene and were agr-III/SCCmecXI/ST1945 (four spa-t843 and seven spa-t1535). All mecC-MRSA carried blaZ-SCCmecXI and etd2, were IEC-type-E, and belonged to the same PFGE pattern. The five MSSA were typed as spa-t2420/agr-I/ST133. Regarding humans, S. aureus was recovered from six samples (40%). The isolates were MSSA and were typed as spa-t002/agr-II, spa-t012/agr-III or spa-t822/agr-III and showed different IEC types (A, B, D and F). blaZ and erm(A) genes were detected, as well as cna and tst genes. As conclusion, red deer analyzed in this study are frequent carriers of mecC-MRSA CC130 (16.9%), they are characterized by few resistance and virulence determinants, and by the presence of IEC type-E. Deer could be a source of mecC-MRSA which could potentially be transmitted to other animals, or even to humans. PMID:25912021

  10. Comparison of the next-generation Xpert MRSA/SA BC assay and the GeneOhm StaphSR assay to routine culture for identification of Staphylococcus aureus and methicillin-resistant S. aureus in positive-blood-culture broths.

    PubMed

    Buchan, Blake W; Allen, Stephen; Burnham, Carey-Ann D; McElvania TeKippe, Erin; Davis, Thomas; Levi, Michael; Mayne, Donna; Pancholi, Preeti; Relich, Ryan F; Thomson, Richard; Ledeboer, Nathan A

    2015-03-01

    A bloodstream infection with Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), is a serious condition that carries a high mortality rate and is also associated with significant hospital costs. The rapid and accurate identification and differentiation of methicillin-susceptible S. aureus (MSSA) and MRSA directly from positive blood cultures has demonstrated benefits in both patient outcome and cost-of-care metrics. We compare the next-generation Xpert MRSA/SA BC (Xpert) assay to the GeneOhm StaphSR (GeneOhm) assay for the identification and detection of S. aureus and methicillin resistance in prospectively collected blood culture broths containing Gram-positive cocci. All results were compared to routine bacterial culture as the gold standard. Across 8 collection and test sites, the Xpert assay demonstrated a sensitivity of 99.6% (range, 96.4% to 100%) and a specificity of 99.5% (range, 98.0% to 100%) for identifying S. aureus, as well as a sensitivity of 98.1% (range, 87.5% to 100%) and a specificity of 99.6% (range, 98.3% to 100%) for identifying MRSA. In comparison, the GeneOhm assay demonstrated a sensitivity of 99.2% (range, 95.2% to 100%) and a specificity of 96.5% (range, 89.2% to 100%) for identifying S. aureus, as well as a sensitivity of 94.3% (range, 87.5% to 100%) and a specificity of 97.8% (range, 96.1% to 100%) for identifying MRSA. Five of six cultures falsely reported as negative for MRSA by the GeneOhm assay were correctly identified as positive by the Xpert assay, while one culture falsely reported as negative for MRSA by the Xpert assay was correctly reported as positive by the GeneOhm assay. PMID:25540397

  11. Facile method for site-specific gene integration in Lysobacter enzymogenes for yield improvement of the anti-MRSA antibiotics WAP-8294A and the antifungal antibiotic HSAF.

    PubMed

    Wang, Yan; Qian, Guoliang; Liu, Fengquan; Li, Yue-Zhong; Shen, Yuemao; Du, Liangcheng

    2013-11-15

    Lysobacter is a genus of Gram-negative gliding bacteria that are emerged as novel biocontrol agents and new sources of bioactive natural products. The bacteria are naturally resistant to many antibiotics commonly used in transformant selection, which has hampered the genetic manipulations. Here, we described a facile method for quick-and-easy identification of the target transformants from a large population of the wild type and nontarget transformants. The method is based on a distinct yellow-to-black color change as a visual selection marker for site-specific integration of the gene of interest. Through transposon random mutagenesis, we identified a black-colored strain from the yellow-colored L. enzymogenes . The black strain was resulted from a disruption of hmgA, a gene required for tyrosine/phenylalanine metabolism. The disruption of hmgA led to accumulation of dark brown pigments. As proof of principle, we constructed a series of expression vectors for a regulator gene found within the WAP-8294A biosynthetic gene cluster. The yield of WAP-8294A in the black strains increased by 2 fold compared to the wild type. Interestingly, the yield of another antibiotic (HSAF) increased up to 7 fold in the black strains. WAP-8294A is a family of potent anti-MRSA antibiotics and is currently in clinical studies, and HSAF is an antifungal compound with distinct structural features and a novel mode of action. This work represents the first successful metabolic engineering in Lysobacter. The development of this facile method opens a way toward manipulating antibiotic production in the largely unexplored sources. PMID:23937053

  12. Melatonin Might Help Sleepless Kids with Eczema

    MedlinePLUS

    ... M.D., chief and professor, pediatric and adolescent dermatology, University of California, San Diego and Rady Children's Hospital, San Diego; Nov. 16, 2015, JAMA Pediatrics , online HealthDay Copyright (c) 2015 HealthDay . All rights reserved. ...

  13. Disseminated coxsackievirus A6 affecting children with atopic dermatitis.

    PubMed

    Lynch, M D; Sears, A; Cookson, H; Lew, T; Laftah, Z; Orrin, L; Zuckerman, M; Creamer, D; Higgins, E

    2015-07-01

    Coxsackievirus A6 (CV-A6) is an emerging pathogen that has in recent years been associated with atypical hand, foot and mouth disease. This manifests as a generalized papular or vesicular eruption, which may be associated with fever and systemic disturbance. We report a series of six children presenting to a single centre in the UK with disseminated CV-A6 infection on a background of atopic dermatitis (AD). Our patients exhibited a widespread papular or vesicular eruption in association with exacerbation of AD. Several of our cases mimicked eczema herpeticum, but the extent was more generalized, and individual lesions were discrete rather than clustered and were less circumscribed in character. This series highlights that CV-A6 infection may be encountered in the UK, and should be considered in the differential diagnosis of an acute exacerbation of AD, particularly in children. PMID:25677678

  14. MRSA Prevention Information and Advice for Athletes

    MedlinePLUS

    ... be cleaned before and after playing sports and activities such as using shared weight-training equipment, when caring for wounds including changing bandages, and after using the toilet. Both plain and antimicrobial soap are effective for hand washing, but liquid ...

  15. Methicillin-Resistant Staphylococcus aureus (MRSA)

    MedlinePLUS

    ... PARC) Contact Us About Us News Blog Events Facebook Twitter YouTube Instagram Donate Now Take Action Ways ... some antibiotics, nose drops and other therapies. Share Facebook Twitter Email More options Print Share Facebook Twitter ...

  16. Bone Scintigraphic Findings in MRSA Osteomyelitis.

    PubMed

    Cornejo, Patricia; Mandell, Gerald A

    2016-02-01

    Methicillin-resistant Staphylococcus aureus osteomyelitis is a severe form of infection characterized by multifocal or multiple segmental osseous involvement and subperiosteal abscess formation with increased frequency of extraosseous complications including pyomyositis, septic thrombus, and septic arthritis. Bone scan showed long segment and/or multifocal involvement in 4 of 5 patients with areas of abnormal increased and decreased uptake. The clinical presentations included limp and/or pain. Joint involvement was seen in 4 cases. Bone scan abnormalities correlated well with MRI findings of severe and extensive bone disease, abscess formation, muscle, as well as joint and soft tissue involvement. PMID:26571442

  17. Dyshidrotic eczema: relevance to the immune response in situ

    PubMed Central

    Abreu-Velez, Ana Maria; Pinto, Frank J.; Howard, Michael S.

    2009-01-01

    Context: Pompholyx (called dyshidrosis by some) is one of the most common conditions and its immune response is presently poorly understood. Case report: We describe a 58 year old African American female with a clinical history of rheumatoid arthritis and type II diabetes who presented a chronic five-year, itchy vesicular/blistering rash involving her hands and feet. A lesional skin biopsy was taken for hematoxylin and eosin (H & E) analysis. In addition, a multicolor direct immunofluorescence (MDIF) and immunohistochemistry (IHC) studies were performed. The major findings to be reported were: the H & E examination revealed spongiotic dermatitis and pompholix. IHC and MDIF studies demonstrated focally deposits of positive CD45, CD3, CD8, anti myeloperoxidase (MPO), and anti-human IgE, C3C, C3D and anti-human-fibrinogen within the epidermal spongiotic process, as well as around the blood vessels surrounding the inflammatory process especially at the sweat glands and respective ductus. The patient began mycophenolate mofetil therapy, with successful clearing of the palms and soles. Conclusion: The significance of our findings indicates a complex immunological process including complement, MPO and T-cell immune response. In addition, possibly a secondary allergic process for the presence of IgE immune response and possibly aggravation by application of other medicines. Further immunological studies on pompholyx are needed. (Abreu-Velez AM, Pinto FJ, Howard MS. North Am J Med Sci 2009; 1: 117-120). PMID:22666682

  18. [Chromate eczema in food, domestic and cleaning occupations].

    PubMed

    Weiler, K J; Rüssel, H A

    1986-01-01

    No chromium in the form of chromate was found in flour and baking powders. Contradictory reports published elsewhere have not been substantiated. The occasional incidence of chromate allergy observed in the domestic services trades, bakeries, curing houses and bottling plant were found to be due to traces of chromate in the following substances: wood ash 0.23 ppm, lignite ash 0.05 to 1.7 ppm, refractory brick 0.5 to 0.9 ppm, certain alkaline scouring agents 0.1 to 0.2 ppm, suds produced when washing chromate-containing glasses 0.13 to 1.61 ppm. Furthermore, when surface treating heated cr-ni sheet steel sheet panels of 10 square centimetre size with alkalis or organic acids (acetic acid) it was possible to dissolve 0.33 to 60.0 micrograms of chromium as chromate. PMID:2947792

  19. Spontaneous MRSA postcricoid abscess: a case report and literature review.

    PubMed

    Boyce, Brian J; deSilva, Brad W

    2014-11-01

    Laryngeal abscesses are rare but potentially life-threatening infections due to potential airway obstruction. Most abscesses occur in the epiglottis or preepiglottic space as a sequela of acute supraglottitis. Abscesses in the posterior larynx are extremely rare and typically due to instrumentation or trauma. Appropriate workup and management of the airway are essential for optimizing outcomes in these patients. We present an interesting case and our management of a spontaneous posterior laryngeal abscess due to methicillin-resistant Staphlococcus aureus. PMID:25044135

  20. Differential effects of planktonic and biofilm MRSA on human fibroblasts.

    PubMed

    Kirker, Kelly R; James, Garth A; Fleckman, Philip; Olerud, John E; Stewart, Philip S

    2012-01-01

    Bacteria colonizing chronic wounds often exist as biofilms, yet their role in chronic wound pathogenesis remains unclear. Staphylococcus aureus biofilms induce apoptosis in dermal keratinocytes, and given that chronic wound biofilms also colonize dermal tissue, it is important to investigate the effects of bacterial biofilms on dermal fibroblasts. The effects of a predominant wound pathogen, methicillin-resistant S.?aureus, on normal, human, dermal fibroblasts were examined in vitro. Cell-culture medium was conditioned with equivalent numbers of either planktonic or biofilm methicillin-resistant S.?aureus and then fed to fibroblast cultures. Fibroblast response was evaluated using scratch, viability, and apoptosis assays. The results suggested that fibroblasts experience the same fate when exposed to the soluble products of either planktonic or biofilm methicillin-resistant S.?aureus, namely limited migration followed by death. Enzyme-linked immunosorbent assays demonstrated that fibroblast production of cytokines, growth factors, and proteases were differentially affected by planktonic and biofilm-conditioned medium. Planktonic-conditioned medium induced more interleukin-6, interleukin-8, vascular endothelial growth factor, transforming growth factor-?1, heparin-bound epidermal growth factor, matrix metalloproteinase-1, and metalloproteinase-3 production in fibroblasts than the biofilm-conditioned medium. Biofilm-conditioned medium induced more tumor necrosis factor-? production in fibroblasts compared with planktonic-conditioned medium, and suppressed metalloproteinase-3 production compared with controls. PMID:22332802

  1. Differential Effects of Planktonic and Biofilm MRSA on Human Fibroblasts

    PubMed Central

    Kirker, Kelly R.; James, Garth A.; Fleckman, Philip; Olerud, John E.; Stewart, Philip S.

    2012-01-01

    Bacteria colonizing chronic wounds often exist as biofilms, yet their role in chronic wound pathogenesis remains unclear. Staphylococcus aureus biofilms induce apoptosis in dermal keratinocytes, and given that chronic wound biofilms also colonize dermal tissue, it is important to investigate the effects of bacterial biofilms on dermal fibroblasts. The effects of a predominant wound pathogen, methicillin-resistant S. aureus, on normal, human, dermal fibroblasts were examined in vitro. Cell culture medium was conditioned with equivalent numbers of either planktonic or biofilm methicillin-resistant S. aureus, and then fed to fibroblast cultures. Fibroblast response was evaluated using scratch, viability, and apoptosis assays. The results suggested that fibroblasts experience the same fate when exposed to the soluble products of either planktonic or biofilm methicillin-resistant S. aureus, namely limited migration followed by death. Enzyme-linked immunosorbent assays demonstrated that fibroblast production of cytokines, growth factors, and proteases were differentially affected by planktonic and biofilm-conditioned medium. Planktonic-conditioned medium induced more interleukin-6, interleukin-8, vascular endothelial growth factor, transforming growth factor-?1, heparin-bound epidermal growth factor, matrix metalloproteinase-1, and metalloproteinase-3 production in fibroblasts than the biofilm-conditioned medium. Biofilm-conditioned medium induced more tumor-necrosis factor-? production in fibroblasts compared to planktonic-conditioned medium, and suppressed metalloproteinase-3 production compared to controls. PMID:22332802

  2. Improving the management of Staphylococcus aureus bacteraemia, including MRSA

    PubMed Central

    Meyer, Claudia; Pett, Eleanor

    2013-01-01

    Staphylococcus aureus bacteraemia is a serious infection associated with significant complications, including recurrence of bacteraemia, endocarditis and metastatic foci of infection. The management of these patients is often complex, involving appropriate source control, a thorough review and investigations to exclude metastatic foci and infective endocarditis. Additionally, a prolonged course of intravenous antibiotics is often required. As part of our quality improvement project, the following five aspects were evaluated in 56 patients with S. aureus bacteraemia at two District General Hospitals: 1) adequate and timely removal of the source of bacteraemia, 2) echocardiography to exclude endocarditis, 3) repeat blood culture to prove clearance of bacteraemia, 4) adequate duration and choice of antibiotics and 5) documentation of bacteraemia in the discharge summary. After an initial review revealed several areas for improvement, we instituted five Plan-Do-Study-Act learning cycles which involved: teaching microbiology trainees and junior doctors, improving clinical liaison and communication between the microbiology team and clinicians, as well as a clinical review of patients by the microbiology team where appropriate. The post-intervention review evaluated 24 patients with S. aureus bacteraemia between November 2012 and May 2013. The proportion of patients undergoing an echocardiogram improved from 49% to 88%. Another marked improvement was seen in the timely obtaining of clearance blood cultures, with 88% of patients having clearance blood cultures within the 2-4 day window, compared to 56% pre-intervention. 70% of patients with uncomplicated S. aureus bacteraemia received an appropriate antibiotic course post-intervention, compared with 59% pre-intervention. Documentation of the S. aureus bacteraemia in the discharge summary improved from 65% to 75%. The support of the entire microbiology team was pivotal in the successful outcome of the quality improvement project.

  3. Filaggrin breakdown products determine corneocyte conformation in patients with atopic dermatitis

    PubMed Central

    Riethmuller, Christoph; McAleer, Maeve A.; Koppes, Sjors A.; Abdayem, Rawad; Franz, Jonas; Haftek, Marek; Campbell, Linda E.; MacCallum, Stephanie F.; McLean, W.H. Irwin; Irvine, Alan D.; Kezic, Sanja

    2015-01-01

    Background Loss-of-function (LOF) mutations in the filaggrin gene (FLG) are a well-replicated risk factor for atopic dermatitis (AD) and are known to cause an epidermal barrier defect. The nature of this barrier defect is not fully understood. Patients with AD with FLG LOF mutations are known to have more persistent disease, more severe disease, and greater risk of food allergies and eczema herpeticum. Abnormalities in corneocyte morphology have been observed in patients with AD, including prominent villus-like projections (VP); however, these ultrastructural features have not been systematically studied in patients with AD in relation to FLG genotype and acute and convalescent status. Objective We sought to quantitatively explore the relationship between FLG genotype, filaggrin breakdown products (natural moisturizing factor [NMF]), and corneocyte morphology in patients with AD. Methods We studied 15 children at first presentation of AD and after 6 weeks of standard therapy. We applied atomic force microscopy to study corneocyte conformation in patients with AD stratified by FLG status and NMF level. By using a new quantitative methodology, the number of VPs per investigated corneocyte area was assessed and expressed as the Dermal Texture Index score. Corneocytes were also labeled with an anti-corneodesmosin antibody and visualized with scanning electron microscopy. Results We found a strong correlation between NMF levels and Dermal Texture Index scores in both acute and convalescent states (respective r = ?0.80 and ?0.75, P < .001 and P = .002). Most, but not all, VPs showed the presence of corneodesmosin abundantly all over the cell surface in homozygous/compound heterozygous FLG patients and, to a lesser extent, in heterozygous and wild-type patients. Conclusions NMF levels are highly correlated with corneocyte morphology in patients with AD. These corneocyte conformational changes shed further insight into the filaggrin-deficient phenotype and help explain the barrier defect in patients with AD with FLG LOF mutations. PMID:26071937

  4. [Allergic contact eczema caused by a UV radiation filter in a sunscreen cream--2 case reports].

    PubMed

    Haussmann, A; Kleinhans, D

    1986-11-15

    A 44-year-old woman suffered from allergic contact dermatitis due to sunscreen agent Eusolex 6300. A 28-year-old woman developed photoallergic contact dermatitis obviously derived from Eusolex 2020. Reactions to sunscreen agents like these may actually occur more often than they are usually supposed to do. PMID:2949440

  5. Update on the management of chronic eczema: new approaches and emerging treatment options

    PubMed Central

    Walling, Hobart W; Swick, Brian L

    2010-01-01

    Atopic dermatitis (AD) is a common disease with worldwide prevalence, affecting up to 20% of children and 3% of adults. Recent evidence regarding pathogenesis has implicated epidermal barrier defects deriving from filagrin mutations with resulting secondary inflammation. In this report, the authors comprehensively review the literature on atopic dermatitis therapy, including topical and systemic options. Most cases of AD will benefit from emollients to enhance the barrier function of skin. Topical corticosteroids are first-line therapy for most cases of AD. Topical calcineurin inhibitors (tacrolimus ointment, pimecrolimus cream) are considered second line therapy. Several novel barrier-enhancing prescription creams are also available. Moderate to severe cases inadequately controlled with topical therapy may require phototherapy or systemic therapy. The most commonly employed phototherapy modalites are narrow-band UVB, broadband UVB, and UVA1. Traditional systemic therapies include short-term corticosteroids, cyclosporine (considered to be the gold standard), methotrexate, azathioprine, mycophenolate mofetil, and most recently leflunamide. Biologic therapies include recombinant monoclonal antibodies acting on the immunoglobulin E / interleukin-5 pathway (omalizumab, mepolizumab), acting as tumor necrosis factor-? inhibitors (infliximab, etanercept, adalimumab), and acting as T-cell (alefacept) and B-cell (rituxumab) inhibitors, as well as interferon ? and intravenous immunoglobulin. Efficacy, safety, and tolerability are reviewed for each medication. PMID:21437065

  6. Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea

    PubMed Central

    Lee, Jin Yong; Kim, Chul Woo; Kim, Sang Seok

    2015-01-01

    Background Topical corticosteroids (TCS) are the first-line agents for the treatment of atopic dermatitis (AD). However, a vague phobia concerning the use of TCS exists among parents of children with AD because of misinformation, and studies on the subject are insufficient. Objective To assess the current state of steroid phobia among parents of atopic children in Korea and to investigate the importance of education in its reduction. Methods By using a structured questionnaire, 126 parents of children with AD (22.2% fathers, 77.8% mothers) were interviewed. After the questionnaire administration, all participants were educated about TCS use. Results Overall, 67.5% of the parents showed steroid phobia. A statistical correlation was found between steroid phobia and knowledge of potential adverse events, experience of TCS use, and adherence to treatment (p<0.05). Adherence to treatment tended to be lower among parents with steroid phobia. The most recognized adverse effects of TCS were skin atrophy and thinning (71.9%). The most prevalent information source leading to steroid phobia was the Internet (49.2%). The risk factors for steroid phobia were AD severity (odds ratio [OR]=5.332 [moderate], 9.040 [severe] vs. mild; p=0.001) and the knowledge of potential adverse events (OR=2.658; p=0.021). Conclusion We found a high prevalence of steroid phobia among parents of patients with AD, and here show the impact of this phobia on treatment adherence. We emphasize the important role of dermatologists as providers of accurate information and appropriate education about the use of TCS. PMID:26512163

  7. Causes and Triggers

    MedlinePLUS

    ... United States NEA Funded Research Eczema Therapies in Development Clinical Trials DONATE Ways to Donate Eczema Symptoms of ... United States NEA Funded Research Eczema Therapies in Development Clinical Trials DONATE Ways to Donate Causes & Triggers Eczema ...

  8. Capturing the cloud of diversity reveals complexity and heterogeneity of MRSA carriage, infection and transmission.

    PubMed

    Paterson, Gavin K; Harrison, Ewan M; Murray, Gemma G R; Welch, John J; Warland, James H; Holden, Matthew T G; Morgan, Fiona J E; Ba, Xiaoliang; Koop, Gerrit; Harris, Simon R; Maskell, Duncan J; Peacock, Sharon J; Herrtage, Michael E; Parkhill, Julian; Holmes, Mark A

    2015-01-01

    Genome sequencing is revolutionizing clinical microbiology and our understanding of infectious diseases. Previous studies have largely relied on the sequencing of a single isolate from each individual. However, it is not clear what degree of bacterial diversity exists within, and is transmitted between individuals. Understanding this 'cloud of diversity' is key to accurate identification of transmission pathways. Here, we report the deep sequencing of methicillin-resistant Staphylococcus aureus among staff and animal patients involved in a transmission network at a veterinary hospital. We demonstrate considerable within-host diversity and that within-host diversity may rise and fall over time. Isolates from invasive disease contained multiple mutations in the same genes, including inactivation of a global regulator of virulence and changes in phage copy number. This study highlights the need for sequencing of multiple isolates from individuals to gain an accurate picture of transmission networks and to further understand the basis of pathogenesis. PMID:25814293

  9. Evolutionarily distinct bacteriophage endolysins featuring conserved peptidoglycan cleavage sites protect mice from MRSA infection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Staphylococcus aureus is a Gram-positive pathogen relevant for both human and animal health. With multi-drug resistant S. aureus strains becoming increasingly prevalent, alternative therapeutics are urgently needed. Bacteriophage endolysins (peptidoglycan hydrolases, PGH) are capable of killing Gra...

  10. Bio-inspired porous SiC ceramics loaded with vancomycin for preventing MRSA infections.

    PubMed

    Díaz-Rodríguez, P; Landin, M; Rey-Rico, A; Couceiro, J; Coenye, T; González, P; Serra, J; López-Álvarez, M; León, B

    2011-02-01

    Implant-related infections are a serious complication in orthopaedic and dental surgery resulting in prolonged hospitalization, high medical costs and patient mortality. The development of porous implants loaded with antibiotics may enable a local delivery for preventing surface colonization and biofilm formation. A new generation of bio-derived porous ceramic material that mimics hierarchical structures from Nature was evaluated. Silicon carbide ceramics derived from Sapelli wood (bioSiC) were obtained by pyrolysis of Entandrophragma cylindricum wood followed by infiltration with molten silicon. This process renders disks that keep the bimodal pore size distribution (3 and 85 ?m) of the original material and are highly cytocompatible (BALB/3T3 cell line). The ability of the bio-ceramic to load the antimicrobial agent vancomycin was evaluated by immersion of disks in drug solutions covering a wide range of concentrations. The disks released at pH 7.4 an important amount of drug during the first 2 h (up to 11 mg/g bioSiC) followed by a slower release, which is related to the presence of macro- and mesopores. Finally, the anti-biofilm effect against methicillin resistant Staphylococcus aureus was assessed and a considerable reduction (92%) of the bacterial film was observed. Results highlight the bioSiC potential as component of medicated medical devices. PMID:21132518

  11. Atopic dermatitis - self-care

    MedlinePLUS

    Eczema - self-care ... Eczema is a chronic skin disorder that involves scaly and itchy rashes. Atopic dermatitis is the most ... Call for an appointment with your doctor if: Eczema does not respond to moisturizers or avoiding allergens. ...

  12. Journal of Biological Dynamics Vol. 4, No. 1, January 2010, 115129

    E-print Network

    Ruan, Shigui

    (HA-MRSA) with the community-acquired MRSA (CA-MRSA) and to quantify the effectiveness of inter- ventions aimed at limiting the spread of CA-MRSA in the hospital setting. Numerical simulations of the model strongly suggest that CA-MRSA will become the dominant MRSA strain in the hospital setting

  13. Sorocenols G and H, Anti-MRSA Oxygen Heterocyclic Diels-Alder-type Adducts from Sorocea muriculata Roots

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bioassay-guided fractionation of a root extract of Sorocea muriculata led to the isolation and identification of two new oxygen heterocyclic Diels-Alder-type adducts, sorocenols G (1) and H (2), along with lupeol-3-(3'R-hydroxytetradecanoate) and oxyresveratrol. The structures of 1 and 2 were eluci...

  14. Understanding the Structural Basis for Functional Differences in Staphylococcal MSCRAMMS SDRE1 and BBP/SDRE2 and Their Role in Species Tropism 

    E-print Network

    Francis, Mathew Prashanth

    2015-04-29

    280, Abs450: Absorbance at 280 nm or 450 nm Bbp: BSP-Binding Protein BSA: Bovine Serum Albumin BSP: Bone Sialoprotein CA-MRSA: Community Acquired – MRSA CD: Circular Dichroism ClfA: Clumping Factor A ClfB: Clumping Factor B DAP: Daptomycin...-binding Protein B HA-MRSA: Hospital Acquired – MRSA IPTG: Isopropyl ?-D-1-thiogalactopyranoside ITC: Isothermal Titration Calorimetry IV: Intravenous LA-MRSA: Livestock Acquired – MRSA MRSA: Methicillin-Resistant Staphylococcus aureus OE-PCR: Overlap...

  15. Senescence and antibiotic resistance in an age-structured population model

    E-print Network

    Gedeon, Tomas

    of Staphylococcus aureus (MRSA) has been modeled. One strain, community acquired CA-MRSA was assumed to have higher growth rate than the hospital acquired strain HA-MRSA. In agreement with the principle of competitive exclusion [15, 37] the model [11] predicts that CA-MRSA will eventually dominate and outcompete HA-MRSA

  16. Screening of plant extracts for antimicrobial activity against bacteria and yeasts with dermatological relevance.

    PubMed

    Weckesser, S; Engel, K; Simon-Haarhaus, B; Wittmer, A; Pelz, K; Schempp, C M

    2007-08-01

    There is cumulative resistance against antibiotics of many bacteria. Therefore, the development of new antiseptics and antimicrobial agents for the treatment of skin infections is of increasing interest. We have screened six plant extracts and isolated compounds for antimicrobial effects on bacteria and yeasts with dermatological relevance. The following plant extracts have been tested: Gentiana lutea, Harpagophytum procumbens, Boswellia serrata (dry extracts), Usnea barbata, Rosmarinus officinalis and Salvia officinalis (supercritical carbon dioxide [CO2] extracts). Additionally, the following characteristic plant substances were tested: usnic acid, carnosol, carnosic acid, ursolic acid, oleanolic acid, harpagoside, boswellic acid and gentiopicroside. The extracts and compounds were tested against 29 aerobic and anaerobic bacteria and yeasts in the agar dilution test. U. barbata-extract and usnic acid were the most active compounds, especially in anaerobic bacteria. Usnea CO2-extract effectively inhibited the growth of several Gram-positive bacteria like Staphylococcus aureus (including methicillin-resistant strains - MRSA), Propionibacterium acnes and Corynebacterium species. Growth of the dimorphic yeast Malassezia furfur was also inhibited by Usnea-extract. Besides the Usnea-extract, Rosmarinus-, Salvia-, Boswellia- and Harpagophytum-extracts proved to be effective against a panel of bacteria. It is concluded that due to their antimicrobial effects some of the plant extracts may be used for the topical treatment of skin disorders like acne vulgaris and seborrhoic eczema. PMID:17291738

  17. 75 FR 32783 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-09

    ...Bacteria (Methicillin Resistant Staphylococcus aureus, or MRSA).'' In accordance...Bacteria (Methicillin Resistant Staphylococcus aureus, or MRSA) Healthcare Acquired...with Methicillin Resistant Staphylococcus aureus (MRSA) being the most...

  18. MDRO - Multidrug-Resistant Organisms

    MedlinePLUS

    ... MRSA in the workplace, see: Methicillin-resistan t Staphylococcus aure us (MRSA) . Provides links with general information, ... of these organisms include: MRSA - Methicillin/oxacillin-resistant Staphylococcus aureus VRE - Vancomycin-resistant enterococci ESBLs - Extended-spectrum ...

  19. This Just In… The Latest Research Findings

    MedlinePLUS

    ... page please turn Javascript on. Understanding and Controlling MRSA MRSA (pron. MUHR-suh) is a type of "staph" ... are difficult to treat with several common antibiotics. MRSA stands for Methicillin-resistant Staphylococcus aureus. It's sometimes ...

  20. An antibacterial hydroxy fusidic acid analogue from Acremonium crotocinigenum

    E-print Network

    Griffith, Gareth

    against a panel of multidrug-resistant (MDR) and methicillin-resistant Staphylococcus aureus (MRSA reserved. Keywords: Acremonium crotocinigenum; Fusidane triterpene; Fusidic acid; Antibacterial; MRSA; MDR, fusidic acid, a widely used therapeutic for methicillin-resistant Staphylococcus aureus (MRSA) infections

  1. Home National World Business Sports Cricket Entertainment Health Science Bollywood Celebs Geekwerks Now, 'artificial nose' to sniff out bacterial infections!

    E-print Network

    Suslick, Kenneth S.

    the hard-to-kill hospital infection methicillin-resistant Staphylococcus aureus (MRSA), with 98.8 percent breeds drug-resistant diseases Struggling With MRSA? MRSA30Day.com Information On Why It Returns And What

  2. 77 FR 24209 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... for Invasive Methicillin-resistant Staphylococcus aureus (MRSA) among Patients Recently Discharged from Acute Care Hospitals through the Active Bacterial Core Surveillance for Invasive MRSA infections (ABCs MRSA)--NEW--National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers...

  3. Tacrolimus Topical

    MedlinePLUS

    ... ointment is used to treat the symptoms of eczema (atopic dermatitis; a skin disease that causes the ... use other medications for their condition or whose eczema has not responded to another medication. Tacrolimus is ...

  4. Pimecrolimus Topical

    MedlinePLUS

    Pimecrolimus is used to control the symptoms of eczema (atopic dermatitis; a skin disease that causes the ... treat patients who cannot use other medications for eczema, or whose symptoms were not controlled by other ...

  5. Chickenpox (Varicella)

    MedlinePLUS

    ... infection (encephalitis). Children who have weak immune systems, eczema, or recent sunburns have more severe symptoms. Because ... people who have a weak immune system or eczema. Once all the blisters have dried up into ...

  6. Xerosis

    MedlinePLUS

    Asteatotic eczema; Eczema craquele ... Beiber T, Bussmann C. Atopic dermatitis. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds. Dermatology . 3rd ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 12. Gilchrest ...

  7. 21 CFR 524.1484h - Neomycin, penicillin, polymyxin B, and hydrocortisone suspension.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...dermatitis, interdigital eczema, and otitis externa caused by bacteria susceptible to neomycin, penicillin, and polymyxin B. ...dermatitis, interdigital eczema, and otitis externa caused by bacteria susceptible to neomycin, penicillin, and polymyxin B....

  8. Contact Dermatitis

    MedlinePLUS

    ... Bumps and growths Color problems Contagious skin diseases Cosmetic treatments Dry / sweaty skin Eczema / dermatitis Hair and ... Bumps and growths Color problems Contagious skin diseases Cosmetic treatments Dry / sweaty skin Eczema / dermatitis Atopic dermatitis ...

  9. ANTIMICROBIAL SURFACES: A Broad Market Opportunity Robert Engel

    E-print Network

    Wolberg, George

    "superbugs" MRSA (Methacillin-Resistant Staphylococcus aureus) Other multiresistant bacteria Other serious against Bacteria (Gram positive & Gram negative) Staphylococcus aureus (including MRSA) Pseudomonas

  10. Atopic Dermatitis: Who Gets and Causes

    MedlinePLUS

    ... treatment Tips Eczema: Bleach bath therapy Share your child's eczema story Basal cell carcinoma Bedbugs Botulinum toxin Chemical peel Contact dermatitis Dry skin Dermatofibrosarcoma protuberans Dyshidrotic eczema E - H I - L M - P Q - T U - W Health and beauty For ...

  11. Atopic Dermatitis: Diagnosis, Treatment, and Outcome

    MedlinePLUS

    ... treatment Tips Eczema: Bleach bath therapy Share your child's eczema story Basal cell carcinoma Bedbugs Botulinum toxin Chemical peel Contact dermatitis Dry skin Dermatofibrosarcoma protuberans Dyshidrotic eczema E - H I - L M - P Q - T U - W Health and beauty For ...

  12. Atopic Dermatitis: Signs and Symptoms

    MedlinePLUS

    ... treatment Tips Eczema: Bleach bath therapy Share your child's eczema story Basal cell carcinoma Bedbugs Botulinum toxin Chemical peel Contact dermatitis Dry skin Dermatofibrosarcoma protuberans Dyshidrotic eczema E - H I - L M - P Q - T U - W Health and beauty For ...

  13. Traditional Smallpox Vaccines and Atopic Dermatitis

    MedlinePLUS

    ... By 1986, routine vaccination had ceased in all countries. Who is at risk of having eczema vaccinatum? In the past, eczema vaccinatum has occurred in persons suffering from, or with a history of, atopic dermatitis/eczema who were vaccinated or ...

  14. Draft Genome Sequences of Clinical Daptomycin-Nonsusceptible Methicillin-Resistant Staphylococcus aureus (MRSA) Strain APS211 and Its Daptomycin-Susceptible Progenitor APS210

    PubMed Central

    Cameron, David R.; Jiang, Jhih-Hang; Abbott, Iain J.; Spelman, Denis W.

    2015-01-01

    To assess the genetic factors contributing to daptomycin resistance in Staphylococcus aureus, the draft genome of a clinically derived daptomycin-nonsusceptible isolate APS211 was generated and compared to the draft sequence of its susceptible progenitor strain APS210. Four genetic differences were identified including a previously described mutation within the mprF gene. PMID:26067951

  15. Toward New Therapeutics for Skin and Soft Tissue Infections: Propargyl-Linked Antifolates Are Potent Inhibitors of MRSA and Streptococcus pyogenes

    PubMed Central

    Scocchera, Eric W.; Martin, Brooke D.; Swain III, P. Whitney; Alverson, Jeremy B.; Priestley, Nigel D.; Anderson, Amy C.; Wright, Dennis L.

    2012-01-01

    Hospital- and community-acquired, complicated skin and soft tissue infections, often attributed to Staphylococcus aureus and Streptococcus pyogenes, present a significant health burden that is associated with increased health care costs and mortality. As these two species are difficult to discern on diagnosis and are associated with differential profiles of drug resistance, the development of an efficacious antibacterial agent that targets both organisms is a high priority. Herein we describe a structure-based drug development effort that has produced highly potent inhibitors of dihydrofolate reductase from both species. Optimized propargyl-linked antifolates containing a key pyridyl substituent display antibacterial activity against both methicillin-resistant S. aureus and S. pyogenes at MIC values below 0.1 µg/mL and minimal cytotoxicity against mammalian cells. Further evaluation against a panel of clinical isolates shows good efficacy against a range of important phenotypes such as hospital- and community-acquired strains as well as strains resistant to vancomycin. PMID:22347365

  16. Efficacy of alcohol gel for removal of methicillin-resistant Staphylococcus aureus from hands of colonized patients.

    PubMed

    Sunkesula, Venkata; Kundrapu, Sirisha; Macinga, David R; Donskey, Curtis J

    2015-02-01

    Of 82 patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization, 67 (82%) had positive hand cultures for MRSA. A single application of alcohol gel (2 mL) consistently reduced the burden of MRSA on hands. However, incomplete removal of MRSA was common, particularly in those with a high baseline level of recovery. PMID:25633009

  17. Analysis of the Effects of Cigarette Smoke on Staphylococcal Virulence Elisa K. McEachern,a,b

    E-print Network

    Nizet, Victor

    , Staphylococcus aureus, and in partic- ular methicillin-resistant S. aureus (MRSA), one of the leading causes of invasive bacterial infections. MRSA colonizes the naso- pharynx and is thus exposed to inhalants, including cigarette smoke. MRSA exposed to cigarette smoke extract (CSE-MRSA) was more resistant to macrophage killing

  18. 77 FR 40363 - Agency Forms Undergoing Paperwork Reduction Act Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-09

    ... notice. Proposed Project Risk Factors for Invasive Methicillin-resistant Staphylococcus aureus (MRSA... Surveillance for Invasive MRSA infections (ABCs MRSA)--NEW--National Center for Emerging and Zoonotic... Description Essential steps in reducing the occurrence of healthcare-associated invasive MRSA infections...

  19. UHS Health Promotion Office, 110 Anderson Tower, 273-5775 The Monthly InSTALLment November 2007

    E-print Network

    Cantlon, Jessica F.

    -275-2662 to schedule an appointment at UHS. www.rochester.edu/uhs What is MRSA? Although MRSA has recently been a hot media topic, it's been a health concern for years. Methicillin-resistant Staphylococcus aureus, or MRSA MRSA, occur most frequently in hospital and healthcare facilities (such as nursing homes), and among

  20. Chamchod and Ruan Theoretical Biology and Medical Modelling 2012, 9:25 http://www.tbiomed.com/content/9/25

    E-print Network

    Ruan, Shigui

    : Methicillin-resistant Staphylococcus aureus (MRSA) is endemic in many hospital settings, posing substantial the transmission dynamics of MRSA and determine factors that influence the prevalence of MRSA infection when antibiotics are given to patients to treat or prevent infections with either MRSA itself or other bacterial

  1. 274 CID 2009:48 (1 February) D'Agata et al. M A J O R A R T I C L E

    E-print Network

    Ruan, Shigui

    Gables, Florida Background. Methicillin-resistant Staphylococcus aureus (MRSA) has traditionally been associated with infec- tions in hospitals. Recently, a new strain of MRSA has emerged and rapidly spread that a particular clone (USA300) of a community-acquired MRSA (CA-MRSA) strain is infiltrating hospitals

  2. 1 | P a g e Chem 124H Organic Chemistry Case Study #2: "Overcoming Bacterial

    E-print Network

    Reed, Christopher A.

    resistance worldwide: causes, challenges and responses" Nat. Med. 2004, 10, pS122. c) "MRSA" (wikipedia, http://en.wikipedia.org/wiki/Mrsa. The most notable resistant bacterium is Methicillin Resistant Staphylococcus Aureus (MRSA, "Superbug and sterilization are essential in hospitals to prevent the spread of MRSA and other resistant bacterial infections

  3. 24 IEEE TRANSACTIONS ON COMPUTER-AIDED DESIGN OF INTEGRATED CIRCUITS AND SYSTEMS, VOL. 17, NO. 1, JANUARY 1998 Efficient Algorithms for the Minimum

    E-print Network

    Cong, Jason "Jingsheng"

    of the MSPSA problem is called the minimum rectilinear Steiner arborescence (MRSA) problem. Given a set be shown that an MSPSA of is an MRSA of . The MSPSA and MRSA problems have applications to performance for the MRSA problem can be cl

  4. Mathematical models of infectious disease dynamics --transmission models --have become valuable tools for

    E-print Network

    Blower, Sally

    ,anoutbreakofcommunity-acquiredmeticil- lin-resistantStaphylococcusaureus(CA-MRSA).Strainsof CA-MRSA have recently emerged, and one of CA-MRSA in the Los Angeles County Jail (LACJ). We show how to design a within-jail transmission model outbreak; and, third, design effective interventions for outbreak control. The epidemiology of CAMRSA CA-MRSA

  5. EFFICIENT HEURISTICS FOR THE MINIMUM SHORTEST PATH STEINER ARBORESCENCE PROBLEM WITH APPLICATIONS TO VLSI PHYSICAL DESIGN

    E-print Network

    Kahng, Andrew B.

    problem is called the Minimum Rectilinear Steiner Arborescence MRSA problem. Given a set of terminals N. It can be shown that an MSPSA of GHN;N;r is an MRSA of N. Exact methods for the MRSA problem can in the RSA DP algorithm by Leung and Cong 18 . Nastansky et al. 20 formulated the MRSA problem and its D

  6. EFFICIENT HEURISTICS FOR THE MINIMUM SHORTEST PATH STEINER ARBORESCENCE PROBLEM WITH APPLICATIONS TO VLSI PHYSICAL DESIGN

    E-print Network

    Kahng, Andrew B.

    the Minimum Rectilinear Steiner Arborescence (MRSA) problem. Given a set of terminals N (including the root r be shown that an MSPSA of (GH(N) ; N; r) is an MRSA of N . Exact methods for the MRSA problem can in the RSA/DP algorithm by Leung and Cong [18]. Nastansky et al. [20] formulated the MRSA problem (and its D

  7. Potential role of pet animals in household transmission of methicillin-resistant Staphylococcus aureus: a narrative review.

    PubMed

    Bramble, Manuel; Morris, Daniel; Tolomeo, Pam; Lautenbach, Ebbing

    2011-06-01

    In this narrative review, we found numerous reports suggesting that dogs and cats may play a role in household methicillin-resistant Staphylococcus aureus (MRSA) transmission and recurrent MRSA infection in human contacts. Future work should emphasize elucidating more clearly the prevalence of MRSA in household pets and characterize transmission dynamics of MRSA humans and pet animals. PMID:21142959

  8. A Comparison of Clinical Features between Community-Associated and Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Keratitis

    PubMed Central

    Ong, Sherine Jue; Chuang, Chih-Chun; Ma, David H. K.; Huang, Yhu-Chering

    2015-01-01

    Purpose. To compare the clinical features of community-associated (CA) and healthcare-associated (HA) methicillin-resistant Staphylococcus aureus (MRSA) keratitis. Methods. Patients presenting with culture-proven MRSA keratitis between January 1, 2006, and December 31, 2010, at Chang Gung Memorial Hospital, Taiwan, were included in this study. The patients' demographic and clinical information were reviewed retrospectively. Antibiotic susceptibility was verified using the disk diffusion method. Results. Information on 26 patients with MRSA keratitis was collected, including 12 cases of CA-MRSA and 14 cases of HA-MRSA. All MRSA isolates were susceptible to vancomycin; the only difference in drug susceptibility was that CA-MRSA isolates were more susceptible to trimethoprim/sulfamethoxazole than HA-MRSA (P = .034). The most common risk factor for MRSA keratitis was ocular surface disease. No significant differences were observed between the 2 groups in terms of clinical features, treatments, and visual outcomes. Conclusion. In Taiwan, CA-MRSA rivals HA-MRSA as a critical cause of MRSA keratitis. Furthermore, CA-MRSA isolates are multidrug resistant. CA-MRSA and HA-MRSA keratitis are clinically indistinguishable, although larger studies are warranted to further evaluate this association. PMID:25653870

  9. Molecular and Clinical Characteristics of Hospital and Community Onset Methicillin-Resistant Staphylococcus aureus Strains Associated with Bloodstream Infections

    PubMed Central

    Hines, Lisa; van Balen, Joany; Mediavilla, José R.; Pan, Xueliang; Hoet, Armando E.; Kreiswirth, Barry N.; Pancholi, Preeti; Stevenson, Kurt B.

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSI) are classified epidemiologically as health care-associated hospital onset (HAHO)-, health care-associated community onset (HACO)-, or community-associated (CA)-MRSA. Clinical and molecular differences between HAHO- and HACO-MRSA BSI are not well known. Thus, we evaluated clinical and molecular characteristics of MRSA BSI to determine if distinct features are associated with HAHO- or HACO-MRSA strains. Molecular genotyping and medical record reviews were conducted on 282 MRSA BSI isolates from January 2007 to December 2009. MRSA classifications were 38% HAHO-, 54% HACO-, and 8% CA-MRSA. Comparing patients with HAHO-MRSA to those with HACO-MRSA, HAHO-MRSA patients had significantly higher rates of malignancy, surgery, recent invasive devices, and mortality and longer hospital stays. Patients with HACO-MRSA were more likely to have a history of renal failure, hemodialysis, residence in a long-term-care facility, long-term invasive devices, and higher rate of MRSA relapse. Distinct MRSA molecular strain differences also were seen between HAHO-MRSA (60% staphylococcal cassette chromosome mec type II [SCCmec II], 30% SCCmec III, and 9% SCCmec IV) and HACO-MRSA (47% SCCmec II, 35% SCCmec III, and 16% SCCmec IV) (P < 0.001). In summary, our study reveals significant clinical and molecular differences between patients with HAHO- and HACO-MRSA BSI. In order to decrease rates of MRSA infection, preventive efforts need to be directed toward patients in the community with health care-associated risk factors in addition to inpatient infection control. PMID:25740776

  10. 21 CFR 524.1484h - Neomycin, penicillin, polymyxin B, and hydrocortisone suspension.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., atopic dermatitis, interdigital eczema, and otitis externa caused by bacteria susceptible to neomycin... caused by bacteria susceptible to neomycin, penicillin, and polymyxin B. (3) Limitations. For use in...

  11. Commentary: Twisting the Th1/Th2 immune response via the retinoid

    E-print Network

    Spilianakis, Charalampos G. "Babis"

    ) diseases such as bronchial asthma, allergic rhinoconjunctivitis ("hay fever") and atopic eczema/dermatitis dermatitis. "Atopy" is the genetic predisposition determining the susceptibility to develop atopic dis- eases

  12. Methicillin-Resistant Staphylococcus aureus Ocular Infection in Taiwan

    PubMed Central

    Kang, Yu-Chuan; Hsiao, Ching-Hsi; Yeh, Lung-Kun; Ma, David H.K.; Chen, Phil Y.F.; Lin, Hsin-Chiung; Tan, Hsin-Yuan; Chen, Hung-Chi; Chen, Shin-Yi; Huang, Yhu-Chering

    2015-01-01

    Abstract Methicillin-resistant Staphylococcus aureus (MRSA) infection is an important public health issue. This observational study aimed to characterize clinical features, antibiotic susceptibility, and genotypes of ocular infections caused by MRSA based on the clinical and molecular definitions of community-associated (CA) and healthcare-associated (HA) strains. Fifty-nine patients with culture-proven S aureus ocular infection were enrolled from January 1, 2010 to December 31, 2011 at Chang Gung Memorial Hospital, Taiwan. Antibiotic susceptibility was verified using disk diffusion/E test. For characterization, staphylococcal cassette chromosome mec (SCCmec), pulsed-field gel electrophoresis (PFGE), multilocus sequence type (MLST), and Panton–Valentine leukocidin (PVL) gene, were performed. MRSA isolates from the patients with HA factors were classified as clinically defined HA-MRSA, and those carrying SCCmec type I to III as molecularly defined HA-MRSA. Thirty-four patients with MRSA ocular infection were identified. The most common clone of CA-MRSA and HA-MRSA isolates was ST59/PFGE type D/SCCmec IV,VT/PVL (+) (n?=?12) and CC 239/PFGE type A/SCCmec III, IIIA/PVL(?) (n?=?10), respectively. All the 11 patients with molecularly defined HA-MRSA infections and 50% of the 22 patients with molecularly defined CA-MRSA infections were found to have HA factors (P?=?.005). CA-MRSA tended to cause lid infections, whereas HA-MRSA tended to cause corneal infections. Contrary to HA-MRSA isolates, nearly all the CA-MRSA isolates were susceptible to trimethoprim/sulfamethoxazole and fluoroquinolones under either clinical or molecular classifications. In Taiwan, CA-MRSA isolates exhibited considerably higher susceptibility to fluoroquinolones when compared with HA-MRSA isolates. A strong correlation was observed between the HA factors and molecularly defined HA-MRSA isolates. PMID:26496268

  13. Carriage and Genetic Diversity of Methicillin-Resistant Staphylococcus aureus among Patients and Healthcare Workers in a Serbian University Hospital

    PubMed Central

    Cirkovic, Ivana; Stepanovic, Srdjan; Skov, Robert; Trajkovic, Jasmina; Grgurevic, Anita; Larsen, Anders Rhod

    2015-01-01

    Objectives There is a paucity of data on methicillin-resistant Staphylococcus aureus (MRSA) epidemiology among Balkan countries. The aim of our study was to determine the prevalence of nasal and pharyngeal carriages and diversity of MRSA among patients and healthcare workers (HCWs) in the major referral centre in Serbia, and to evaluate performance of three different media for MRSA screening. Methods Nasal and pharyngeal swabs were obtained from 195 patients and 105 HCWs in Emergency Department (ED), Surgical Department (SD) and Medical Department (MD). After broth enrichment, samples were inoculated onto MRSA-ID, ORSA and oxacillin-MSA and incubated for 24/48 hours. Characterisation of isolated MRSA strains was determined by MLVA, spa, SCCmec and agr typing, PVL genes detection and antimicrobial susceptibility. Results MRSA carriage prevalence was 11.8% in patients and 7.6% in HCWs. Introduction of pharyngeal swabs in screening procedure increased MRSA carriage rate by over 30%. Variable found to be independently associated with an increased risk for MRSA carriage was ED (odd ratio (OR) = 4.45, 95% confidence interval (CI) 1.78-11.14). A higher risk of multidrug-resistant MRSA carriage was observed among patients (OR = 22; 95% CI 1.92-251.54). CC5-MRSA-SCCmecI was the dominant clone among patients and HCWs in ED and MD, while high genetic diversity of community-associated MRSA (CA-MRSA) was shown in SD especially among HCWs. MRSA-ID was superior to the other tested media with a sensitivity/specificity of 95.2% and 99.6% after 48 hours of incubation. Conclusions These results indicate high MRSA carriage rate in the hospital and emergence of CA-MRSA through HCWs in these settings. MRSA-ID was the optimal available choice for MRSA screening. PMID:25993538

  14. An alternative approach for computing seismic response with accidental eccentricity

    NASA Astrophysics Data System (ADS)

    Fan, Xuanhua; Yin, Jiacong; Sun, Shuli; Chen, Pu

    2014-09-01

    Accidental eccentricity is a non-standard assumption for seismic design of tall buildings. Taking it into consideration requires reanalysis of seismic resistance, which requires either time consuming computation of natural vibration of eccentric structures or finding a static displacement solution by applying an approximated equivalent torsional moment for each eccentric case. This study proposes an alternative modal response spectrum analysis (MRSA) approach to calculate seismic responses with accidental eccentricity. The proposed approach, called the Rayleigh Ritz Projection-MRSA (RRP-MRSA), is developed based on MRSA and two strategies: (a) a RRP method to obtain a fast calculation of approximate modes of eccentric structures; and (b) an approach to assemble mass matrices of eccentric structures. The efficiency of RRP-MRSA is tested via engineering examples and compared with the standard MRSA (ST-MRSA) and one approximate method, i.e., the equivalent torsional moment hybrid MRSA (ETM-MRSA). Numerical results show that RRP-MRSA not only achieves almost the same precision as ST-MRSA, and is much better than ETM-MRSA, but is also more economical. Thus, RRP-MRSA can be in place of current accidental eccentricity computations in seismic design.

  15. Antibiotics DOI: 10.1002/anie.200801801

    E-print Network

    Nizet, Victor

    that has over- come every antibiotic cam- paign. Methicillin-resistant S. aureus (MRSA) infections proceeds through the same early steps as sterol biosynthesis. A recent anti- MRSA drug-discovery effort

  16. Fax +41 61 306 12 34 E-Mail karger@karger.ch

    E-print Network

    Nizet, Victor

    , such as communi- ty-acquired methicillin-resistant S. aureus (CA-MRSA), have reached epidemic proportions globally. In addition to their increasing prevalence and incidence, CA-MRSA strains appear to be especially virulent

  17. Stabilityiseverything Phys. Rev. A 75, 011801 (2007)

    E-print Network

    Conrad, Clint

    2007-01-01

    methicillin-resistant Staphylococcus aureus (MRSA, pictured). Antibiotic-resistant S.aureus has plagued, studied the toxin `Panton Valentine leukocidin', which is produced by some MRSA strains that cause

  18. SHORT COMMUNICATION Public computer surfaces are reservoirs

    E-print Network

    Sigler, Von

    )-resistant Staphylococcus aureus (MRSA), -S. epidermidis (MRSE) and -S. hominis (MRSH) were present on two, five and two., 2006). Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a significant nosocomial

  19. Healthcare-Associated Infections (HAIs) Data and Statistics

    MedlinePLUS

    ... infections ( C. difficile ), and hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (bloodstream infections). The current report ... Personnel Klebsiella MRSA Mycobacterium abscessus Norovirus ... Staphylococcus aureus Tuberculosis VISA / VRSA Vancomycin-resistant Enterococci (VRE) ...

  20. A Shared Population of Epidemic Methicillin-Resistant Staphylococcus aureus 15 Circulates in Humans and Companion Animals

    E-print Network

    Harrison, Ewan M.; Weinert, Lucy A.; Holden, Matthew T. G.

    2014-05-13

    Methicillin-resistant Staphylococcus aureus(MRSA) is a global human health problem causing infections in both hospitals and the community. Companion animals, such as cats, dogs, and horses, are also frequently colonized by MRSA and can become...

  1. Novel Daptomycin Combinations against Daptomycin-Nonsusceptible Methicillin-Resistant Staphylococcus aureus in an In Vitro Model of Simulated Endocardial Vegetations

    E-print Network

    Steed, Molly E.; Vidaillac, Celine; Rybak, Michael J.

    2010-12-01

    Reduced susceptibility to daptomycin has been reported in patients with infections due to methicillin-resistant Staphylococcus aureus (MRSA). Although infections with daptomycin-nonsusceptible (DNS) MRSA are infrequent, optimal therapy...

  2. 76 FR 569 - Draft Guidance for Industry and Food and Drug Administration Staff; Establishing the Performance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... Detection and Differentiation of Methicillin-Resistant Staphylococcus aureus and Staphylococcus aureus... Methicillin-Resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (SA).'' The draft guidance... detection and differentiation of methicillin-resistant Staphylococcus aureus (MRSA) and...

  3. 2014 Incidental Fees Page 1 of 8

    E-print Network

    Mucina, Ladislav

    Social Work) RM Essential 50 - 70 50 - 75 Externally MRSA Testing (following Interstate or International Practice 332 MRSA Testing (following Interstate or International clinical placements) Cert Essential 37 39

  4. Attachment 1 PMC XXXXX/14

    E-print Network

    Mucina, Ladislav

    , Social Work) RM Essential 50 - 75 50 - 75 Externally MRSA Testing (following Interstate or International Practice 436 / MRSA Testing 311434 / Medical Science Practice 331 / Medical Science Practice 332 (following

  5. Impetigo

    MedlinePLUS

    ... or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus ( MRSA ) is becoming a common cause. Skin normally has ... in the lab.This can help determine if MRSA is the cause. Specific antibiotics are needed to ...

  6. Summary Annual Review 2012 Highlights of the Wellcome

    E-print Network

    Rambaut, Andrew

    exhibition to date explored the history of human efforts to understand the brain's mysteries. Tracking MRSA of MRSA. UK Biobank opens Researchers can now apply to use the UK Biobank database, with health

  7. Annual Review 2012 Highlights of the Wellcome Trust's

    E-print Network

    Rambaut, Andrew

    and experiment kits for schools. Tracking MRSA Rapid whole-genome sequencing shows success in identifying, tracking and stopping hospital outbreaks of MRSA. Urbanisation and health An Indian study is revealing

  8. Structures of Four Crystal Forms of Decaplanin by Christopher Lehmanna

    E-print Network

    by methicillin-resistant Staph- ylococcus aureus (MRSA) strains, calls for new approaches in antibacterial chemo concentrations of 1 suffice to make cephalosporins effective in the treatment of MRSA infections that are caused

  9. Why Is Hand Washing So Important? (For Parents)

    MedlinePLUS

    ... Tips From School Nurses on Keeping Students Healthy MRSA Hand, Foot, and Mouth Disease "Stomach Flu" Being ... Wash My Hands Without Spreading Germs? Staph Infections MRSA Flu Facts Contact Us Print Additional resources Send ...

  10. Osteomyelitis

    MedlinePLUS

    ... For Kids For Parents MORE ON THIS TOPIC MRSA Staph Infections Dealing With Cuts First Aid & Safety ... Scratches, and Scrapes Wound Healing and Care Osteomyelitis MRSA Dealing With Broken Bones Staph Infections Bones, Muscles, ...

  11. Summarised Financial Statements 2012 Chairman's Statement 02

    E-print Network

    Rambaut, Andrew

    methicillin-resistant Staphylococcus aureus (MRSA). Retrospective analysis of samples from a real outbreak of MRSA in a hospital showed that the outbreak could have been identified and stopped sooner with the new

  12. Immobilized phage proteins for specific detection of staphylococci

    E-print Network

    Peter, Yves-Alain

    in hospitals are now due to methicillin-resistant S. aureus (MRSA), which is resistant to b-lactams.2,3 It is estimated that at least 3.4 million hospital patients in the U.S. are infected by MRSA each year.4 Community-acquired MRSA is showing a very rapid rise and now accounts for 14% of MRSA infections;5 these infections

  13. La(III) complex involving the O,N-donor environment of quinazoline-4(3H)-one Schiff’s base and their antimicrobial attributes against methicillin-resistant Staphylococcus aureus (MRSA)

    NASA Astrophysics Data System (ADS)

    Siddappa, K.; Mane, Sunilkumar B.; Manikprabhu, Deene

    2014-09-01

    The incidence of methicillin-resistant Staphylococcus aureus increased during the past few decades, so there is an urgent need of new antimicrobial agents if public health is concerned. Though the Schiff’s bases and La(III) complex have enormous biological activity, but less attention was given in their synthesis. In the present investigation, we synthesized a new (E)-3-((2-hydroxynaphthalen-1-yl) methyleneamino)-2-methylquinazoline-4(3H)-one HNMAMQ Schiff’s base by the condensation of 3-(2-aminophenyl) quinazolin-2-methyl-4(3H)-one and 2-hydroxy-1-naphthaldehyde. The Schiff’s base HNMAMQ and its La(III) complex were characterized by elemental analyses, IR, NMR, mass spectra, and thermal studies. The newly synthesized Schiff’s base HNMAMQ and its La(III) complex were evaluated for their antimicrobial activity against methicillin-resistant Staphylococcus aureus isolated from the Gulbarga region in India. The Schiff’s base HNMAMQ and its La(III) complex showed good antimicrobial activity and thus represents a potential new drug of choice.

  14. Methicillin-Resistant Staphylococcus aureus Prevalence among Captive Chimpanzees, Texas, USA, 20121

    PubMed Central

    Barnhart, Kirstin F.; Abee, Christian R.; Lambeth, Susan P.; Weese, J. Scott

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infection in humans and animals is concerning. In 2012, our evaluation of a captive chimpanzee colony in Texas revealed MRSA prevalence of 69%. Animal care staff should be aware of possible zoonotic MRSA transmission resulting from high prevalence among captive chimpanzees. PMID:26583847

  15. Recently, doctors in Texas have been seeing an increasing number of patients with skin

    E-print Network

    Recently, doctors in Texas have been seeing an increasing number of patients with skin infections this is happening and how to prevent antibiotic (drug) resistant Staph/MRSA skin infections from spreading. What is a Staph/MRSA skin infection? It can be a pimple, rash, boil, or an open wound. Staph/MRSA is often

  16. Prevalence and characterization of Methicillin-resistant Staphylococcus aureus isolates from retail meat and humans in Georgia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is increasing interest in the presence of Staphylococcus aureus, specifically methicillin-resistant S. aureus (MRSA), on retail meat products. In this study, staphylococci were isolated from retail pork and retail beef in Georgia and MRSA from the products were compared to human MRSA from the...

  17. SUPPLEMENTAL INFORMATION Novel"Phenol"Soluble"Modulin"Derivatives"in"Community9Associated"Methicillin9Resistant""

    E-print Network

    Nizet, Victor

    "Hughes"Medical"Institute,"Chevy"Chase,"MD"20815"" " *Running"title:"Novel"PSM"derivatives"in"CA9MRSA"" " To"whom"correspondence"should"be. IMS molecular fingerprint of CA-MRSA TCH1516 2 Supplemental Figure S2. TOF/TOF spectrum of dPSM1 312. Structures of additional MRSA PSM derivatives identified by MALDI9MS 13 Supplemental Figure S13

  18. This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research

    E-print Network

    Ruan, Shigui

    -resistant Staphylococcus aureus (MRSA) in the emergency ward (EW) and respiratory intensive care unit (RICU) for volunteers-to- one basis, this study showed that the number of MRSA-positive patients would increase if volunteers of properly trained volunteers is an attractive alternative to decrease MRSA and other multi-drug resistant

  19. Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not

    E-print Network

    Greene, William A.

    straight to the right or straight above. A minimal RSA (a MRSA) is one for which the total path length, to our knowledge, previous genetic attacks on the MRSA problem have not used tree-based approaches a lower total path length than the original. A minimal rectilinear Steiner arborescence (MRSA) for a given

  20. Fijimycins AC, three antibacterial etamycin-class depsipeptides from a marine-derived Streptomyces sp.

    E-print Network

    Nizet, Victor

    : Antibacterial depsipeptides MRSA activity Etamycin class antibacterials a b s t r a c t Three new depsipeptides antibacterial activity against three methicillin-resistant Staphylococcus aureus (MRSA) strains with MIC100 caused by methicillin-resistant Staphylococcus aureus (MRSA) is a growing problem of potential urgency

  1. Comparison of ESwab with traditional swabs for detection of methicillin-resistant Staphylococcus aureus using two different walk-away commercial real-time PCR methods.

    PubMed

    Silbert, Suzane; Kubasek, Carly; Uy, Dominic; Widen, Raymond

    2014-07-01

    The ESwab system (Copan Diagnostics) was evaluated as a nasopharyngeal specimen collection device to be used for methicillin-resistant Staphylococcus aureus (MRSA) detection by the GeneXpert and BD Max MRSA assays. Different MRSA strains and dilutions of each strain were tested in triplicate. ESwabs proved to be a suitable collection system for the two assays tested. PMID:24759722

  2. Incidence of community-acquired methicillin-resistant Staphylococcus aureus carrying Pantone-Valentine leucocidin gene at a referral hospital in United Arab Emirates.

    PubMed

    Dash, Nihar; Panigrahi, Debadatta; Al Zarouni, Mansour; Yassin, Faten; Al-Shamsi, Moza

    2014-04-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen in hospitalized patients worldwide. The present study was undertaken to identify CA-MRSA in hospitalized patients in a 350-bed tertiary care hospital in Sharjah, UAE over a 2-year period from January 2011 to December 2012. CA-MRSA was defined based on identification within first 48 h of admission in the hospital. Staphylococcal cassette chromosome (SCC) mec typing of the CA-MRSA isolates was carried out by multiplex polymerase chain reaction (PCR). Detection of PVL and mecA genes was done by PCR using the GenoType(®) MRSA test system (Hain Lifescience). Patient's clinical data and antimicrobial susceptibility pattern of the CA-MRSA isolates were also evaluated. Fifty seven of the 187 MRSA isolates were identified as CA-MRSA. All the CA-MRSA strains in our study belonged to SCCmecIV type and were positive for both PVL and mecA genes. The patients with CA-MRSA infections were young (median age, 32 years) and the majority of infections involved the skin and soft tissue (36%). Antimicrobial susceptibility pattern of the CA-MRSA isolates showed a better susceptibility profile to the non-beta-lactam antimicrobials with the exception of ciprofloxacin having 28% resistance. This study evidently strengthens the recent observation of an increase in CA-MRSA emergence among hospitalized patients in the UAE. PMID:23919760

  3. Methicillin-Resistant Staphylococcus aureus Prevalence among Captive Chimpanzees, Texas, USA, 2012(1).

    PubMed

    Hanley, Patrick W; Barnhart, Kirstin F; Abee, Christian R; Lambeth, Susan P; Weese, J Scott

    2015-12-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infection in humans and animals is concerning. In 2012, our evaluation of a captive chimpanzee colony in Texas revealed MRSA prevalence of 69%. Animal care staff should be aware of possible zoonotic MRSA transmission resulting from high prevalence among captive chimpanzees. PMID:26583847

  4. Community-Acquired Methicillin-Resistant "Staphylococcus aureus": Considerations for School Nurses

    ERIC Educational Resources Information Center

    Alex, Aniltta; Letizia, MariJo

    2007-01-01

    Methicillin-resistant "Staphylococcus aureus" (MRSA) is a disease-causing organism that has been present in hospital settings since the 1960s. However, a genetically distinct strain of MRSA, called community-acquired methicillin-resistant "Staphylococcus aureus" (CA-MRSA), has emerged in recent years in community settings among healthy…

  5. Preventing Community-Associated Methicillin-Resistant "Staphylococcus aureus" among Student Athletes

    ERIC Educational Resources Information Center

    Many, Patricia S.

    2008-01-01

    Methicillin-resistant "Staphylococcus aureus" (MRSA) was once thought to be a bacterium causing infections in only hospitalized patients. However, a new strain of MRSA has emerged among healthy individuals who have not had any recent exposure to a hospital or to medical procedures. This new strain is known as "community-associated MRSA". Studies…

  6. Staphylococcus aureus induces hypoxia and cellular damage in porcine dermal explants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methicillin-resistant Staphylococcus aureus (MRSA) can infect wounds and produce difficult-to- treat biofilms. To determine the extent that MRSA biofilms can deplete oxygen, change pH and damage host tissue, we developed a porcine dermal explant model on which we cultured GFP-labeled MRSA biofilms. ...

  7. Carriage of methicillin-resistant Staphylococcus aureus by healthy companion animals

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methicillin-resistant Staphylococcus aureus (MRSA) is a significant human pathogen and has also been associated with wounded or ill companion animals. Healthy animals may also harbor MRSA without presenting any symptoms, but little is known about the prevalence of MRSA among these animals. Therefo...

  8. Proceedings of The National Conference On Undergraduate Research (NCUR) 2008

    E-print Network

    Sigler, Von

    antibiotic-resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), are increasing-clinical environments, including public facilities. While methods of isolation and detection of MRSA in clinical settings are established, methods to detect MRSA in non-clinical environments have not been fully evaluated

  9. Efficient Algorithms for the Minimum Shortest Path Steiner Arborescence Problem with Applications to VLSI Physical Design

    E-print Network

    Kahng, Andrew B.

    ]. The rectilinear version of the MSPSA problem is called the Minimum Rectilinear Steiner Arborescence (MRSA) problem(N) ) be the induced Hanan grid graph [10] of N . It can be shown that an MSPSA of (G H(N) ; N; r) is an MRSA of N . Exact methods for the MRSA problem can be classified into (1) dynamic programming, (2) integer

  10. The prevalence of multidrug-resistant bacterial strains has substantially

    E-print Network

    Nizet, Victor

    against methicillin-resistant Staphylococcus aureus (MRSA). S. aureus is the leading cause of many human infections, particularly those of the skin and soft tissues. Moreover, MRSA -- a variation of this bacterium MRSA. Such virulence-factor-based approaches offer a new direction for therapies targeting multidrug

  11. DOI: 10.1002/cmdc.200800171 "Superbugs Bunny" Outsmarts Our Immune Defense

    E-print Network

    Nizet, Victor

    . aureus (MRSA)[2] has exceeded the number of HIV-associated deaths in the US.[3] Bacteria rapidly mutate population and select for re- sistant organisms.[4] Multi-resistant and hyper-virulent microbes such as MRSA have become a physician's nightmare in hospitals and in the community (e.g. CA- MRSA USA300

  12. Protein design algorithms predict viable resistance to an experimental antifolate

    E-print Network

    Donald, Bruce Randall

    resistance | antifolate | protein design | DHFR | MRSA Effectively treating infectious disease has become in dihydrofolate reductase (DHFR) from methicillin- resistant Staphylococcus aureus (MRSA) that confer resistance-linked antifolates exhibit greater affinity for the mutant enzymes and are active against MRSA strains resistant

  13. BioMed Central Page 1 of 12

    E-print Network

    Tian, Weidong

    _jiang@merck.com * Corresponding author Abstract Background: Staphylococcus aureus or MRSA (Methicillin Resistant S. aureus pathway, and tagA, tagB, tagD, tagE, tagF for the tag pathway. With the genome sequences of several MRSA strains: Mu50, MW2, N315, MRSA252, COL as well as methicillin susceptible strain MSSA476 available

  14. ORIGINAL ARTICLE Activity of the streptogramin antibiotic etamycin

    E-print Network

    Nizet, Victor

    -associated methicillin-resistant Staphylococcus aureus (HA- and CA-MRSA) infections has prompted a desperate search by 2D NMR spectroscopy. Etamycin demonstrated potent activity against HA- and CA-MRSA in microbroth dilution assays, with minimum inhibitory concentrations (MIC) as low as 1­2 mg lÀ1 against HA- and CA-MRSA

  15. 1224 Mol. BioSyst., 2011, 7, 12241231 This journal is c The Royal Society of Chemistry 2011 Cite this: Mol. BioSyst., 2011, 7, 12241231

    E-print Network

    Tsai, Ming-Daw

    vancomycin against MRSA as they carry an extra aliphatic acyl side chain on glucosamine (Glm) at residue 4 (r the drugs of the last resort to treat methicillin-resistant Staphylococcus aureus (MRSA) infections. Lipoglycopeptides, Tei and A40926 (3, Fig. 1) were reported to be more effective than vancomycin against MRSA

  16. ORIGINAL ARTICLE An in vitro model for the growth and analysis of chronic

    E-print Network

    Parker, Albert E.

    ORIGINAL ARTICLE An in vitro model for the growth and analysis of chronic wound MRSA biofilms A, biofilms, chronic wounds, in vitro model, MRSA. Correspondence Alessandra M. Agostinho, Center for Biofilm) for the growth and analysis of methicillin-resistant Staphylococcus aureus (MRSA) biofilms. Methods and Results

  17. Mar. Drugs 2012, 10, 953-962; doi:10.3390/md10040953 Marine Drugs

    E-print Network

    Nizet, Victor

    . The ongoing spread of methicillin-resistant Staphylococcus aureus (MRSA) strains exemplifies the urgent need antibiotic activity against Gram-positive pathogens, including MRSA. However, its minimum inhibitory concentration (MIC) against MRSA was increased by >500 fold in the presence of 20% human serum, thus greatly

  18. P E R S P E C T I V E www.ScienceTranslationalMedicine.org 27 January 2010 Vol 2 Issue 16 16ps4 1

    E-print Network

    Nizet, Victor

    of methicillin-resistant Staphylococcus au- reus (MRSA) as the showcase pathogen. S current classes of antimicro- bial agents. MRSA presents a critical global challenge to the public health.S. Centers for Disease Control estimated that more than 90,000 Americans developed invasive MRSA in 2005

  19. Mar. Drugs 2011, 9, 680-689; doi:10.3390/md9040680 Marine Drugs

    E-print Network

    Nizet, Victor

    - and community-associated methicillin-resistant Staphylococcus aureus (MRSA) infections. Previous work has, for their specific activities against contemporary and clinically relevant MRSA. Reported are studies of the in vitro kinetics of these chemical scaffolds in time-kill MRSA assays. Both napyradiomycin derivatives demonstrate

  20. n engl j med 359;1 www.nejm.org july 3, 2008 85 clinical implications of basic research

    E-print Network

    Nizet, Victor

    (MRSA) infections -- have been declared a public health imperative. A recent report from the Centers MRSA infections in 2005. A new therapeutic approach to the management of these infections would therefore be welcome. The development of new antibiotics to treat MRSA infections has slowed for complex

  1. Health Beat Avian Flu Continued...

    E-print Network

    Sorin, Eric J.

    prevention steps for yourself, but also for others. You will be reducing the spread of staph and MRSA. Practice your personal hygiene and live MRSA free. References 1. Division of Healthcare Quality Promotion. Community-Associated MRSA Information for the Public Center of Disease Control and Prevention. Retrieved May

  2. MGB Biopharma, a Glasgow-based biopharmaceutical company which has licensed technology from

    E-print Network

    Strathclyde, University of

    MRSA and Clostridium difficile infections. Infections under the microscope Clostridium difficile (C focus on gram-positive bacteria, e.g. C. difficile and MRSA, both of which can be fatal in humans. Whilst there are treatments on the market for MRSA, such as vancomycin, resistant strains of bacteria

  3. Edinburgh Research Explorer Dental and microbiological risk factors for hospital-acquired

    E-print Network

    Millar, Andrew J.

    April 2009-July 2010. We used novel real-time multiplex PCR assays to detect S. aureus, MRSA, E. coli, P. HAP was associated with prior oral carriage with E. coli/S. aureus/P.aeruginosa/MRSA (p = 0.002, OR 9 within 72 hours of admission in 90% participants, but HAP was sig- nificantly associated with S. aureus/MRSA

  4. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, July 2011, p. 33053312 Vol. 55, No. 7 0066-4804/11/$12.00 doi:10.1128/AAC.01211-10

    E-print Network

    Nizet, Victor

    -resistant Staphylococcus aureus (MRSA) strains in hospital and commu- nity settings presents a great challenge to public against clinically relevant hospital- and community- acquired MRSA strains, a prolonged postantibiotic, its antibiotic activity against MRSA was effectively neutralized by 20% human serum. A variety

  5. Edinburgh Research Explorer A Novel Core Genome-Encoded Superantigen Contributes to

    E-print Network

    Schnaufer, Achim

    of Community-Associated MRSA Necrotizing Pneumonia Citation for published version: Wilson, GJ, Seo, KS to Lethality of Community-Associated MRSA Necrotizing Pneumonia' PLoS Pathogens, vol 7, no. 10, pp. e1002271 to Lethality of Community-Associated MRSA Necrotizing Pneumonia Gillian J. Wilson1 , Keun Seok Seo2 , Robyn A

  6. Detection of methicillin-resistant staphylococci by biosensor assay consisting of nanoscale films on optical fiber long-period gratings

    E-print Network

    Heflin, Randy

    exposure of the LPG-ISAM to 102 colony forming units (CFU)/ml of MR S. aureus (MRSA) for 50 min., light of liver, lungs, or spleen from mice infected with MRSA attenuated light transmission by 11 from mice infected with MRSA, there was complete agreement between MR and non-MR bacteria determined

  7. Evaluating how users interact with NHS Direct Dr Shirley Large, and Kate Arnold

    E-print Network

    Grasso, Floriana

    on one health topic, MRSA for one-day's website visits, proved informative and highlighted a number of interesting questions about the user interaction with the MRSA topic and about navigation on the website. The findings show 242 visits to the Methicillin-resistant staphylococcus aureus (MRSA) topic, the PDF or print

  8. Timing-Driven Steiner Trees are (Practically) Free Charles J. Alpertt Andrew B. Kahng, C. N. Szet and Qinke Wang

    E-print Network

    Kahng, Andrew B.

    of (a) Tree with (b) RSMT (c) MRSA routing resource and capacitance). This paper studies several differ Algorithms, Design, Performance (MRSA) (which is an RST such that each source-to-sink path is a Keywords by switching from RSMT to MRSA on culate near-optimal RSMT quickly such as BI1S [10] and BOI [4]. a variety

  9. ORIGINAL ARTICLE Anthracimycin activity against contemporary

    E-print Network

    Nizet, Victor

    -susceptible, methicillin-resistant (MRSA) and vancomycin-resistant strains of S. aureus, were susceptible to anthracimycin potent and rapid bactericidal activity, with a 44-log kill of USA300 MRSA within 3 h at five times its MIC. At concentrations significantly below the MIC, anthracimycin slowed MRSA growth and potentiated

  10. Edinburgh Research Explorer Livestock origin for a human pandemic clone of community-

    E-print Network

    Schnaufer, Achim

    MRSA Citation for published version: Spoor, L, McAdam, P, Weinert, LA, Rambaut, A, Hasman, H, Aarestrup clone of community-associated MRSA' Mbio, vol 13, no. 4, e00356-13., 10.1128/mBio.00356-13 Digital increase in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections

  11. B R I E F R E P O R T Use of Antistaphylococcal b-Lactams

    E-print Network

    Nizet, Victor

    plus antistaphylococcal b-lactams (ASBL) to clear refractory MRSA bacteremia. In vitro studies showed surface charge induced by ASBLs against daptomycin non- susceptible MRSA. Addition of ASBLs to daptomycin may be of benefit in refractory MRSA bacteremia. (Although the official designation is ``daptomycin

  12. Origin -Universiteit Leiden4 Streptomyceten zijn naast voor de biotechnologie ook

    E-print Network

    . In een tijd waar multi-drug resistente pathogenen als Mycobacterium tuberculosis (veroorzaakt TB) en MRSA tijd het aantal ziekenhuisopnames met multi-drug resistente infecties zoals MRSA en MDR tuberculose Overkleeft en Mark Overhand, LIC), metabolomics (Rob Verpoorte en Young Choi, IBL), MRSA/Tb testing (van

  13. R E S E A R C H L E T T E R Toxin^antitoxin (TA) systems are prevalent and transcribed

    E-print Network

    Hergenrother, Paul J.

    problematic hospital and community- acquired pathogens are methicillin-resistant Staphylococcus aureus (MRSA bacteria; however, the prevalence and identity of TA systems in clinical isolates of MRSA and PA has not been defined. We isolated DNA from 78 MRSA and 42 PA clinical isolates and used PCR to probe

  14. ORIGINAL ARTICLE Activity of the thiopeptide antibiotic nosiheptide

    E-print Network

    Nizet, Victor

    by methicillin-resistant Staphylococcus aureus (MRSA). However, antimicrobial development has been largely contemporary MRSA strains tested including multiple drug-resistant clinical isolates, with MIC values p0.25 mg tested. Time-kill analysis revealed nosiheptide to be rapidly bactericidal against MRSA

  15. Mar. Drugs 2014, 12, 2458-2470; doi:10.3390/md12052458 marine drugs

    E-print Network

    Nizet, Victor

    methicillin-resistant Staphylococcus aureus (MRSA). Although compound (1) exhibits a significant reduction in MRSA activity in the presence of human serum, we have identified key modifications that partially) featuring a 2­4 fold improved minimum inhibitory concentration (MIC) against MRSA, significantly less

  16. ATN UNIVERSITy Manuka Honey as an Effective

    E-print Network

    University of Technology, Sydney

    . The research showed MRSA did not become resistant to the honey, and using the combination of the honey and the antibiotic can be seen to be more effective in killing MRSA than the antibiotic alone. It also delivers-resistant bacteria such as the superbug MRSA (golden staph). Combination of medical-grade Manuka honey (Medihoney

  17. RESEARCH ARTICLE Beta-Lactamase Repressor BlaI Modulates

    E-print Network

    Nizet, Victor

    in S. aureus Newman and MRSA Sanger 252 strains, we confirmed the role of BlaI in resistance to human, but the first methicillin-resistant S. aureus (MRSA) strains appeared shortly thereafter. Recent reports of S) from National Institutes of Health grants (5 F31 GM090658-02). The isolate MRSA252 (NRS71) was obtained

  18. J. Microbiol. Biotechnol. (2011), 21(4), 391399 doi: 10.4014/jmb.1011.11014

    E-print Network

    Zhang, Liangfang

    2011-01-01

    -resistant Staphylococcus aureus (MRSA) is demonstrated in cultures and in mice. Among a series of FFAs, only oleic acid (OA growth of a number of Gram-positive bacteria, including hospital and community-associated MRSA at a dose demonstrated in vivo through injection of OA into mouse skin lesions previously infected with a strain of MRSA

  19. Structural and Dynamic Requirements for Optimal Activity of the Essential Bacterial Enzyme

    E-print Network

    Hickman, Mark

    and also the native dimeric form from methicillin-resistant Staphylococcus aureus (MRSA). These reveal is relatively rigid, both the E. coli and MRSA DHDPS dimers display high flexibility, resulting in monomer and removal of key hydrogen bonds that render it inactive, whereas the similarly flexible MRSA DHDPS dimer

  20. Nature Reviews | Microbiology 5 10 15 20 25 30 35 40 45 50

    E-print Network

    Blower, Sally

    -acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). As they discussed, it is unclear what factors be worsening the epidemic of CA-MRSA by acting as `amplification zones'. The United States has the highest outbreaks of CA-MRSA have occurred in correctional facilities in California, Texas, Missouri, Georgia

  1. Genetic characterization of Staphylococcus aureus isolates causing bloodstream infections in Austria.

    PubMed

    Luxner, Josefa; Zarfel, Gernot; Johler, Sophia; Feierl, Gebhard; Leitner, Eva; Hoenigl, Martin; Grisold, Andrea J

    2014-02-01

    A total of 112 Staphylococcus aureus bloodstream isolates were genetically characterized. Spa typing and DNA microanalysis exhibited high diversity, resulting in 64 different spa types and 9 different SplitsTree clusters. Methicillin-resistant S. aureus (MRSA) were found in 6 cases only, including the first case of life-stock-associated MRSA (MRSA ST398) in bloodstream infection in Austria. PMID:24321355

  2. Rare variants of cutaneous leishmaniasis presenting as eczematous lesions

    PubMed Central

    Ayatollahi, Jamshid; Fattahi Bafghi, Ali; Shahcheraghi, Seyed Hossein

    2014-01-01

    Cutaneous Leishmaniasis may present with clinical presentation such as zosteriform, sporotrichoid and erysipeloid. The eczema variant has rarely been reported. We report a 27- year- old patient with atypical cutaneous leishmaniasis resembling eczema on the hand of a man in Yazd province in the central of Iran. PMID:25405136

  3. Trend in vancomycin susceptibility and correlation with molecular characteristics of methicillin-resistant Staphylococcus aureus causing invasive infections in Taiwan: results from the Tigecycline in vitro Surveillance in Taiwan (TIST) study, 2006-2010.

    PubMed

    Tsao, Shin-Ming; Wang, Wei-Yao; Ko, Wen-Chien; Huang, Cheng-Hua; Lu, Chin-Te; Chuang, Yin-Ching; Liu, Chia-Ying; Liao, Chun-Hsing; Chen, Yao-Shen; Liu, Yung-Ching; Chen, Wei-Yu; Jang, Tsrang-Neng; Lin, Hsiu-Chen; Chen, Chih-Ming; Shi, Zhi-Yuan; Pan, Sung-Ching; Yang, Jia-Ling; Kung, Hsiang-Chi; Liu, Chun-Eng; Cheng, Yu-Jen; Liu, Jien-Wei; Sun, Wu; Wang, Lih-Shinn; Yu, Kwok-Woon; Chiang, Ping-Cherng; Lee, Ming-Hsun; Lee, Chun-Ming; Hsu, Gwo-Jong; Chen, Yen-Hsu; Lu, Po-Liang; Thomas, Chang-Yao Tsao; Hsueh, Po-Ren

    2014-10-01

    This study was intended to investigate the trend in vancomycin susceptibility and correlation with molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) causing invasive infections. A total of 670 MRSA isolates were collected from patients with invasive infections as part of bacterial collection in the Tigecycline in vitro Surveillance in Taiwan (TIST) from 2006 to 2010. MICs of the isolates to vancomycin were determined using the agar dilution method. Characteristics of staphylococcal cassette chromosome mec (SCCmec), mec-associated hypervariable region (dru), and accessory gene regulator (agr) of the isolates were identified by polymerase chain reaction methods. MRSA isolates with SCCmec types I, II, and III were molecularly defined as hospital-associated MRSA (HA-MRSA), and those with SCCmec types IV, V, and VT were assigned as community-associated MRSA (CA-MRSA). All but 1 MRSA isolates exhibited vancomycin MICs ?1 mg/L. A declining trend in vancomycin MICs among MRSA isolates was noted, which was associated with the decline in proportion of HA-MRSA. The percentage of CA-MRSA increased from 25.6% in 2006 to 46.0% in 2010. An increase in the geometric mean of vancomycin MICs was found in MRSA with particular molecular types such as SCCmec types II and III, agr groups I and II, and dru10-14. A significant correlation among particular molecular types was found, including SCCmecII-agr group II-dru4, SCCmecIII-agr group I-dru11-14, SCCmecIV-agr group II-dru9, and SCCmecVT-agr group I-dru9 and dru11. There was no vancomycin creep among MRSA isolates, and the declining trend of vancomycin MIC against MRSA was attributed to the increasing prevalence of CA-MRSA over time. PMID:25053202

  4. Hand and Nasal Carriage of Discordant Staphylococcus aureus Isolates among Urban Jail Detainees

    PubMed Central

    Siegel, Jane D.; Henderson, Janet; Leos, Greg; Lo, Kaming; Iwuora, Jerry; Taylor, Alexis R.; Zychowski, Diana L.; Porsa, Esmaeil; Boyle-Vavra, Susan; Daum, Robert S.

    2014-01-01

    In 928 Dallas County Jail detainees, nasal carriage of Staphylococcus aureus was found in 32.8% (26.5% methicillin-susceptible Staphylococcus aureus [MSSA] and 6.3% methicillin-resistant S. aureus [MRSA]), and hand carriage was found in 24.9% (20.7% MSSA and 4.1% MRSA). Among MRSA nasal carriers, 41% had hand MRSA carriage; 29% with hand MRSA carriage had no nasal S. aureus carriage. The prevalence of carriage was not associated with duration of the jail stay up to 180 days. PMID:24958796

  5. Medical and Household Characteristics Associated with Methicillin Resistant Staphylococcus aureus Nasal Carriage among Patients Admitted to a Rural Tertiary Care Hospital

    PubMed Central

    Schinasi, Leah; Wing, Steve; MacDonald, Pia D. M.; Richardson, David B.; Stewart, Jill R.; L.Augustino, Kerri; Nobles, Delores L.; Ramsey, Keith M.

    2013-01-01

    Background Methicillin resistant Staphylococcus aureus (MRSA) poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011. Methods Using a case-control design, hospitalized patients ages 18 – 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR) estimates of association between MRSA carriage and medical and household exposures. Results In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI): 1.24–8.57) and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12–9.23). A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19–0.87). Conclusion These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission. PMID:23991200

  6. mecA-positive methicillin-sensitive Staphylococcus aureus clinical isolates in Zenica-Doboj Canton, Bosnia and Herzegovina.

    PubMed

    Kamberovi?, Farah; Ibrahimagi?, Amir; Uzunovi?, Selma; Budimir, Ana; Rijnders, Michelle I A; Stobberingh, Ellen E

    2014-08-11

    Forty-four mecA-positive and eight mecA-negative Staphylococcus aureus isolates confirmed by PCR were further tested by disc-diffusion (DD) oxacillin and cefoxitin, oxacillin Epsilon (E)-test, and oxacillin and cefoxitin minimal inhibitory concentration (MIC) Strip methicillin-resistant phenotype in S. aureus (MRSA) tests. Among 44 mecA-positive S. aureus isolates, two (4·5%) were detected as MRSA by DD-oxacillin, 17 (38·6%) by DD-cefoxitin test, and seven (15·9%) by the E-test. In the cefoxitin MIC Strip MRSA test, 19 (43·2%) isolates were resistant. In the oxacillin MIC Strip MRSA test, 18 (40·9%) isolates were resistant and 26 (59·1%) were sensitive, i.e. oxacillin-sensitive MRSA (OS-MRSA) (MIC range 0·25-?0·25 mg/l). Fifteen out of 26 OS-MRSA (57·7%) belonged to spa-CC 355/595, 78% of which belonged to the largest PFGE clone. Some discrepancies between the phenotypic methods for MRSA identification obtained in this study were caused by large proportion of OS-MRSA. Misidentification of OS-MRSA as MSSA might result in an appearance of highly resistant MRSA in patients treated with beta-lactam antibiotics. PMID:25112955

  7. Antimicrobial activity of berberine alone and in combination with ampicillin or oxacillin against methicillin-resistant Staphylococcus aureus.

    PubMed

    Yu, Hyeon-Hee; Kim, Kang-Ju; Cha, Jeong-Dan; Kim, Hae-Kyoung; Lee, Young-Eun; Choi, Na-Young; You, Yong-Ouk

    2005-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) bacteria have been responsible for substantial morbidity and mortality in hospitals because they usually have multidrug resistance. Some natural products are candidates as new antibiotic substances. In the present study, we investigated the antimicrobial activity of berberine, the main antibacterial substance of Coptidis rhizoma (Coptis chinensis Franch) and Phellodendri cortex (Phellodendron amurense Ruprecht), against clinical isolates of MRSA, and the effects of berberine on the adhesion to MRSA and intracellular invasion into human gingival fibroblasts (HGFs). Berberine showed antimicrobial activity against all tested strains of MRSA. Minimum inhibition concentrations (MICs) of berberine against MRSA ranged from 32 to 128 microg/mL. Ninety percent inhibition of MRSA was obtained with 64 microg/mL or less of berberine. In the checkerboard dilution test, berberine markedly lowered the MICs of ampicillin and oxacillin against MRSA. An additive effect was found between berberine and ampicillin, and a synergistic effect was found between berberine and oxacillin against MRSA. In the presence of 1-50 microg/mL berberine, MRSA adhesion and intracellular invasion were notably decreased compared with the vehicle-treated control group. These results suggest that berberine may have antimicrobial activity and the potential to restore the effectiveness of beta-lactam antibiotics against MRSA, and inhibit the MRSA adhesion and intracellular invasion in HGFs. PMID:16379555

  8. Evaluation of two commercially available chromogenic media for confirmation of methicillin-resistant Staphylococcus aureus from human, animal, and food samples.

    PubMed

    Ariza-Miguel, Jaime; Oniciuc, Elena-Alexandra; Sanz, Iván; Fernández-Natal, Isabel; Hernández, Marta; Rodríguez-Lázaro, David

    2015-09-16

    We compared the diagnostic performance of two chromogenic media, Brilliance MRSA 2 agar (Thermo Fisher Scientific) and ChromID MRSA agar (bioMérieux), for MRSA confirmation of 239 Staphylococcus aureus isolates from clinical, animal and food samples. Statistically significant differences were not observed between MRSA confirmation by mecA/mecC PCR, and by culture in both chromogenic media. However, a statistically significant difference was observed between the results obtained by both chromogenic media (p = 0.003). Segregated analysis of the results depending on the origin of the isolates (clinical, animal, and food) revealed a significant lower performance in the MRSA confirmation of food-derived isolates by using Brilliance MRSA 2 agar in comparison to PCR confirmation (p = 0.003) or ChromID MRSA agar (p<0.001). Both chromogenic media provided a good diagnostic performance for detection of MRSA isolates of human and animal origin. In conclusion, the use of chromogenic agar plates for MRSA confirmation of S. aureus isolates can provide a good diagnostic performance (sensitivity >92% and specificity >89%) regardless of the type of chromogenic media used or the origin of the S. aureus isolates. However, our results revealed a lower diagnostic performance for MRSA confirmation of S. aureus isolates from food samples by using Brilliance MRSA 2 agar. PMID:26026664

  9. Clonal distribution and possible microevolution of methicillin-resistant Staphylococcus aureus strains in a teaching hospital in Malaysia

    PubMed Central

    Tan, Xin Ee; Neoh, Hui-min; Hussin, Salasawati; Zin, Noraziah Mohamad

    2013-01-01

    Objective To genotypically characterize methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from medical and surgical wards in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in 2009. Methods MRSA strains were collected and molecularly typed by pulsed-field gel electrophoresis (PFGE). Results PFGE typing on 180 MRSA isolated in UKMMC identified 5 pulsotypes (A-E) and 6 singletons, where pulsotypes B and C were suspected to be divergent clones originating from a single ancestor. This study also showed that most MRSA strains were isolated from swab (119 isolates), followed by blood (22 isolates), tracheal aspirate (11 isolates) and sputum (10 isolates). On the other hand, urine and bone isolates were less, which were 4 and 1 isolates, respectively. The distribution of different pulsotypes of MRSA among wards suggested that MRSA was communicated in surgical and medical wards in UKMMC, with pulsotype B MRSA as the dominant strain. Besides, it was found that most deceased patients were infected by pulsotype B MRSA, however, no particular pulsotype could be associated with patient age, underlying disease, or ward of admittance. Conclusions Five pulsotypes of MRSA and 6 singletons were identified, with pulsotype B MRSA as the endemic strains circulating in these wards, which is useful in establishment of preventive measures against MRSA transmission. PMID:23620843

  10. Improved understanding of factors driving methicillin-resistant Staphylococcus aureus epidemic waves

    PubMed Central

    Chatterjee, Som S; Otto, Michael

    2013-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most important causes of nosocomial infections worldwide. Since the global spread of MRSA in the 1960s, MRSA strains have evolved with increased pathogenic potential. Notably, some strains are now capable of causing persistent infections not only in hospitalized patients but also in healthy individuals in the community. Furthermore, MRSA is increasingly associated with infections among livestock-associated workers, primarily because of transmission from animals to humans. Moreover, many MRSA strains have gained resistance to most available antibiotics. In this review, we will present current knowledge on MRSA epidemiology and discuss new endeavors being undertaken to understand better the molecular and epidemiological underpinnings of MRSA outbreaks. PMID:23861600

  11. Risk Factors of Methicillin-Resistant Staphylococcus aureus Infection and Correlation With Nasal Colonization Based on Molecular Genotyping in Medical Intensive Care Units

    PubMed Central

    Kao, Kuo-Chin; Chen, Chun-Bing; Hu, Han-Chung; Chang, Hui-Ching; Huang, Chung-Chi; Huang, Yhu-Chering

    2015-01-01

    Abstract Methicillin-resistant Staphylococcus aureus (MRSA) is a common and important cause of colonization and infection in medical intensive care units (ICU). The aim of this study was to assess association factors between MRSA nasal colonization and subsequent infections in medical ICU patients by clinical investigation and molecular genotyping. A prospective cohort observational analysis of consecutive patients admitted to medical ICUs between November 2008 and May 2010 at a tertiary teaching hospital were included. To detect MRSA colonization, the specimens from the nares were obtained within 3 days of admission to the ICU and again 1 week following admission to the ICU. Genetic relatedness for colonized and clinical isolates from each study patient with MRSA infection were analyzed and compared. A total of 1266 patients were enrolled after excluding 195 patients with already present MRSA infections. Subsequent MRSA infection rates were higher in patients with nasal colonization than in those without (39.1% versus 14.7%, respectively). Multivariate Poisson regression analysis demonstrated that nasal MRSA colonization (relative risk [RR]: 2.50; 95% confidence interval [CI]: 1.90–3.27; P?MRSA infections. History of tracheostomy, however, was a protective predictor in all patients (RR: 0.38; 95% CI: 0.18–0.79; P?=?0.010) and in patients with MRSA nasal colonization (RR: 0.22; 95% CI: 0.55–0.91; P?=?0.037). Molecular genetics studies revealed that most MRSA isolates were healthcare-associated clones and that nasal and clinical isolates exhibited up to 75% shared identity. Methicillin-resistant S. aureus nasal colonization was significantly associated with subsequent MRSA infection among medical ICU patients. Previous MRSA infection was associated with subsequent MRSA infections, and history of tracheostomy associated with reducing this risk. Most MRSA isolates were healthcare-associated strains that were significantly correlated between nasal and clinical isolates. PMID:26181545

  12. Tracking Methicillin-Resistant Staphylococcus aureus Clones during a 5-Year Period (1998 to 2002) in a Spanish Hospital

    PubMed Central

    Pérez-Roth, Eduardo; Lorenzo-Díaz, Fabián; Batista, Ninivé; Moreno, Antonio; Méndez-Álvarez, Sebastián

    2004-01-01

    Three hundred seventy-five consecutive methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates recovered between 1998 and 2002 at the Nuestra Señora de Candelaria University Hospital in Tenerife, Spain, were analyzed by molecular fingerprinting techniques to determine MRSA clonal types and their prevalence over time. After determining antibiotic susceptibility, we used SmaI-digested genomic DNA separated by pulsed-field gel electrophoresis (PFGE) to characterize MRSA isolates and to establish PFGE types. Additionally, several selected isolates representative of each major PFGE type were tested by multilocus sequence typing (MLST) and by a multiplex PCR method capable of identifying the structural type of the staphylococcal cassette chromosome mec (SCCmec), generating the corresponding sequence type (ST)-SCCmec types. Results of PFGE, supported by those of MLST and SCCmec typing, allowed us to identify six MRSA clones within the five major PFGE types and document temporal shifts in the prevalence of these MRSA clones from 1998 to 2002. Four of the clones were the pandemic “Iberian” (designated ST247-MRSA-IA), EMRSA-15 (ST22-MRSA-IV), EMRSA-16 (ST36-MRSA-II), and the so-called pediatric (ST5-MRSA-IV) clones, while the other two (ST125-MRSA-IVA and ST146-MRSA-IVA) clones could be derived from the pediatric one. The most striking temporal shift in the dominance of MRSA clones was the replacement of the multidrug-resistant and highly epidemic Iberian clone by the so-called British EMRSA-16 clone during the 5-year surveillance period. Our results are in accordance with previously stated findings showing the worldwide hospital dominance of relatively few pandemic and presumably virulent MRSA clones. We report for the first time the detection in Spain of the British EMRSA-15 and pediatric clones, as well as the abrupt replacement of the Iberian by the EMRSA-16 as the major MRSA clone. PMID:15472324

  13. Complete Genome Sequence of a Pantón-Valentine Leukocidin-Negative Community-Associated Methicillin-Resistant Staphylococcus aureus Strain of Sequence type 72 from Korea

    PubMed Central

    Chen, Yan; Chatterjee, Som S.; Porcella, Stephen F.; Yu, Yun-Song; Otto, Michael

    2013-01-01

    In the past decade, community-associated (CA-) infections with methicillin-resistant Staphylococcus aureus (MRSA) have emerged throughout the world. Different CA-MRSA strains dominate in different geographical locations. Many CA-MRSA lineages contain genes coding for the Pantón-Valentine leukocidin. However, the role of this leukotoxin in CA-MRSA pathogenesis is still controversial. The genome sequences of two key PVL-positive CA-MRSA strains (USA300, USA400) have been reported, but we lack information on the more recently found PVL-negative CA-MRSA strains. One such strain is the PVL-negative ST72, the main cause of CA-MRSA infections in Korea. Here, we report the entire genome sequence of CA-MRSA ST72 and analyze its gene content with a focus on virulence factors. Our results show that this strain does not have considerable differences in virulence factor content compared to other CA-MRSA strains (USA300, USA400), indicating that other toxins do not substitute for the lack of PVL in ST72. This finding is in accordance with the notion that differential expression of widespread virulence determinants, rather than the acquisition of additional virulence factors on mobile genetic elements, such as PVL, is responsible for the increased virulence of CA- compared to hospital-associated MRSA. PMID:23977354

  14. Methicillin-Resistant Staphylococcus aureus Associated with Animals and Its Relevance to Human Health

    PubMed Central

    Pantosti, Annalisa

    2012-01-01

    Staphylococcus aureus is a typical human pathogen. Some animal S. aureus lineages have derived from human strains following profound genetic adaptation determining a change in host specificity. Due to the close relationship of animals with the environmental microbiome and resistome, animal staphylococcal strains also represent a source of resistance determinants. Methicillin-resistant S. aureus (MRSA) emerged 50?years ago as a nosocomial pathogen but in the last decade it has also become a frequent cause of infections in the community. The recent finding that MRSA frequently colonizes animals, especially livestock, has been a reason for concern, as it has revealed an expanded reservoir of MRSA. While MRSA strains recovered from companion animals are generally similar to human nosocomial MRSA, MRSA strains recovered from food animals appear to be specific animal-adapted clones. Since 2005, MRSA belonging to ST398 was recognized as a colonizer of pigs and human subjects professionally exposed to pig farming. The “pig” MRSA was also found to colonize other species of farmed animals, including horses, cattle, and poultry and was therefore designated livestock-associated (LA)-MRSA. LA-MRSA ST398 can cause infections in humans in contact with animals, and can infect hospitalized people, although at the moment this occurrence is relatively rare. Other animal-adapted MRSA clones have been detected in livestock, such as ST1 and ST9. Recently, ST130 MRSA isolated from bovine mastitis has been found to carry a novel mecA gene that eludes detection by conventional PCR tests. Similar ST130 strains have been isolated from human infections in UK, Denmark, and Germany at low frequency. It is plausible that the increased attention to animal MRSA will reveal other strains with peculiar characteristics that can pose a risk to human health. PMID:22509176

  15. A kwashiorkor case due to the use of an exclusive rice milk diet to treat atopic dermatitis.

    PubMed

    Mori, Francesca; Serranti, Daniele; Barni, Simona; Pucci, Neri; Rossi, Maria Elisabetta; de Martino, Maurizio; Novembre, Elio

    2015-01-01

    Although several cases of severe hypoalbuminemia resulting from rice milk have been described in the past, today the use of rice milk without nutritional counseling to treat eczema is still a continuing, poor practice. We describe a kwashiorkor case in an infant with severe eczema exclusively fed with rice milk. It is well documented that rice milk is not a sufficient protein source. Moreover, only a small portion of eczema is triggered by food allergy. In conclusion this case raises the importance of managing dietary changes facing food allergies with responsibility for specialized consensus among pediatricians, nutritionists, endocrinologists and allergists all of them specialist professionals. PMID:26293684

  16. [Diagnosis of Ramsey Hunt syndrome is both simple and difficult. The viral attack is more extensive than expected earlier].

    PubMed

    Hydén, D; Roberg, M

    2000-03-01

    In Ramsay Hunt's syndrome (herpes zoster of the head and neck in combination with facial palsy), the vesicles often appear on the external ear (herpes zoster oticus) but they can also be found on the exterior of the neck. Serologically verified cases without vesicles occur (zoster sine herpeticum). Complications from the eighth cranial nerve (hearing loss and vertigo) are common. MR and PCR studies show a more extensive viral attack than was earlier believed to be the case. Due to the risk of remaining cranial nerve dysfunctions, as exemplified in a case report, antiviral treatment is indicated, in severe cases combined with corticosteroids. The potential value of varicella vaccination to reduce zoster complications is discussed. PMID:10750383

  17. Characterization of methicillin-resistant Staphylococcus aureus strains recovered from a phase IV clinical trial for linezolid versus vancomycin for treatment of nosocomial pneumonia.

    PubMed

    Mendes, Rodrigo E; Deshpande, Lalitagauri M; Smyth, Davida S; Shopsin, Bo; Farrell, David J; Jones, Ronald N

    2012-11-01

    A total of 434 methicillin-resistant Staphylococcus aureus (MRSA) baseline isolates were collected from subjects enrolled in a prospective, double-blind randomized trial comparing linezolid versus vancomycin for the treatment of nosocomial pneumonia. Isolates were susceptibility tested by broth microdilution, examined for inducible clindamycin resistance by D-test, and screened for heterogeneous resistance to vancomycin (hVISA) by the Etest macromethod. All strains were subjected to Panton-Valentine leukocidin (PVL) screening, and SCCmec, pulsed-field gel electrophoresis (PFGE), and spa typing. Selected strains were evaluated by multilocus sequence typing (MLST). Clonal complexes (CCs) were assigned based on the spa and/or MLST results. Most strains were CC5 (56.0%), which originated from North America (United States) (CC5-MRSA-SCCmec II/IV; 70.0%), Asia (CC5-MRSA-II; 14.0%) and Latin America (CC5-MRSA-I/II; 12.3%). The second- and third-most-prevalent clones were CC8-MRSA-IV (23.3%) and CC239-MRSA-III (11.3%), respectively. Furthermore, the CC5-MRSA-I/II clone predominated in Asia (50.7% within this region) and Latin America (66.7%), followed by CC239-MRSA-III (32.8% and 28.9%, respectively). The European strains were CC8-MRSA-IV (34.5%), CC22-MRSA-IV (18.2%), or CC5-MRSA-I/II/IV (16.4%), while the U.S. MRSA isolates were CC5-MRSA-II/IV (64.4%) or CC8-MRSA-IV (28.8%). Among the U.S. CC8-MRSA-II/IV strains, 73.7% (56/76 [21.2% of all U.S. MRSA strains]) clustered within USA300. One strain from the United States (USA800) was intermediate to vancomycin (MIC, 4 ?g/ml). All remaining strains were susceptible to linezolid, daptomycin, vancomycin, and teicoplanin. hVISA strains (14.5%) were predominantly CC5-MRSA-II, from South Korea, and belonged to a single PFGE type. Overall, each region had two predominant clones. The USA300 rate corroborates previous reports describing increased prevalence of USA300 strains causing invasive infections. The prevalence of hVISA was elevated in Asia, and these strains were associated with CC5. PMID:22972817

  18. Use of copper alloy for preventing transmission of methicillin-resistant Staphylococcus aureus contamination in the dermatology ward.

    PubMed

    Niiyama, Nanako; Sasahara, Takeshi; Mase, Hiroshi; Abe, Michiko; Saito, Haruo; Katsuoka, Kensei

    2013-05-01

    Metallic copper has been shown significantly to reduce methicillin-resistant Staphylococcus aureus (MRSA) contamination of the ambient surroundings of the beds of MRSA-carrying patients in dermatology wards. The aim of this study was to determine whether a bed sheet made of copper-coated film will reduce the spread of MRSA contamination in the environment of a heavily-colonized patient. The bacterial count was highest on the bed sheet. MRSA cell counts on the surface of the non-film-coated control sheet were high (6,600-11,000 colony forming units (cfu)), but those on the copper film were considerably lower (20-130 cfu). Use of metallic copper on the bed sheets of patients who are likely to be a source of MRSA contamination may help to prevent the spread of MRSA contamination in hospital wards. PMID:23038099

  19. The Control of Methicillin-Resistant Staphylococcus aureus Blood Stream Infections in England

    PubMed Central

    Duerden, Brian; Fry, Carole; Johnson, Alan P.; Wilcox, Mark H.

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infection (BSI) is a major healthcare burden in some but not all healthcare settings, and it is associated with 10%–20% mortality. The introduction of mandatory reporting in England of MRSA BSI in 2001 was followed in 2004 by the setting of target reductions for all National Health Service hospitals. The original national target of a 50% reduction in MRSA BSI was considered by many experts to be unattainable, and yet this goal has been far exceeded (?80% reduction with rates still declining). The transformation from endemic to sporadic MRSA BSI involved the implementation of serial national infection prevention directives, and the deployment of expert improvement teams in organizations failed to meet their improvement trajectory targets. We describe and appraise the components of the major public health infection prevention campaign that yielded major reductions in MRSA infection. There are important lessons and opportunities for other healthcare systems where MRSA infection remains endemic. PMID:26380336

  20. Evaluation of a new CHROMagar medium for detection of methicillin-resistant Staphylococcus aureus.

    PubMed

    Rahbar, Mohammad; Islami, Parisa; Saremi, Mahnaz

    2008-02-01

    Four laboratory methods including, E-test MIC, Oxacillin screen agar, manitol salt agar plus oxacillin and CHROMagar MRSA were compared for detection of methicilin resistant Staphylococcus aureus (MRSA). CHROMagar MRSA had a high sensitivity and specificity comparing to conventional E-test method. Sensitivity and specificity by manitol salt agar was 95 and 100%, respectively, while oxacillin screening agar method had 100% sensitivity and 95% specificity. PMID:18817183