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1

Treatment of Recurrent Eczema Herpeticum in Pregnancy With Acyclovir  

PubMed Central

Background: Eczema herpeticum is an uncommon manifestation of an infection with herpes simplex virus (HSV). The disease is primarily seen in patients with histories of atopic eczema. Eczema herpeticum may be a life-threatening illness, but the mortality is felt to be <10% with modern antiviral and antibacterial agents. The use of acyclovir for other viral infections secondary to herpesvirus in pregnancy has been well documented. The authors now present a case report of eczema herpeticum treated with acyclovir during pregnancy. Case: A patient with a history of eczema herpeticum presented in pregnancy with a recurrence. She was successfully treated with intravenous (IV) acyclovir with good maternal and fetal outcome. Conclusion: Acyclovir may be utilized in pregnancy for several manifestations of HSV including eczema herpeticum. PMID:18476099

Baker, David A.

1996-01-01

2

A Case of Eczema Herpeticum with Hailey-Hailey Disease  

PubMed Central

Eczema herpeticum is the dissemination of herpes simplex virus in the setting of a preexisting skin disease. Hailey-Hailey disease [familial benign chronic pemphigus] is a blistering dermatosis that is inherited as an autosomal dominant trait and it usually presents itself around the third or fourth decades. Coexistence of eczema herpeticum and Hailey-Hailey disease is an infrequent occurrence. Four such cases have been reported in the English and German medical literature. We report here on an unusual case of eczema herpeticum that coexisted with Hailey-Hailey disease in a 47 years old man and we review the relevant literatures. PMID:20523813

Lee, Gun Hong; Kim, Yun Mi; Lee, Jong Suk; Park, Young Lip; Whang, Kyu Uang

2009-01-01

3

Fifteen-minute consultation: eczema herpeticum in a child.  

PubMed

Eczema herpeticum (EH) occurs when there is secondary skin infection with herpes simplex virus in an atopic patient. The patient may not have unusually severe or active eczema. It is thought that the abnormal skin barrier function predisposes to infection, which can spread rapidly. Viraemia and secondary septicaemia can occur, and the condition can be life-threatening. The first episode of herpes infection is usually the worst and requires systemic treatment. Early recognition is vital. The presentation may be difficult to distinguish from secondary bacterial infection, which is common in eczema. A useful clinical clue is the presence of many very similar shaped and sized eroded lesions. Intact blisters may not be seen due to scratching. A rapid deterioration in eczema in a child who is systemically unwell should prompt consideration of EH. PMID:25406412

Khan, Amjad; Shaw, Lindsay; Bernatoniene, Jolanta

2015-04-01

4

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 ...

5

Eczema  

PubMed Central

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

Krafchik, Bernice R

2000-01-01

6

MRSA  

MedlinePLUS

... should be cleaned before each use with a disinfectant that works against MRSA. Back Continue How Is ... People with infections also can help prevent other bacteria from becoming resistant to antibiotics in the future ...

7

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. ...

8

Immunological studies of herpes simplex virus infection in children with atopic eczema.  

PubMed

This study examines the role of immune defence mechanisms in herpes simplex virus (HSV) infections in atopic eczema and whether impairment of these mechanisms explains the susceptibility of some children with atopic eczema to cutaneous HSV infections. Ten children with eczema herpeticum and 13 with atopic eczema and recurrent HSV infection affecting multiple skin sites were studied, together with relevant control groups. In all children with atopic eczema, in vitro lymphoproliferation in response to stimulation with concanavalin A (Con A) was significantly decreased and natural killer (NK) cells (CD16 + 56) were reduced compared with non-atopic controls. IL-2 receptors, a marker for lymphocyte activation, were decreased during the acute phase of eczema herpeticum, and for 1 month thereafter. A positive stimulation index (> 3) to HSV antigen, and high HSV IgG antibody titres measured by ELISA, Western blotting and neutralization assay, were seen in children with eczema herpeticum by 6 weeks, and also in children with atopic eczema and recurrent HSV infections. No evidence of an HSV-specific immune defect (either cell-mediated or humoral) was found in atopic eczema. Impairment of cell-mediated immunity in atopic eczema was suggested by the reduced response to Con A. It is likely that reduced numbers of circulating NK cells and a decrease in IL-2 receptors during early eczema herpeticum contribute to the susceptibility of children with atopic eczema to cutaneous HSV infections. PMID:8745891

Goodyear, H M; McLeish, P; Randall, S; Buchan, A; Skinner, G R; Winther, M; Rolland, J; Morgan, G; Harper, J I

1996-01-01

9

Recurrent MRSA skin infections in atopic dermatitis.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of recurrent skin and soft tissue infections. For patients with atopic dermatitis, recurrent skin infections with MRSA often lead to eczema exacerbation. There currently is no standard practice in the prevention of recurrent MRSA soft tissue infections in the general and the atopic dermatitis populations. The current article reviews recent data on S aureus decolonization treatments for the prevention of recurrent MRSA soft tissue infections in the community setting. PMID:25017526

Ong, Peck Y

2014-01-01

10

Hand eczema.  

PubMed

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

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

2014-05-01

11

Hand Eczema  

PubMed Central

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

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

2014-01-01

12

Photos of MRSA Infections  

MedlinePLUS

... Methicillin-resistant Staphylococcus aureus (MRSA) Infections Share Compartir Photos of MRSA Infections In the community, most MRSA ... Educational Resources Environmental Cleaning & Disinfecting Athletic Facilities Laundry Photos of MRSA Infections MRSA in Healthcare Settings Patients ...

13

Eczema Health Risks  

MedlinePLUS Videos and Cool Tools

... lower right-hand corner of the player. Eczema Health Risks HealthDay January 22, 2015 Related MedlinePlus Pages ... with eczema. But a new study finds the health risks from this disease may go way beyond ...

14

MRSA Screening  

MedlinePLUS

... in a molecular test, but the specimen is analyzed for the genetic markers to identify S. aureus and ... Skin Infections In the News: MRSA Prevention Strategies Analyzed, Screening Policies Challenged (2013) Elsewhere On The Web ...

15

Stopping MRSA  

ERIC Educational Resources Information Center

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…

Vogel, Carl

2008-01-01

16

Eczema and Atopic Dermatitis  

MedlinePLUS

... your skin include household cleansers, detergents, aftershave lotions, soap, gasoline, turpentine and other solvents. Try to avoid ... things that make you break out with eczema. Soaps and wetness can cause skin irritation. Wash your ...

17

Treatment of Eczema  

Microsoft Academic Search

Eczema is a chronic inflammatory skin disease that has reached nearly epidemic proportions in childhood. Moreover, it is a\\u000a difficult disease to control and, with its onset in childhood, is often the first manifestation of atopy. The clinical features\\u000a of eczema include itchy red skin accompanied by dryness and lichenification. In the past, treatment options consisted primarily\\u000a of avoidance of

Christopher Chang; Carl L. Keen; M. Eric Gershwin

2007-01-01

18

Eczema Coxsackium” and Unusual Cutaneous Findings in an Enterovirus Outbreak  

PubMed Central

OBJECTIVE: To characterize the atypical cutaneous presentations in the coxsackievirus A6 (CVA6)–associated North American enterovirus outbreak of 2011–2012. METHODS: We performed a retrospective case series of pediatric patients who presented with atypical cases of hand, foot, and mouth disease (HFMD) from July 2011 to June 2012 at 7 academic pediatric dermatology centers. Patients were included if they tested positive for CVA6 or if they met clinical criteria for atypical HFMD (an enanthem or exanthem characteristic of HFMD with unusual morphology or extent of cutaneous findings). We collected demographic, epidemiologic, and clinical data including history of skin conditions, morphology and extent of exanthem, systemic symptoms, and diagnostic test results. RESULTS: Eighty patients were included in this study (median age 1.5 years, range 4 months–16 years). Seventeen patients were CVA6-positive, and 63 met clinical inclusion criteria. Ninety-nine percent of patients exhibited a vesiculobullous and erosive eruption; 61% of patients had rash involving >10% body surface area. The exanthem had a perioral, extremity, and truncal distribution in addition to involving classic HFMD areas such as palms, soles, and buttocks. In 55% of patients, the eruption was accentuated in areas of eczematous dermatitis, termed “eczema coxsackium.” Other morphologies included Gianotti-Crosti–like (37%), petechial/purpuric (17%) eruptions, and delayed onychomadesis and palm and sole desquamation. There were no patients with serious systemic complications. CONCLUSIONS: The CVA6-associated enterovirus outbreak was responsible for an exanthem potentially more widespread, severe, and varied than classic HFMD that could be confused with bullous impetigo, eczema herpeticum, vasculitis, and primary immunobullous disease. PMID:23776120

Oza, Vikash; Frieden, Ilona J.; Cordoro, Kelly M.; Yagi, Shigeo; Howard, Renee; Kristal, Leonard; Ginocchio, Christine C.; Schaffer, Julie; Maguiness, Sheilagh; Bayliss, Susan; Lara-Corrales, Irene; Garcia-Romero, Maria Teresa; Kelly, Dan; Salas, Maria; Oberste, M. Steven; Nix, W. Allan; Glaser, Carol; Antaya, Richard

2013-01-01

19

Pet Care: MRSA FAQ  

MedlinePLUS

... in horses, dogs, cats, pet birds, cattle and pigs. Q: How common is MRSA? A: MRSA is ... term care facilities For large animals (horses, cattle, pigs), risk factors may include nasal/facial contact with ...

20

Gastrointestinal symptoms in atopic eczema  

Microsoft Academic Search

AIMSTo determine the prevalence of gastrointestinal symptoms in children with eczema and the association of such symptoms with the extent of eczema or skin prick test results.METHODSSixty five children with atopic eczema and a control group matched for age and sex were recruited. Their parents completed a questionnaire about the children’s gastrointestinal symptoms. The children’s skin was examined; their weight,

Carlo Caffarelli; Giovanni Cavagni; Franca M Deriu; Paola Zanotti; David J Atherton

1998-01-01

21

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 ...

22

MRSA in Schools  

ERIC Educational Resources Information Center

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…

US Department of Education, 2007

2007-01-01

23

Eczema (Atopic Dermatitis) in Adults  

MedlinePLUS

... primarily affecting allergy-prone people. Heat, humidity, detergents/soaps, abrasive clothing (eg, very scratchy wools), chemicals, smoke, ... eczema. Moisturizing skin-care routines are essential. Non-soap cleansers, such as Cetaphil®, or moisturizing soaps, such ...

24

Eczema (Atopic Dermatitis) in Infants  

MedlinePLUS

... humidity Abrasive clothing Tobacco smoke and chemicals Some soaps and detergents Who's At Risk Infants are more ... eczema. Moisturizing skin-care routines are essential. Non-soap cleansers, such as Cetaphil®, or moisturizing soaps, such ...

25

Gastrointestinal symptoms in atopic eczema  

PubMed Central

AIMS—To determine the prevalence of gastrointestinal symptoms in children with eczema and the association of such symptoms with the extent of eczema or skin prick test results.?METHODS—Sixty five children with atopic eczema and a control group matched for age and sex were recruited. Their parents completed a questionnaire about the children's gastrointestinal symptoms. The children's skin was examined; their weight, height, and abdominal circumference were measured; and skin prick tests were carried out.?RESULTS—Gastrointestinal symptoms, especially diarrhoea, vomiting, and regurgitation, were more common in the children with eczema. Diarrhoea appeared to be associated with the ingestion of specific foods. Gastrointestinal symptoms were related to diffuse eczema and positive skin prick tests to foods. There was no anthropometric differences between the patient and control groups.?CONCLUSIONS—A gastrointestinal disorder is common in children with eczema, especially with diffuse distribution. This may be responsible for substantial symptoms and may play a part in the pathogenesis of the disease and in the failure to thrive with which it is sometimes associated.?? PMID:9613352

Caffarelli, C.; Cavagni, G.; Deriu, F.; Zanotti, P.; Atherton, D.

1998-01-01

26

MRSA - Multiple Languages: MedlinePlus  

MedlinePLUS

... enable JavaScript. MRSA - Multiple Languages Arabic (???????) Bosnian (Bosanski) Chinese - Simplified (????) Chinese - Traditional (????) French (français) ... ???????? ???????????? - ??????? Multimedia Patient Education ... (Bosanski) MRSA (Methicillin Resistant Staphylococcus Aureus) MRSA (meticilin rezistentni ...

27

National Eczema Association for Science and Education  

MedlinePLUS

... Patient Conference - Get Support Eczema Products - About NEA Seal of Acceptance ™ - Glossary of Skin Care Terms - Moisturizers - ... Patient Conference Get Support Eczema Products About NEA Seal of Acceptance ™ Glossary of Skin Care Terms Moisturizers ...

28

The digital eczema centre utrecht.  

PubMed

The University Medical Centre Utrecht (UMC Utrecht) has developed an eczema portal that combines e-consulting, monitoring and self-management training by a dermatology nurse online for patients and parents of young children with atopic dermatitis (AD). Patient satisfaction with the portal was high. It could be extended to become a Digital Eczema Centre for multidisciplinary collaboration between health-care providers from different locations and the patient. Before starting the construction of the Digital Eczema Centre, the feasibility was examined by carrying out a business case analysis. The purposes, strength and weaknesses showed that the Digital Eczema Centre offered opportunities to improve care for patients with AD. The financial analysis resulted in a medium/best case scenario with a positive result of euro50-240,000 over a period of five years. We expect that the Digital Eczema Centre will increase the accessibility and quality of care. The web-based patient record and the digital chain-of-care promote the involvement of patients, parents and multidisciplinary teams as well as the continuity and coordination of care. PMID:20086261

van Os-Medendorp, Harmieke; van Veelen, Carien; Hover, Maaike; Eland-de Kok, Petra; Bruijnzeel-Koomen, Carla; Sonnevelt, Gert-Jan; Mensing, Geert; Pasmans, Suzanne

2010-01-01

29

General Information about MRSA in the Community  

MedlinePLUS

... Share Compartir General Information About MRSA in the Community MRSA is methicillin-resistant Staphylococcus aureus , a type ... Risk, and How is MRSA Spread in the Community? Anyone can get MRSA through direct contact with ...

30

Chinese herbal medicine research in eczema treatment  

PubMed Central

Eczema is a chronic relapsing atopic dermatitis (AD) associated with pruritus, sleep disturbance and poor quality of life of the patient. Treatment of eczema includes use of emollient, topical and systemic antimicrobial agents, corticosteroid or immunomodulating agents. Many patients also seek alternative treatments such as dietary avoidance, supplementation or both. This article reviews the basic pathophysiology of eczema and clinical trials involving Chinese medicine in the treatment of eczema. Research reports on Chinese herbal medicine for eczema were retrieved from PubMed and the Cochrane Database for Systematic Reviews for this review. Only a few RCTs demonstrated the efficacy (or lack of efficacy) of Chinese medicinal herbs in treating atopic eczema. Further larger scale trials are warranted. PMID:21527032

2011-01-01

31

General Information about MRSA in Healthcare Settings  

MedlinePLUS

... Infections Share Compartir General Information About MRSA in Healthcare Settings In a healthcare setting, such as a ... at Risk, and How is MRSA Spread in Healthcare Settings? MRSA is usually spread by direct contact ...

32

Atopic dermatitis/atopic eczema.  

PubMed

Atopic dermatitis was described in 1933 but exists since antiquity. We review descriptions of a childhood skin disease compatible with our modern diagnosis of atopic dermatitis, in ancient medicine and in nineteenth century dermatology texts. We identify Hebra's prurigo and Besnier's diathetic prurigo as forerunners of atopic dermatitis, the latter being a synthesis of infantile eczema and prurigo. The pathogenic theories which link atopic dermatitis to humoralistic medicine, to digestive diseases, to allergy may have had consequences on today's reluctance to consider atopic dermatitis as a skin disorder, the treatment of which relies mainly on topicals. PMID:24925387

Wallach, Daniel; Taïeb, Alain

2014-01-01

33

Eczema  

MedlinePLUS

... Have you ever tried a new type of soap and developed an itchy rash? That reaction may ... wash gently with a nondrying facial cleanser or soap substitute, use a facial moisturizer that says noncomedogenic/ ...

34

JAMA Patient Page: MRSA Infections  

MedlinePLUS

... JAMA . CAUSES OF MRSA INFECTIONS Leading causes of antibiotic resistance include • Bacterial mutation—bacteria that survive treatment with one antibiotic may develop resistance to the effects of that drug and similar ...

35

Eczema Linked to Other Health Problems  

MedlinePLUS

... often starts in early childhood, it can affect self-esteem and identity, he said. And those factors may ... Eczema can have a major impact on the self-esteem and overall well-being of the patient," she ...

36

Environmental Cleaning and Disinfecting for MRSA  

MedlinePLUS

... is not absolutely necessary. More about laundry... Top Facility Cleaning & Disinfection after a MRSA Infection When MRSA ... that have been exposed to infections. Top Shared Equipment Shared equipment that comes into direct skin contact ...

37

Mouse Models of Atopic Eczema Critically Evaluated  

Microsoft Academic Search

Atopic eczema (AE) is a chronic relapsing inflammatory skin disorder with increasing prevalence in Western societies. Even though we have made considerable progress in understanding the cellular and molecular nature of cutaneous inflammation, the precise pathomechanisms of AE still remain elusive. Experimental animal models are indispensable tools to study the pathogenic mechanisms and to test novel therapeutic approaches in vivo.

Jan Gutermuth; Markus Ollert; Johannes Ring; Heidrun Behrendt; Thilo Jakob

2004-01-01

38

Chronic hand eczema: a prevalent and challenging skin condition.  

PubMed

Hand eczema is a common condition in the industrialized world and the most common occupational skin disorder. The economic impact of hand eczema is daunting, with both direct and indirect costs. The former include medical costs, as well as costs associated with disability, workers' compensation, and rehabilitation, while the latter include absence from work, loss of productivity, job changes, and even job loss. Individuals with more severe, recurrent, or protracted hand eczema can endure serious psychosocial repercussions and a substantially impaired quality of life (QOL). In some cases, hand eczema adversely affects patients' social lives. Individuals with hand eczema also may experience emotional distress, including depression, mood disorders, and disrupted sleep. Because of these potentially deleterious economic and psychosocial consequences, hand eczema should be regarded as an important public health challenge. PMID:19202670

Fowler, Joseph

2008-10-01

39

Mite elimination--clinical effect on eczema.  

PubMed

Allergic reactivity to house-dust mites (HDM) can be detected in patients with atopic eczema by prick and patch test challenge. To determine the clinical relevance of this reactivity, we performed a placebo-controlled, double-blind trial of anti-HDM measures. Active treatment comprised Gortex bags for all the bedding elements, a high-powered vacuum cleaner, and a spray containing benzyl alcohol and tannic acid to kill mites and denature allergens. Placebo treatment was light cotton bags, a cheap vacuum cleaner, and water spray. Forty-eight patients (28 active group) completed the trial, which lasted 6 months. Dust was sampled from the mattress surface and bedroom and living-room carpets before and at monthly intervals after institution of the measures. Dust was weighed and Der p 1 determined by ELISA (ALK). Patients were assessed for area and severity of eczema by a blinded observer. There was a highly significant reduction in bed surface dust - most beds yielded insufficient dust to extract and assay. Carpet Der p 1 levels were reduced to similar minimal levels by both active and placebo treatments (about 250 ng/m2). There were highly significant benefits on the eczema scores, the active treatment being greatly superior to placebo (P< or =0.0006; analysis of covariance). In conclusion, Gortex bed bags were highly effective at containing dust within the bed. This was associated with clinical improvement in most patients with atopic eczema - the biggest improvements were seen in the most severely affected subjects. PMID:10096818

Friedmann, P S; Tan, B B

1998-01-01

40

MRSA  

Microsoft Academic Search

\\u000a The patient, a 16-year-old male, who was a previously healthy high school athlete, was admitted to the intensive care unit\\u000a via the emergency department (ED) with a four day history of fever, chills, and occasional rigor, myalgia, and productive\\u000a cough, now with increasing dyspnea and hemoptysis over the past 24 hours. His temperature was 38.1°C, blood pressure was 133\\/87\\u000a mm

Donna M. Wolk

41

MRSA  

MedlinePLUS

... and is most often caused by the bacteria Streptococcus or Staphylococcus . These bacteria are able to enter ... Bacteria commonly causing abscesses are Staphylococcus aureus and Streptococcus . These bacteria… About Us | Terms of Use | Contact ...

42

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...

43

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 ...

44

Update on Epidemiology and Treatment of MRSA Infections in Children  

PubMed Central

In 2000-10 the epidemiology of pediatric MRSA infections in the United States was transformed with an epidemic of CA-MRSA infections. We review the epidemiology of MRSA in the community and in the health care setting, including intensive care units, among infants and CF patients, and in households as well as the impact that the CA-MRSA epidemic has had on hospitalization with MRSA infections. Risk factors for carriage, transmission, and initial and recurrent infection with MRSA are discussed. New studies on the treatment of pediatric MRSA infections and on the efficacy of MRSA decolonization are reviewed. PMID:24040579

David, Michael Z.; Daum, Robert S.

2013-01-01

45

A case of cutaneous protothecosis mimics eczema.  

PubMed

We report a case of cutaneous protothecosis due to Prototheca wickerhamii in an immunocompetent man presented with a specific eczema-like lesions. Dermatological examination revealed erythematous plaques, dark red papules with some coalescence, and a few superficial ulcerations, covered with less scales on his right side chest and neck. Fungal culture, histopathological examination and molecular identification confirmed the organism. Antifungal susceptibility testing revealed strain sensitive to amphotericin B, Fluconazole, itraconazole and voriconazole. The patient was cured by oral itraconazole capsules and topical cream ketoconazole 2%. PMID:25200680

Zhang, Qiangqiang; Li, Li; Yuli, Kang; Zhao, Ying; Zhu, Junhao; Zhu, Min

2015-02-01

46

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 ...

47

Multiple Myeloma and Atopic Eczema in an Adult  

PubMed Central

Multiple myeloma is the fourteenth cause of cancer-related death. The symptoms of myeloma are mostly nonspecific, and there is significant delay between the first symptoms and diagnosis of myeloma. Atopic eczema is a common chronic inflammatory skin disease associated with dysregulation of the immune system. It generally develops in early childhood but can also occur in adults. Eczema is associated with a variety of hematological and solid malignancies, and possibly multiple myeloma. We report a patient with eczema that developed 5 years before the diagnosis of multiple myeloma but was mistaken for psoriasis.

Hossain, Mohammad Amir; Nai, Qiang; Zhang, Ping; Luo, Hongxiu; Hossain, Mohammed Amzad; Mahmad, Abdul; Yousif, Abdalla M.; Sen, Shuvendu

2015-01-01

48

Multiple myeloma and atopic eczema in an adult.  

PubMed

Multiple myeloma is the fourteenth cause of cancer-related death. The symptoms of myeloma are mostly nonspecific, and there is significant delay between the first symptoms and diagnosis of myeloma. Atopic eczema is a common chronic inflammatory skin disease associated with dysregulation of the immune system. It generally develops in early childhood but can also occur in adults. Eczema is associated with a variety of hematological and solid malignancies, and possibly multiple myeloma. We report a patient with eczema that developed 5 years before the diagnosis of multiple myeloma but was mistaken for psoriasis. PMID:25848353

Hossain, Mohammad Amir; Nai, Qiang; Zhang, Ping; Luo, Hongxiu; Hossain, Mohammed Amzad; Mahmad, Abdul; Yousif, Abdalla M; Sen, Shuvendu

2015-01-01

49

Family eczema-history in 2-year olds with eczema; a prospective, population-based study. The PACT-study, Norway  

PubMed Central

Background A maternal line of inheritance regarding eczema has been described in several studies, whereas others find associations to both a maternal as well as a paternal line of inheritance. When studying family history of eczema symptoms, cohort studies including siblings are rare. Time point for assessing family eczema-history could be of importance when studying the associations between family eczema-history and children with eczema, as parents with unaffected children may not recall mild symptoms in other siblings or their own disease history. We therefore aimed to study the associations between reported eczema in mother, father and siblings and reported eczema in index child where information on family history was collected at two different ages of index child. Methods Parents/children participating in The Prevention of Allergy among Children in Trondheim (PACT) study were given questionnaires on reported eczema symptoms in mother, father and siblings at 6 weeks and 1 year. When index child was 2 years of age, a detailed questionnaire on different health issues with emphasize on different allergy related disorders were filled in. Results Both maternal and paternal reports on eczema were significantly associated with eczema in index child. Reporting family eczema-history at 1 year (N = 3087), "eczema sibling only" [adjusted odds ratio (aOR) = 3.13 (2.27-4.33)] as well as all other family-groups containing siblings with eczema were strongly associated with eczema 2 years. When family eczema-history was reported at 6 weeks (N = 2657), reporting of "eczema sibling only" was not associated to reported eczema at 2 years in index child [aOR = 1.31 (0.77-2.23)]. Conclusions Having sibling(s) with eczema strengthened the associations between maternal and paternal reports on eczema with eczema in index child only when exposure was reported at 1 year. These findings indicate that results from questionnaires-based studies of family eczema-history depend on whether or not index child has yet developed eczema. Trial registration ISRCTN: ISRCTN28090297 PMID:21599876

2011-01-01

50

Methicillin-resistant Staphyloccocus aureus (MRSA) isolation from diabetic foot ulcers correlates with nasal MRSA carriage  

Microsoft Academic Search

Methicillin-resistant Staphylococcus aureus is increasingly isolated from diabetic foot ulcers, and may be associated with an adverse prognosis. We have explored the relationship between MRSA isolation from foot ulcers and nasal MRSA carriage. Over a 12 month period, 65 consecutively attending patients with diabetic foot ulceration were recruited. Demographic information was collected, and the ulcer and nose swabbed bacteriologically using

Stephen Stanaway; Deborah Johnson; Probal Moulik; Geoffrey Gill

2007-01-01

51

MRSA prevention strategies and current guidelines.  

PubMed

We review prevention strategies to minimise the risk of MRSA soft tissue and bone infections, which can be devastating for the patient and costly for the healthcare provider. Department of Health (England) policy is that screening for emergency admissions will be mandatory from 2011, in addition to existent elective admission screening. Rapid screening technology has not been shown to be cost-effective, meaning that there will be a lag time between admission and the patient's MRSA status being known. Thus, standard infection control policies regarding isolation of high-risk patients will remain, with a continuing focus on MRSA decolonisation, aimed at minimising the risks of auto-infection and transmission to other patients. Antimicrobial prescribing policies should be designed to take into account the local burden of resistant organisms, but also minimise unnecessary antibiotic use. There is an increasing realisation that reducing the use of fluoroquinolones and third-generation cephalosporins (which have been associated with increased carriage of MRSA) in patient populations where MRSA is prevalent can be a useful control measure. Prevention of orthopaedic infections clearly involves general operating theatre protocols, such as suitable antiseptic skin preparation, and additional measures including the use of laminar airflow. Antibiotic prophylaxis is adjusted in patients known to have MRSA to include a glycopeptide, and local guidelines may adopt such regimens for all patients due to the burden of MRSA in the local patient population. A future development that may have an effect on practice is the development of a Staphylococcus aureus vaccine, which has been shown to be cost-effective in a computer-modelled evaluation. PMID:22196908

Byrne, F M; Wilcox, M H

2011-12-01

52

Atopic eczema: its impact on the family and financial cost  

Microsoft Academic Search

OBJECTIVETo evaluate the impact of childhood atopic eczema on families and assess the personal financial cost of its management.DESIGNCross sectional survey.SETTINGPaediatric dermatology and paediatric diabetology outpatient clinics.PATIENTSParents of 48 randomly selected children with atopic eczema and 46 with insulin dependent diabetes mellitus.MAIN OUTCOME MEASURESThe impact on family score, the reported cost of relevant medical treatments, medical consultations, relevant hospitalisation, and

John C Su; Andrew S Kemp; George A Varigos; Terence M Nolan

1997-01-01

53

Distinct Pattern of Commensal Gut Microbiota in Toddlers with Eczema  

Microsoft Academic Search

Background: Recent studies have demonstrated differences in the composition of gut microbiota in infants with and without allergic diseases, particularly eczema. Methods: A case-control study involving 21 toddlers (age 3.0 ± 0.5 years) with and 28 age-matched toddlers without eczema was conducted. Four groups of aerobic gut microbiota were identified and quantitated in stool samples grown on selective media. Three

K. W. Mah; B. Björkstén; B. W. Lee; H. P. van Bever; L. P. Shek; T. N. Tan; Y. K. Lee; K. Y. Chua

2006-01-01

54

Sleep and neurocognitive functioning in children with eczema.  

PubMed

Sleep disruption in childhood is associated with clearly defined deficits in neurocognition and behaviour. Childhood eczema is also a potent cause of sleep disruption though it is unknown whether it too results in neurocognitive deficits. To test this hypothesis, neurocognitive (WISC-IV), parental-reported sleep quality (Sleep Disturbance Scale of Children (SDSC)) and overnight polysomnographic (PSG) data were collected in 21 children with eczema and 20 healthy controls (age range 6-16 years). Children with eczema had worse sleep quality on both PSG (notably increased nocturnal wakefulness, a higher number of stage shifts and a longer latency to REM onset) and parental report. In addition, they demonstrated significant neurocognitive deficits (especially verbal comprehension, perceptual reasoning and to a lesser extent working memory) with a composite Full Scale IQ 16 points lower than controls. Parental reported sleep problems but not PSG parameters were correlated with reduced neurocognitive performance. However, hierarchical regression analyses revealed that eczema status was predictive while sleep fragmentation (parental or PSG) was not predictive of neurocognitive performance. As this is the first study to systematically examine neurocognitive functioning in children with eczema and given the finding of significant deficits it merits replication especially given the prevalence of the condition. The unanswered question is whether these cognitive deficits normalise with effective eczema treatment and if this is mediated by improvements in sleep architecture. PMID:23353660

Camfferman, Danny; Kennedy, J Declan; Gold, Michael; Simpson, Carol; Lushington, Kurt

2013-08-01

55

[Relevance of MRSA on a Visceral Surgical Intensive Care Unit.  

PubMed

Background: Resistance to antibiotics is a worldwide increasing problem. A well-known example is methicillin resistant Staphylococcus aureus, MRSA. What is the relevance of MRSA on a surgical ICU? Patients/Material and Methods: On a 20 bed academic SICU/intermediate care ward 14,976 patients were treated in a seven-year period. We identified only 98 MRSA-positive patients. 56 (57?%) of them were merely colonised, 42 (43?%) suffered from an MRSA infection. A control group comprised 56 similar patients without MRSA detection. Results: Patients with MRSA infection had a higher mortality rate (OR 4.18; p?=?0.002), but only 4 out of 20 patients died due to the MRSA infection. APACHE 2 score of more than 20 was predictive for being colonised with MRSA (OR 3.08; p?=?0.04), but it was not a risk factor for developing an MRSA infection (OR 1.03; p?=?0.95). Patients with MRSA colonisation did not have a higher mortality rate than patients without. Conclusion: Outcome depended on severity of the disease, but not on the MRSA colonisation status. Patients with MRSA infection were more likely to die, but the reason of death rarely was MRSA. PMID:25076165

Utzolino, S; Baier, P; Riediger, H; Rösch, S; Hopt, U T

2014-07-30

56

[MRSA - hygiene management, diagnostics and treatment].  

PubMed

Methicillin-resistant Staphyococcus aureus strains remain a challenge to both patient care and infection control efforts. In addition to the defining resistance to beta-lactams several other antibiotic classes may be ineffective. Some resistance phenotypes exhibit a characteristic distribution pattern between healthcare-associated, community-associated, and livestock-associated MRSA strains. For patients with defined risk factors a search-, destroy-, follow-up-strategy is recommended in order to identify and eliminate MRSA colonization. Mupirocin nasal ointment and extensive hygiene measures are the mainstays of decolonization efforts. Besides vancomycin several other antimicrobials such as rifampin, trimethoprim-sulfamethoxazol, clindamycin, linezolid, and daptomycin are used to treat specific MRSA infections. PMID:24648177

Wagener, J; Seybold, U

2014-03-01

57

LA-MRSA CC398 differ from classical community acquired-MRSA and hospital acquired-MRSA lineages: functional analysis of infection and colonization processes.  

PubMed

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) of the clonal complex (CC) 398 became primarily known as colonizers of livestock animals. In the past few years, they have been increasingly introduced into hospitals with subsequent emergence of human infections. However, the (re-)adaptation to the human host is only incompletely understood. This study aimed to assess virulence properties of LA-MRSA CC398 by functional modeling of infection and colonization processes. A selection of 15 human LA-MRSA CC398 isolates and 11 pig-colonizing isolates were characterized regarding their virulence capacities and compared with human isolates of hospital-acquired (HA)-MRSA (CC5, CC22 and CC45) and community-associated (CA)-MRSA (CC8, CC30 and CC80) clonal lineages. Our investigations demonstrated that LA-MRSA CC398 adhered less efficient to human cells and human/bovine plasma fibronectin than CA-MRSA and HA-MRSA isolates. In contrast, the LA-MRSA CC398 isolates revealed a high cytotoxic potential comparable to certain CA-MRSA. Comparing the most prevalent LA-MRSA CC398 spa types (t011, t034, t108), isolates associated with spa t108 showed an increased adhesive and invasive potential paired with an increased ability to evade phagocytosis. The results underline both the pathogenic potential of LA-MRSA in general and the heterogeneity within the CC398 clade regarding the virulence characteristics of CC398 subpopulations. Assuming an ongoing (re-)adaptation to the human host combined with a huge reservoir of LA-MRSA CC398 in livestock and constant zoonotic transmission, the LA-MRSA CC398 lineage has the potential to pose a serious threat to human health. PMID:25034858

Ballhausen, Britta; Jung, Philipp; Kriegeskorte, André; Makgotlho, Phuti Edward; Ruffing, Ulla; von Müller, Lutz; Köck, Robin; Peters, Georg; Herrmann, Mathias; Ziebuhr, Wilma; Becker, Karsten; Bischoff, Markus

2014-10-01

58

Patients and Loved Ones: Information about MRSA in Healthcare Settings  

MedlinePLUS

... Methicillin-resistant Staphylococcus aureus (MRSA) Infections Share Compartir Patients and Loved Ones: Information about MRSA in Healthcare ... making them sick. Also, hospital or nursing home patients who have been treated with antibiotics are more ...

59

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 ...

60

Developmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies  

E-print Network

concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheezeDevelopmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether

Bishop, Christopher M.

61

Probiotics in the prevention of eczema: a randomised controlled trial  

PubMed Central

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

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

62

Predicting phenotypes of asthma and eczema with machine learning  

PubMed Central

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

2014-01-01

63

Alitretinoin for the treatment of severe chronic hand eczema  

PubMed Central

Chronic hand eczema is a common and often debilitating condition. Alitretinoin, a 9-cis-retinoic acid and pan-retinoic acid agonist, is a new and effective systemic treatment for chronic hand eczema, which provides another treatment option. A “clear” or “almost clear” response can be achieved in up to half of patients within a 24-week course of treatment. Even higher rates of remission can be obtained with a longer duration of treatment. Alitretinoin has a favorable overall profile of adverse effects; however, female patients who are at risk of becoming pregnant should follow a strict pregnancy-prevention program due to the teratogenic effects of this drug. PMID:25525339

King, Thomas; McKenna, John; Alexandroff, Anton B

2014-01-01

64

MRSA bij een patiënt: hoe te handelen?  

Microsoft Academic Search

Casus  Een tandarts schrijft: ‘Ik heb vandaag iets licht-ongebruikelijks in de praktijk meegemaakt. Een 49-jarige man met een zwaar\\u000a gerestaureerd gebit gaat achteruit. Hij heeft inmiddels diabetes II en hij heeft in overleg besloten naar een volledige prothese\\u000a toe te werken. In het ziekenhuis is enige maanden geleden ontdekt dat hij MRSA-drager is. Hij mag pas terugkomen in het ziekenhuis\\u000a als

L. Abraham-Inpijn

2010-01-01

65

Characterization of PVL-positive MRSA from Norway.  

PubMed

Norway is a country in which the Methicillin-resistant Staphylococcus aureus (MRSA) prevalence has been low for the last decades. There are virtually no epidemic, hospital-acquired MRSA because of an emphasis on strict infection control rules and restrictive use of antibiotics. However, community-acquired and/or Panton-Valentine leucocidin (PVL)-positive MRSA need to be monitored as these strains are transmitted outside of healthcare facilities and cannot be contained by healthcare-centred strategies. All 179 non-repetitive isolates of PVL-positive MRSA that were received during 2011 at the regional infection control laboratory at Akershus University Hospital were preserved and spa typed. Seventy isolates were further characterized by DNA microarray hybridization. The most common PVL-MRSA lineages were ST8-MRSA-IV and CC30-MRSA-IV. Further common clones were CC80-MRSA-IV and CC5-MRSA-IV. Other clones were found sporadically. These included ST772-MRSA-V and ST834-MRSA-IV, the latter in patients with epidemiological connections to the Philippines. Small-scale family outbreaks affecting at least 49 individuals were noted, with numbers of known cases per outbreak ranging from two to seven. At least 24 cases were related to foreign travel to Eritrea, India, Iraq, Macedonia, Pakistan, the Philippines, Poland, Singapore, Turkey, the USA and Vietnam. These data show that community-acquired/PVL-positive MRSA are not yet a major public health problem in Southern Norway. Our study corroborates the current practice of mandatory screening of patients and staff with travel histories, admissions or employment in healthcare institutions outside the Scandinavian countries or with known MRSA contacts. PMID:24106794

Monecke, Stefan; Aamot, Hege Vangstein; Stieber, Bettina; Ruppelt, Antje; Ehricht, Ralf

2014-07-01

66

[MRSA clones identified in outpatient dermatology clinics].  

PubMed

To know the characteristics of methicillin-resistant Staphylococcus aureus (MRSA) strains disseminating through the Japanese community, we have determined types of Staphylococcal cassette chromosome mec (SCCmec) elements, Multi-Locus Sequence Typing (MLST), and carriages of four exotoxin genes (toxic-shock syndrome toxin, Panton-Valentine Leukocidine, and exfoliative toxins a and b) using 54 MRSA strains isolated from outpatients attending dermatology clinics at the four university hospitals of Juntendo University. Ten clonal complexes and 12 SCCmec types have been identified. As a result, more than 15 MRSA clones that were defined by the combination of genotype and SCCmec type, were identified. Among them, Clonal Complex (CC) 5-type IIa SCCmec strains were the most major (16 strains). In contrast to the fact that CC5- type IIa SCCmec strains known as a hospital-associated MRSA clone in Japan carried toxic-shock syndrome toxin gene (tst), only 2 of 16 strains have been shown to carry tst. Thirty-eight (70.4%) of isolates belonged to the clones distinct from the CC5-type IIa SCCmec strains. Among them, CC8 strains were major (12 strains), which contained 9 tst-positive CC8-type IVl SCCmec clones and a CC8-type IVa SCCmec strain carrying the Panton Valentine Leukocidin gene (lukS, F-PV). Clones related to impetigo were also identified: 7 exfoliative toxin b (etb) -positive clones, CC89-type IIa SCCmec and CC89-type V SCCmec strains; and 2 exfoliative toxin a (eta) -positive CC121-type V SCCmec strains. Other clones were as follows: CC1-type IVa SCCmec, CC8-type I SCCmec, CC81-type IVg SCCmec, CC97-type IVc SCCmec, CC91-type IVa SCCmec, CC59-type IVg SCCmec, CC45-type IIn SCCmec, CC89-SCCmec nontypeable, and CC8-type IVm, novel subtype of type IV SCCmec were identified in this study. Our data showed that many novel MRSA clones have emerged in the community. PMID:25764806

Hosoya, Shino; Ito, Teruyo; Misawa, Shigeki; Yoshiike, Takashi; Oguri, Toyoko; Hiramatsu, Keiichi

2014-11-01

67

[Eczema and food allergy--is there a causal relationship?].  

PubMed

In spite of popular beliefs, the relationship between eczema and food allergy still puzzles researchers and clinicians, which in part is due to the variety of mechanisms involved in various types of allergy. One has to realize the differences between hypersensitivity reactions to food proteins (allergens capable of initiating immediate hypersensitivity or immune complex reactions) and low-molecular weight compounds (haptens that may initiate cytotoxic reactions or delayed-type allergy). Hardly doubted is the role of IgE specific to food proteins in anaphylactic reactions and allergic urticaria. The involvement of food protein-specific IgE also is well-documented in protein contact dermatitis, with exposure to offending allergens occurring mainly through direct contact to the skin. In case of oral intake, protein allergens can provoke oral allergy syndrome or allergic reactions of esophageal mucosa, yet after arriving in the stomach they undergo hydrolytic digestion and loose antigenicity. The popular notion "food allergy causes eczema" was challenged by last decade's research suggesting that allergy to food proteins develops secondarily to eczema, and in the later course manifests as anaphylaxis or urticaria, not eczema. On the other hand, somewhat unnoticed remains the wide array of haptens present in food - be it natural components, food additives (dyes, aromas, preservatives, emulsifiers, etc.) or contaminations (e.g. pesticides, veterinary drugs). Haptens can be absorbed already through oral mucosa, they don't undergo digestion and are capable of provoking delayed-type hypersensitivity reactions strongly resembling atopic eczema. Induction of such reactions can be facilitated by cosmetics that frequently contain the same haptens as food. PMID:24720126

Spiewak, Rados?aw

2013-01-01

68

Climatic factors are associated with childhood eczema prevalence in US  

PubMed Central

Atopic dermatitis (AD, atopic eczema) is driven by a complex relationship between genetic predisposition and environmental exposures. We sought to determine the impact of specific climatic factors on the US prevalence of AD. We used a merged analysis of the 2007 National Survey of Children's Health from a representative sample of 91,642 children age 0–17 years and the 2006–2007 National Climate Data Center and Weather Service measurements of relative humidity (%), indoor heating degree days (HDD), clear sky UV indices ozone levels, and outdoor air temperature. As a proxy for AD, we used an affirmative response to the NSCH survey question asking whether the participant’s child has been given a doctor diagnosis of “eczema or any other kind of skin allergy” in the previous 12 months. In multivariate models controlling for sex, race/ethnicity, age and household income, eczema prevalence was significantly lower with highest-quartile mean annual relative humidity (logistic regression, adjusted odds ratio [95% confidence interval]=0.82 [0.71–0.96], P=0.01) and issued UV index (0.73 [0.64–0.84], P<0.0001), and with two other factors associated with increased UV exposure. Eczema prevalence was decreased with highest-quartile air temperature (0.80 [0.70–0.92], P=0.002), but increased with 3rd–quartile mean annual HDD (1.26 [1.11–1.43], P=0.0003). This study provides evidence of climate influences on the US prevalence of childhood eczema. PMID:23334343

Silverberg, Jonathan I.; Hanifin, Jon; Simpson, Eric L.

2013-01-01

69

MRSA and the environment: implications for comprehensive control measures  

Microsoft Academic Search

Environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) is established soon after colonized or infected patients become resident. There are many studies that detail the mechanisms\\u000a of spread and environmental survival of methicillin-susceptible Staphylococcus aureus (MSSA); this knowledge translates directly into the same findings for MRSA. The potential ubiquity of MRSA in a health-care\\u000a setting poses challenges for decontamination. Whereas patients

N. Cimolai

2008-01-01

70

Comparison of the Velogene Rapid MRSA Identification Assay, Denka MRSA-Screen Assay, and BBL Crystal MRSA ID System for rapid identification of methicillin-resistant Staphylococcus aureus.  

PubMed

Early detection of methicillin-resistant S.aureus (MRSA) is critical for both the management of infected patients, and the timely institution of appropriate infection control measures. Although detection of the mecA gene by PCR remains the gold standard, this technology is inaccessible for many laboratories. Therefore, we sought to evaluate several new rapid identification systems and compare them to PCR. A total of 71 methicillin-susceptible S. aureus (MSSA), 25 borderline oxacillin-resistant S. aureus (BORSA), and 213 MRSA were selected for study. S.aureus was identified using standard methods. Initial screening was performed on a Mueller-Hinton agar plate with 6 mg/L of oxacillin. MRSA strains were identified using PCR with primers specific for the mecA gene. PCR was used as the reference method. All isolates were tested using the BBL Crystal MRSA ID System (Becton Dickinson Microbiology Systems, Maryland, USA), the MRSA-Screen Assay (Denka Seiken Co., Ltd., Tokyo, Japan), and the Velogene Rapid MRSA Identification Assay (ID Biomedical Corp, Vancouver, BC). With minor modifications, all assays were performed according to manufacturers' instructions. Overall, the 3 commercial assays performed well. The sensitivity and specificity of the BBL, Denka, and Velogene systems were 99%/100%, 99%/100%, and 96%/100% respectively. The advantages of the phenotypic tests-BBL Crystal Kit and Denka MRSA-Screen Assay include lower cost per test, shelf-life, ease of use, and rapid turn-around times. Advantages of the Velogene Rapid MRSA include ability to perform genotypic high-volume testing without the equipment requirements and technical complexity involved with PCR. Turn-around times ranged from 15 min for the Denka MRSA-Screen Assay, 2 h for the Velogene Rapid MRSA, and 4 h for the BBL Crystal. The BBL Crystal, Denka MRSA-Screen, and Velogene Rapid MRSA identification systems are rapid, easy to perform, and provide accurate identification of MRSA. These rapid kits offer an acceptable alternative for smaller, non-reference, laboratories and reduce the dependency on PCR in larger laboratories for routine confirmation. PMID:11448557

Arbique, J; Forward, K; Haldane, D; Davidson, R

2001-01-01

71

Prevalence, incidence and predictive factors for hand eczema in young adults – a follow-up study  

PubMed Central

Background Hand eczema is common in the general population and affects women twice as often as men. It is also the most frequent occupational skin disease. The economic consequences are considerable for society and for the affected individuals. Methods To investigate the prevalence and incidence of hand eczema and to evaluate risk factors for development of hand eczema in young adults. Subjects and methods; This is a prospective follow-up study of 2,403 young adults, 16 – 19 years old in 1995 and aged 29 – 32 years, 13 years later, in 2008. They completed a postal questionnaire that included questions regarding one-year prevalence of hand eczema, childhood eczema, asthma, rhino-conjunctivitis and factors considered to affect hand eczema such as hand-washing, washing and cleaning, cooking, taking care of small children and usage of moisturisers. These factors were evaluated with the multinominal logistic regression analysis. Results The one-year prevalence of hand eczema was 15.8% (females 20.3% and males 10.0%, p?eczema was the most important risk factor for hand eczema. The odds ratios were 13.17 when having hand eczema 1995 and 2008 compared to 5.17 in 2008 (p?eczema only when having 1-year prevalence 2008, OR 1.02 (p?=?0.038). Conclusions After 13 years an increased 1-year prevalence of hand eczema was found. The significant risk factors for hand eczema changed over time from endogenous to exogenous factors. PMID:24164871

2013-01-01

72

Mortality rates in hospital patients with hyperglycaemia and MRSA bacteraemia  

Microsoft Academic Search

M ethicillin Resistant Staphylococcus Aureus (MRSA) infections in the hospital population have shown a dramatic increase. This pilot study determined whether random\\/fasting blood glucose measurements were performed on patients admitted to hospital with MRSA bacteraemia. We also examined mortality in relationship to hyperglycaemia, defined as random glucose > 11 mmol\\/L. Retrospective data for all in-patients aged > 16 years for

GEORGE I VARUGHESE; KOSTOS MILTSIOS; HARIT N BUCH; JEORGE M ORENDI; JOHN HB SCARPELLO

2010-01-01

73

Mortality rates in hospital patients with hyperglycaemia and MRSA bacteraemia  

Microsoft Academic Search

Methicillin Resistant Staphylococcus Aureus (MRSA) infections in the hospital population have shown a dramatic increase. This pilot study determined whether random\\/fasting blood glucose measurements were performed on patients admitted to hospital with MRSA bacteraemia. We also examined mortality in relationship to hyperglycaemia, defined as random glucose ? 11 mmol\\/L. Retrospective data for all in-patients aged ? 16 years for the

George I Varughese; Kostos Miltsios; Harit N Buch; Jeorge M Orendi; John Hb Scarpello

2006-01-01

74

Diabetic MRSA foot infection — role of linezolid therapy  

Microsoft Academic Search

Diabetic foot ulceration is common and disabling, often leading to amputation of the leg. Foot ulcers commonly become infected and MRSA infection is becoming more prevalent. MRSA is becoming a major public health problem because of its associated high morbidity and mortality, due to difficulty in its eradication with conventional antibiotics. Although vancomycin is the present mainstay of treatment of

Joanna M Turner; Lukman M Hakeem; K Ann Lockman; Diptendu N Bhattacharyya; Ian W Campbell

2004-01-01

75

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...

76

Clobetasol propionate versus fluocinonide creams in psoriasis and eczema.  

PubMed

A double-blind, parallel comparison was made of the short-term efficacy and safety of three times daily regimens of 0.05% clobetasol propionate cream and 0.05% fluocinonide cream in 114 adolescent and adult patients with psoriasis and 113 with eczema. After 2 weeks of topical applications, patients were assessed according to (1) investigators' overall judgment of clinical response, (2) degree of severity of specific signs and symptoms, and (3) patients' evaluation of improvement. In all three response categories in psoriasis, and in two of three in eczema, clobetasol was statistically significantly superior to fluocinonide (p less than 0.05-p less than 0.001). Healing commenced more rapidly with clobetasol and there was no indication of tachyphylaxis. In contrast, the healing rate with fluocinonide slowed noticeably after the first week, and there was a greater tendency to relapse following fluocinonide treatment. Both regimens were safe: drug-related side effects were generally mild and occurred most commonly with fluocinonide therapy in eczema patients. Overall, drug-related effects occurred in 4% of patients receiving clobetasol and 12% receiving fluocinonide (p less than 0.05). Transient morning plasma cortisol reductions below 5 micrograms/dl occurred in 6% of clobetasol-treated patients, reverting to normal within 1 week of the end of treatment. PMID:3902682

Jegasothy, B; Jacobson, C; Levine, N; Millikan, L; Olsen, E; Pinnell, S; Cole, G; Weinstein, G; Porter, M

1985-09-01

77

DOES THE NOSE KNOW? AN UPDATE ON MRSA DECOLONIZATION STRATEGIES  

PubMed Central

Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is an important step in the pathogenesis of active infection and is a key factor in the epidemiology of MRSA infection. Decolonization of patients found to have MRSA carriage may be of value in certain patient populations, especially those undergoing elective surgery. However, the most commonly used agent for decolonization, mupirocin, comes with a considerable risk of resistance if widely employed. Recent studies of other novel agents for decolonization show promise but further research is necessary. This review focuses on the pathogenesis from MRSA colonization to infection, identifies the risk factors for colonization, and summarizes decolonization strategies, including novel approaches that may ave a role in decreasing MRSA disease burden. PMID:24150839

Abad, C.L.; Pulia, M. S.; Safdar, N.

2014-01-01

78

Does the nose know? An update on MRSA decolonization strategies.  

PubMed

Colonization with methicillin-resistant Staphylococcus aureus (MRSA) is an important step in the pathogenesis of active infection and is a key factor in the epidemiology of MRSA infection. Decolonization of patients found to have MRSA carriage may be of value in certain patient populations, especially those undergoing elective surgery. However, the most commonly used agent for decolonization, mupirocin, comes with a considerable risk of resistance if widely employed. Recent studies of other novel agents for decolonization show promise, but further research is necessary. This review focuses on the pathogenesis from MRSA colonization to infection, identifies the risk factors for colonization, and summarizes decolonization strategies, including novel approaches that may have a role in decreasing MRSA disease burden. PMID:24150839

Abad, C L; Pulia, M S; Safdar, N

2013-12-01

79

Traffic-related air pollution, climate, and prevalence of eczema in Taiwanese school children.  

PubMed

The prevalence of childhood eczema is increasing in many countries. Epidemiological studies, however, say little of its association to outdoor air pollution and climate factors. We conducted a nationwide survey of middle-school students in Taiwan from 1995 to 1996. The 12-month prevalence of eczema was compared with air monitoring station data of temperature, relative humidity, and criteria air pollutants. A total of 317,926 children attended schools located within 2 km of 55 stations. Prevalence rates of recurrent eczema were 2.4 and 2.3% in boys and girls, respectively, with prevalence rates of flexural eczema 1.7% in both sexes. After adjustment for possible confounders, flexural eczema was found to be associated with traffic-related air pollutants, including nitrogen oxides and carbon monoxide. Recurrent eczema was associated with traffic-related air pollution only in girls. There were no associations for the highest monthly means of temperature, whereas the annual means and the lowest monthly means of temperature were negatively related to flexural eczema, but only in girls. The lowest monthly mean relative humidity was positively related to eczema. The results suggest that air pollution and climatic factors, which showed stronger associations in girls than boys, may affect the prevalence of childhood eczema. PMID:18449213

Lee, Yung-Ling; Su, Huey-Jen; Sheu, Hamm-Ming; Yu, Hsin-Su; Guo, Yueliang L

2008-10-01

80

Developmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies  

PubMed Central

Background The term “atopic march” has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhinitis during childhood. We propose that this paradigm arose from cross-sectional analyses of longitudinal studies, and may reflect a population pattern that may not predominate at the individual level. Methods and Findings Data from 9,801 children in two population-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether the manifestations of these symptoms followed an atopic march pattern. Children were assessed at ages 1, 3, 5, 8, and 11 y. We used Bayesian machine learning methods to identify distinct latent classes based on individual profiles of eczema, wheeze, and rhinitis. This approach allowed us to identify groups of children with similar patterns of eczema, wheeze, and rhinitis over time. Using a latent disease profile model, the data were best described by eight latent classes: no disease (51.3%), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%). When latent variable modelling was carried out separately for the two cohorts, similar results were obtained. Highly concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheeze. The main limitation of this study was the difference in wording of the questions used to ascertain the presence of eczema, wheeze, and rhinitis in the two cohorts. Conclusions The developmental profiles of eczema, wheeze, and rhinitis are heterogeneous; only a small proportion of children (?7% of those with symptoms) follow trajectory profiles resembling the atopic march. Please see later in the article for the Editors' Summary PMID:25335105

2014-01-01

81

What's new in atopic eczema? An analysis of systematic reviews published in 2009-2010.  

PubMed

This review provides a summary of key findings from 18 systematic reviews on atopic eczema, published or indexed between January 2009 and 24 August 2010. There was no good evidence on the possible benefit of organic food consumption and eczema. Maternal intake of fish or fish oil may be associated with a reduced risk of eczema in offspring, although further studies are needed. There is some evidence that partially hydrolysed infant formulas rather than standard formulas may be associated with a reduced risk of eczema in infants, but there are shortcomings in the existing evidence. An inverse relationship has been found between gliomas/acute lymphoblastic leukaemia and allergic disease/eczema, but there appears to be no association between multiple sclerosis and eczema. Attention deficit hyperactivity disorder does appear to be associated with eczema, but there is no evidence of a causal link. The risk of eczema seems to be increased in urban compared with rural areas. Some new evidence has suggested superiority of 1% pimecrolimus over potent and mild corticosteroids at 6?months but not 12?months, and there is some evidence for superiority of 0.03% and 0.1% tacrolimus over 1% pimecrolimus. An updated Cochrane Review still found no evidence of a benefit from any form of antistaphylococcal treatment in managing clinically infected or uninfected eczema. The evidence base is poor for bath emollients, occlusive treatments (e.g., wet and dry wraps) and woven silk clothing in treating eczema. In general, the methods used in most systematic reviews of eczema need to be reported more clearly, especially with regard to a more vigorous quality assessment of included studies. Included studies are frequently heterogeneous, proxy reporting is common, and appropriate disease definitions are often lacking. Better adherence to existing guidance on trial reporting and prospective registration of clinical trials may help improve the quality of studies. PMID:21718344

Shams, K; Grindlay, D J C; Williams, H C

2011-08-01

82

Outcome of MRSA carriers in neurological early rehabilitation  

PubMed Central

Background Colonization with MRSA is believed to have deteriorating effects on neurological rehabilitation patients because MRSA carriers need to be isolated. Methods Medical records of neurological early rehabilitation patients (most of them after stroke) admitted to a large rehabilitation facility in Northern Germany in 2010 have been carefully reviewed with respect to MRSA status, outcome variables (functional independence), morbidity, and length of stay (LOS). Results 74/569 (13.0%) patients were MRSA positive on admission. MRSA carriers had a significantly longer LOS in early neurological rehabilitation (63.7 (37.1) vs. 25.8 (24.5) days, p?MRSA positive patients (BI 25.5 (21.2) vs. 47.4 (31.0), p?MRSA positive group due to longer LOS. Conclusions Functional recovery of MRSA carriers in early neurological rehabilitation is worse than in MRSA negative patients. Poorer outcome is not resulting from isolation (less therapy) but from functional status and higher morbidity on admission. PMID:24555811

2014-01-01

83

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

PubMed

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

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

84

Risk Factors for Persistent MRSA Colonization in Children with Multiple Intensive Care Unit Admissions  

PubMed Central

We studied MRSA colonized children with multiple ICU admissions to assess the persistence of MRSA colonization. Our data found that children with more than one year between ICU admissions had a higher MRSA colonization prevalence than the overall ICU population, supporting empiric contact precautions for children with prior MRSA colonization. PMID:23739081

Popoola, Victor O.; Tamma, Pranita; Reich, Nicholas G.; Perl, Trish M.; Milstone, Aaron

2013-01-01

85

Homoeopathic versus Conventional Therapy for Atopic Eczema in Children: Medical and Economic Results  

Microsoft Academic Search

Background: One of five children visiting a homoeopathic physician is suffering from atopic eczema. Objective: To examine the effectiveness, safety and costs of homoeopathic versus conventional treatment in usual care. Methods: In a prospective multicentre comparative observational non-randomised study, 135 children (homoeopathy n = 48 vs. conventional n = 87) with mild to moderate atopic eczema were included. The primary

Claudia M. Witt; Benno Brinkhaus; Daniel Pach; Thomas Reinhold; Katja Wruck; Stephanie Roll; Tanja Jäckel; Doris Staab; Karl Wegscheider; Stefan N. Willich

2009-01-01

86

Therapeutic management of anal eczema: an evidence-based review  

PubMed Central

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

Havlickova, B; Weyandt, G H

2014-01-01

87

Clinical inquiries. Do nonmedicated topicals relieve childhood eczema?  

PubMed

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

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

2009-05-01

88

Anaphylactic shock during elimination diets for severe atopic eczema.  

PubMed Central

Eighty patients with atopic eczema were treated with various elimination diets. Some or all foods were withdrawn then later reintroduced singly to the diet. In four patients reintroduction of a single food (soya, chicken, corn, cows' milk) caused anaphylactic shock. In two patients spontaneous recovery occurred but in two resuscitation and intensive care were required. Anaphylaxis is a definite hazard of these elimination diets. Other than warning the parents, practical precautions are difficult because of the unpredictability of violent reactions and uncertainty about the life saving efficacy of injected adrenaline. PMID:6541895

David, T J

1984-01-01

89

Are healthcare economics a factor behind European MRSA rates?  

PubMed

This study assessed the relationship between meticillin-resistant Staphylococcus aureus (MRSA) prevalence in 26 European countries with two key socioeconomic parameters, namely, gross domestic product per capita (GDP) and infant mortality rate (IMR). Whilst no significant relationship was identified between MRSA and GDP (Spearman correlation: -0.387; 95% confidence interval [CI]: -0.674 to 0.000; p = 0.0528), a significant correlation was evident between MRSA and IMR (Spearman correlation: 0.545; 95% CI: 0.208 to 0.766; p = 0.005). The elimination of a widely outlying data point retained significance. Various studies have shown IMR to be a good marker of healthcare expenditure and it is, therefore, reasonable to postulate that one possible factor in the multi-factorial epidemiology of MRSA in Europe is the level and effectiveness of healthcare expenditure within the individual countries. PMID:20119865

Borg, M A

2010-04-01

90

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

PubMed Central

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

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

2009-01-01

91

Home environment and suspected atopic eczema in Japanese infants: the Osaka Maternal and Child Health Study.  

PubMed

Atopic eczema is most commonly diagnosed in children under the age of 5 yr. Environmental factors during pregnancy or in early life may confer risk for childhood atopic eczema. The present prospective study examined the relationship of the perinatal home environment and the risk of suspected atopic eczema among Japanese infants under the age of 1. Study subjects were 865 parent-child pairs. The term 'suspected atopic eczema' was used to define an outcome based on our questionnaire at 2-9 months postpartum. Adjustment was made for maternal age, gestation, family income, maternal and paternal education, maternal and paternal history of asthma, atopic eczema, and allergic rhinitis, time of delivery before the second survey, baby's older siblings, baby's sex, and baby's birth weight. A high mite allergen level from maternal bedclothes and mold in the kitchen during pregnancy were significantly associated with an increased risk of suspected atopic eczema. Frequent vacuuming practices during pregnancy and giving the infant a bath or shower at least once a day were significantly inversely related to the risk of suspected atopic eczema. Maternal smoking, maternal use of a synthetic duvet and pillow, carpet use in the living room and maternal bedroom, indoor domestic pets, no ducted heating appliance, and gas use for cooking during pregnancy and household smoking in the same room as the infant, infant's synthetic duvet, carpet use in the infant's room, or vacuuming the infant's room were not related to the risk of suspected atopic eczema. High house dust mite allergen levels and mold in the kitchen during pregnancy may increase the risk of infantile atopic eczema, whereas frequent vacuuming practices during pregnancy and giving the infant a bath or shower at least once a day may protect against infantile atopic eczema. PMID:17617810

Miyake, Yoshihiro; Ohya, Yukihiro; Tanaka, Keiko; Yokoyama, Tetsuji; Sasaki, Satoshi; Fukushima, Wakaba; Ohfuji, Satoko; Saito, Kyoko; Kiyohara, Chikako; Hirota, Yoshio

2007-08-01

92

MRSA and diabetic foot wounds: Contaminating or infecting organisms?  

Microsoft Academic Search

Although infection is a well-recognized barrier to healing, evidence has emerged that wound colonization with methicillin-resistant\\u000a Staphylococcus aureus (MRSA) has the same effect, which has been quantified as increasing the time to healing twofold. MRSA is a concern for those\\u000a with diabetic foot ulcers based on evidence of impaired healing when it is present in the wound. However, many studies

Frank L. Bowling; Edward B. Jude; Andrew J. M. Boulton

2009-01-01

93

Blue Light Phototherapy Kills Methycillin Resistant Staphylococcus Aureus (MRSA)  

NASA Astrophysics Data System (ADS)

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.

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

2010-05-01

94

[MRSA--current aspects of resistance, pathology, epidemiology and therapy].  

PubMed

The Methicillin-resistant Staphylococcus aureus (MRSA) is a Staphylococcus aureus (S. aureus) resistant against all kinds of beta-lactam antibiotics. Moreover, resistances against other antibiotics have gradually started to develop. In the last decades, MRSA started as a serious problem only in hospitals, but in recent years it also rose as an alarming community pathogen. In addition to the resistances against Penicillin which emerged in the 1940s. with the use of beta-lactamase proof antibiotics in the 1960s, the resistance of S. aureus against Methicillin started to develop. According to the kind of resistance, the genotype, the time of infection and the origin of the infection, MRSA infections are classified as hospital-associated (HA-MRSA) and community-associated (cMRSA). On the one hand, this differentiation results in distinct strategies of calculated therapy against each class of MRSA. On the other hand, it is important in order to identify relevant judicious aspects of transmission. PMID:21192484

Addicks, J Ph; Götting, M; Jensen, A M; Quarcoo, D; Wicker, S; Uibel, S; Groneberg, D A

2010-12-01

95

Quantitative assessment of human MRSA risks from swine.  

PubMed

The public health community, news media, and members of the general public have expressed significant concern that methicillin-resistant Staphylococcus aureus (MRSA) transmitted from pigs to humans may harm human health. Studies of the prevalence and dynamics of swine-associated (ST398) MRSA have sampled MRSA at discrete points in the presumed causative chain leading from swine to human patients, including sampling bacteria from live pigs, retail meats, farm workers, and hospital patients. Nonzero prevalence is generally interpreted as indicating a potential human health hazard from MRSA infections, but quantitative assessments of resulting risks are not usually provided. This article integrates available data from several sources to construct a conservative (plausible upper bound) probability estimate for the actual human health harm (MRSA infections and fatalities) arising from ST398-MRSA from pigs. The model provides plausible upper bounds of approximately one excess human infection per year among all U.S. pig farm workers, and one human infection per 31 years among the remaining total population of the United States. These results assume the possibility of transmission events not yet observed, so additional data collection may reduce these estimates further. PMID:25100207

Cox, Louis Anthony Tony; Popken, Douglas A

2014-09-01

96

In vitro anti-MRSA activity of carvone with gentamicin.  

PubMed

Carvone is one of the naturally occurring monoterpenes, the largest class of secondary metabolites in plants, and exists in two enantiomers, R-carvone (R-car) and S-car. The objective of this study was to investigate the antimicrobial activity of R-car and S-car with gentamicin (GET) against methicillin-resistant Staphylococcus aureus (MRSA). MRSA is a major human pathogen that causes serious problems, including hospital-acquired pneumonia, abscesses and surgical wound infections. Nosocomial MRSA infections often exhibit multidrug resistance. In the present study, antimicrobial susceptibility testing was performed with R-car, S-car and GET using the broth microdilution method. Minimal inhibitory concentration values for R- and S-car against six different strains of S. aureus ranged between 500 and 1,000 ?g/ml. Anti-MRSA activity was evaluated using the checkerboard and time-kill assays to investigate the potential synergistic effects of different combinations of the carvone enantiomers and GET. R-car plus S-car, R-car plus GET and S-car plus GET exhibited significant synergistic activity against MRSA. These findings suggest that the single-agent anti-MRSA activities of R-car, S-car and GET are effectively increased through combination therapy. This study showed that carvone may be a potential adjuvant antimicrobial agent. PMID:24669246

Mun, Su-Hyun; Kang, Ok-Hwa; Joung, Dae-Ki; Kim, Sung-Bae; Choi, Jang-Gi; Shin, Dong-Won; Kwon, Dong-Yeul

2014-04-01

97

In vitro anti-MRSA activity of carvone with gentamicin  

PubMed Central

Carvone is one of the naturally occurring monoterpenes, the largest class of secondary metabolites in plants, and exists in two enantiomers, R-carvone (R-car) and S-car. The objective of this study was to investigate the antimicrobial activity of R-car and S-car with gentamicin (GET) against methicillin-resistant Staphylococcus aureus (MRSA). MRSA is a major human pathogen that causes serious problems, including hospital-acquired pneumonia, abscesses and surgical wound infections. Nosocomial MRSA infections often exhibit multidrug resistance. In the present study, antimicrobial susceptibility testing was performed with R-car, S-car and GET using the broth microdilution method. Minimal inhibitory concentration values for R- and S-car against six different strains of S. aureus ranged between 500 and 1,000 ?g/ml. Anti-MRSA activity was evaluated using the checkerboard and time-kill assays to investigate the potential synergistic effects of different combinations of the carvone enantiomers and GET. R-car plus S-car, R-car plus GET and S-car plus GET exhibited significant synergistic activity against MRSA. These findings suggest that the single-agent anti-MRSA activities of R-car, S-car and GET are effectively increased through combination therapy. This study showed that carvone may be a potential adjuvant antimicrobial agent. PMID:24669246

MUN, SU-HYUN; KANG, OK-HWA; JOUNG, DAE-KI; KIM, SUNG-BAE; CHOI, JANG-GI; SHIN, DONG-WON; KWON, DONG-YEUL

2014-01-01

98

Guidelines for treatment of atopic eczema (atopic dermatitis) Part II.  

PubMed

The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune-suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies. PMID:22813359

Ring, J; Alomar, A; Bieber, T; Deleuran, M; Fink-Wagner, A; Gelmetti, C; Gieler, U; Lipozencic, J; Luger, T; Oranje, A P; Schäfer, T; Schwennesen, T; Seidenari, S; Simon, D; Ständer, S; Stingl, G; Szalai, S; Szepietowski, J C; Taïeb, A; Werfel, T; Wollenberg, A; Darsow, U

2012-09-01

99

Guidelines for treatment of atopic eczema (atopic dermatitis) part I.  

PubMed

The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune-suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies. PMID:22805051

Ring, J; Alomar, A; Bieber, T; Deleuran, M; Fink-Wagner, A; Gelmetti, C; Gieler, U; Lipozencic, J; Luger, T; Oranje, A P; Schäfer, T; Schwennesen, T; Seidenari, S; Simon, D; Ständer, S; Stingl, G; Szalai, S; Szepietowski, J C; Taïeb, A; Werfel, T; Wollenberg, A; Darsow, U

2012-08-01

100

Evaluation of the LightCycler methicillin-resistant Staphylococcus aureus (MRSA) advanced test for detection of MRSA nasal colonization.  

PubMed

Rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization is crucial for the prevention and control of MRSA infections in health care settings. The LightCycler MRSA Advanced Test (Roche Diagnostics) is a commercially available real-time PCR assay for direct detection of MRSA nasal colonization by targeting of the staphylococcal cassette chromosome mec (SCCmec)-orfX junction. The diagnostic performance of the assay was compared with that of ChromID MRSA agar (bioMérieux) culture and an in-house duplex real-time PCR assay. Among 1,246 nasal swab specimens collected from 2 general hospitals in Hong Kong, 174 (14%) were considered true positive for MRSA. Chromogenic culture and the in-house real-time PCR assay identified 147 (84.5%) and 133 (76.4%) true-positive cases with specificities of 100% and 98.6%, respectively. Based on the target melting temperature (Tm) values (57.0 to 62.0 °C) defined by the manufacturer, the LightCycler MRSA Advanced Test identified only 85 (48.9%) true-positive specimens. Interestingly, an additional 60 (34.5%) true-positive specimens were detected despite atypical Tm values of 55 °C, providing overall sensitivity and specificity values of 83.3% and 99%, respectively. Among isolates with Tm values of 55 °C, most were typed as clonal complex 45 (CC45). By sequence analysis of the SCCmec-orfX junction, characteristic single-nucleotide polymorphisms (SNPs) were identified only in isolates with Tm values of 55°C and not in those with typical Tm values. It is conceivable that those SNPs were located inside the target region of the proprietary hybridization probes, which resulted in a Tm shift in the melting curve analysis. Our study highlights the importance of a global evaluation of commercial kits so that the interpretation algorithm covers different lineages of MRSA clones prevalent in various geographical regions. PMID:23784133

Yam, W C; Siu, Gilman K H; Ho, P L; Ng, T K; Que, T L; Yip, K T; Fok, Cathie P K; Chen, Jonathan H K; Cheng, Vincent C C; Yuen, K Y

2013-09-01

101

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

PubMed

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

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

2014-07-01

102

Association between non-atopic hand eczema and interleukin-13 gene polymorphism in Taiwanese nursing population.  

PubMed

Chronic hand eczema is an important occupational skin disease with atopic dermatitis (AD) and wet work being the most important risk factors. This study was launched to analyse the potential association between AD-related inflammation genes and development of non-atopic hand eczema among nurses in University Hospital. Atopic eczema, non-atopic hand dermatitis and control groups were identified. The association between occurrence of non-atopic hand eczema and interleukin (IL)-13, IL-4 and IL-5 gene variants was analysed. IL13 rs20541 A allele [assuming recessive model; odds ratio (OR) = 3.38, 95% CI: (1.63-7.00)] showed association with development of non-atopic hand eczema. Additive score analyses showed combination of this gene variant with previously identified risk factors including certain SPINK5 polymorphism and more than 10 years of work experience conferred highest risk for development of non-atopic hand eczema. As non-atopic hand eczema made up significant portion of occupational skin diseases, further studies should be focused on this commonly encountered skin condition. PMID:23171465

Chen, Yin-Chun; Tu, Hung-Pin; Wu, Ching-Shuang; Ko, Ying-Chin; Yu, Hsin-Su; Lu, Yi-Wei; Li, Wan-Chen; Chen, Gwo-Shing; Lan, Cheng-Che E

2012-12-01

103

The Quality of Life and Depressive Mood among Korean Patients with Hand Eczema  

PubMed Central

Background Hand eczema is a disease frequently observed in dermatological practice. This condition has negative emotional, social, and psychological effects due to its impact on daily life and morphological appearance. Due to its considerable effect on the quality of life, this disease can lead to depression. However, not many studies have been performed on the quality of life and depression in hand eczema patients. Objective The purpose of this study is to investigate the association between the quality of life, depression, and disease severity in hand eczema patients in South Korea. Methods A total of 138 patients with hand eczema participated in this study. The patients' quality of life was assessed by a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Data on patients suffering from depression was obtained using the Beck's Depression Inventory (BDI-II). The disease severity was determined during the clinical examination, according to the Hand Eczema Severity Index (HECSI). Results We found positive associations between DLQI and HECSI scores (p<0.05). BDI-II scores had also statistically positive correlations with HECSI scores (p<0.05). DLQI and BDI-II scores both increased with disease severity. Conclusion Hand eczema negatively affected the quality of life and mood of patients relative to the disease severity. Therefore, we suggest that quality of life modification and emotional support should be included as a part of treatment for hand eczema. PMID:23197909

Yu, Mi; Lee, June Hyunkyung; Son, Sook-Ja

2012-01-01

104

Asymptomatic nasal carriage of mupirocin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) in a pet dog associated with MRSA infection in household contacts.  

PubMed

Recurrent methicillin-resistant Staphylococcus aureus (MRSA) infection in a patient with diabetes and in his wife is described. Culture of nares samples from the family dog grew mupirocin-resistant (minimum inhibitory concentration >1024 microg/mL) MRSA that had a pulsed-field gel electrophoresis chromosomal pattern identical to the MRSA isolated from the patient's nares and his wife's wound. Further recurrence of MRSA infection and nasal colonization in the couple was prevented only after successful eradication of MRSA from the family dog's nares. PMID:12522764

Manian, Farrin A

2003-01-15

105

The MRSA-import in ICUs is an important predictor for the occurrence of nosocomial MRSA cases.  

PubMed

Nosocomial infections with methicillin-resistant Staphylococcus aureus (MRSA) account for increased morbidity, mortality and healthcare costs in critically ill patients worldwide. The intensive care unit (ICU) component of the German surveillance system for nosocomial infections (Krankenhaus-Infektions-Surveillance-System, KISS) has been supplemented with a module targeting the surveillance of multiresistant pathogens [Multiresistente Erreger (MRE)-KISS] in order to account for the increasing burden of antibiotic-resistant bacteria. The aim of this study was to assess the association between structural and organizational characteristics of ICUs and the number of nosocomial MRSA cases. Data were derived from routine data collected in the frame of the national surveillance system of nosocomial infections (ICU- and MRE-KISS) from January 2007 to December 2008 and from a questionnaire inquiring about structure and process parameters. One hundred and forty ICUs performing active screening have been included. Process parameters such as isolation of MRSA patients, decolonization procedures and introduction of MRSA alert systems have been implemented by the majority of the ICUs, whereas the application mode of screening procedures and pre-emptive isolation measures is heterogeneous. Multivariable analysis using negative binominal regression models shows that a stay on a medical ICU has a protective effect (incidence rate ratio, 0.42; 95% confidence interval, 0.24-0.74; p = 0.003), whereas the imported MRSA incidence is significantly associated with the number of nosocomial MRSA cases (incidence rate ratio, 1.74; 95% confidence interval, 1.23-2.45; p = 0.002). Structure and process parameters do not show any effect. ICU type and imported MRSA incidence should be considered for benchmarking between hospitals. PMID:20977541

Schweickert, B; Geffers, C; Farragher, T; Gastmeier, P; Behnke, M; Eckmanns, T; Schwab, F

2011-06-01

106

Dyshidrotic eczema associated with the use of IVIg  

PubMed Central

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

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

2013-01-01

107

MRSA Transmission on a Neonatal Intensive Care Unit: Epidemiological and Genome-Based Phylogenetic Analyses  

PubMed Central

Background Methicillin-resistant Staphylococcus aureus (MRSA) may cause prolonged outbreaks of infections in neonatal intensive care units (NICUs). While the specific factors favouring MRSA spread on neonatal wards are not well understood, colonized infants, their relatives, or health-care workers may all be sources for MRSA transmission. Whole-genome sequencing may provide a new tool for elucidating transmission pathways of MRSA at a local scale. Methods and Findings We applied whole-genome sequencing to trace MRSA spread in a NICU and performed a case-control study to identify risk factors for MRSA transmission. MRSA genomes had accumulated sequence variation sufficiently fast to reflect epidemiological linkage among individual patients, between infants and their mothers, and between infants and staff members, such that the relevance of individual nurses’ nasal MRSA colonization for prolonged transmission could be evaluated. In addition to confirming previously reported risk factors, we identified an increased risk of transmission from infants with as yet unknown MRSA colonisation, in contrast to known MRSA-positive infants. Conclusions The integration of epidemiological (temporal, spatial) and genomic data enabled the phylogenetic testing of several hypotheses on specific MRSA transmission routes within a neonatal intensive-care unit. The pronounced risk of transmission emanating from undetected MRSA carriers suggested that increasing the frequency or speed of microbiological diagnostics could help to reduce transmission of MRSA. PMID:23382995

Falkenhorst, Gerhard; Benzler, Justus; Hecht, Jochen; Kube, Michael; Bröcker, Felix; Moelling, Karin; Bührer, Christoph; Gastmeier, Petra; Piening, Brar; Behnke, Michael; Dehnert, Manuel; Layer, Franziska; Witte, Wolfgang; Eckmanns, Tim

2013-01-01

108

Contamination of Public Buses with MRSA in Lisbon, Portugal: A Possible Transmission Route of Major MRSA Clones within the Community  

PubMed Central

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

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

2013-01-01

109

Aerosol steroids for the treatment of peristomal mucocutaneous breakdown due to severe eczema  

PubMed Central

INTRODUCTION We describe a novel treatment of mucocutaneous peristomal junction breakdown in a patient with severe eczema using aerosol steroids, where conventional methods failed to achieve healing. PRESENTATION OF CASE Observation and photographic evidence showing resolution of severe peristomal eczema in a patient, in whom systemic steroids were contraindicated, using a topical aerosol steroid. We found complete resolution of peristomal eczema and symptoms within four weeks. DISCUSSION Topical aerosol steroids are better tolerated than alcohol based steroid preparations, achieve improved stoma appliance adherence in comparison to oil based steroid preparations and reduce systemic side effects in comparison to systemic oral steroids. CONCLUSION Aerosol steroids appear to be a safe and effective way to treat refractory peristomal eczema and may be of use in other peristomal inflammatory conditions including contact dermatitis. PMID:25437668

Nicholson, J.; Sriskandarajah, S.; Moore, J.; Clouston, H.; Telford, K.

2014-01-01

110

NOS2 and CCL27: clinical implications for psoriasis and eczema diagnosis and management.  

PubMed

Chronic inflammatory skin diseases such as psoriasis and eczema are a major medical challenge. Development of highly specific therapies for both conditions is opposed by the lack of translation of basic knowledge into biomarkers for clinical use. Furthermore, to distinguish psoriasis from eczema might be difficult occasionally, but specific and costly therapies would not be efficient in misdiagnosed patients. In the era of high-throughput 'omics'-technologies, comparing the molecular signature of psoriasis and eczema is a promising approach to gain insight into their complex pathogeneses and develop new diagnostic and therapeutic strategies. Investigating patients affected by both psoriasis and eczema simultaneously, we recently constructed a disease classifier consisting of only two genes (NOS2 and CCL27) that reliably predicts the correct diagnosis even in clinically unclear cases. When such easy-to-handle approaches are combined with individual therapeutic response, we might reach the ultimate goal of personalized medicine in inflammatory skin diseases in near future. PMID:25539641

Garzorz, Natalie; Eyerich, Kilian

2015-02-01

111

Nasal Screening for MRSA: Different Swabs – Different Results!  

PubMed Central

Objectives Swab-based nasal screening is commonly used to identify asymptomatic carriage of Staphylococcus aureus in patients. Bacterial detection depends on the uptake and release capacities of the swabs and on the swabbing technique itself. This study investigates the performance of different swab-types in nasal MRSA-screening by utilizing a unique artificial nose model to provide realistic and standardized screening conditions. Methods An anatomically correct artificial nose model was inoculated with a numerically defined mixture of MRSA and Staphylococcus epidermidis bacteria at quantities of 4×102 and 8×102 colony forming units (CFU), respectively. Five swab-types were tested following a strict protocol. Bacterial recovery was measured for direct plating and after elution into Amies medium by standard viable count techniques. Results Mean recovered bacteria quantities varied between 209 and 0 CFU for MRSA, and 365 and 0 CFU for S. epidermidis, resulting swab-type-dependent MRSA-screening-sensitivities ranged between 0 and 100%. Swabs with nylon flocked tips or cellular foam tips performed significantly better compared to conventional rayon swabs referring to the recovered bacterial yield (p<0.001). Best results were obtained by using a flocked swab in combination with Amies preservation medium. Within the range of the utilized bacterial concentrations, recovery ratios for the particular swab-types were independent of the bacterial species. Conclusions This study combines a realistic model of a human nose with standardized laboratory conditions to analyze swab-performance in MRSA-screening situations. Therefore, influences by inter-individual anatomical differences as well as diverse colonization densities in patients could be excluded. Recovery rates vary significantly between different swab-types. The choice of the swab has a great impact on the laboratory result. In fact, the swab-type contributes significantly to true positive or false negative detection of nasal MRSA carriage. These findings should be considered when screening a patient. PMID:25353631

Warnke, Philipp; Frickmann, Hagen; Ottl, Peter; Podbielski, Andreas

2014-01-01

112

Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization  

PubMed Central

Background Atopic dermatitis (AD) is associated with multiple comorbid conditions, such as asthma and food allergy. We sought to determine the impact of eczema severity on the development of these disorders and other non-atopic comorbidities in AD. Methods We used the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children age 0-17 years. Prevalence and severity of eczema, asthma, hay fever and food allergy, sleep impairment, healthcare utilization, recurrent ear infections, visual and dental problems were determined. Results In general, more severe eczema correlated with poorer overall health, impaired sleep and increased healthcare utilization, including seeing a specialist, compared to children with mild or moderate disease (Rao-Scott Chi-square, P<0.0001). Severe eczema was associated with higher prevalence of comorbid chronic health disorders, including asthma, hay fever and food allergies (P<0.0001). In addition, the severity of eczema was directly related to the severity of the comorbidities. These associations remained significant in multivariate logistic regression models that included age, sex and race/ethnicity. Severe eczema was also associated with recent dental problems, including bleeding gums (P<0.0001), toothache (P=0.0004), but not broken teeth (P=0.04) or tooth decay (P=0.13). Conclusions These data indicate that severe eczema is associated with multiple comorbid chronic health disorders, impaired overall health and increased healthcare utilization. Further, these data suggest that children with eczema are at risk for decreased oral health. Future studies are warranted to verify this novel association. PMID:23773154

Silverberg, Jonathan I.; Simpson, Eric L.

2015-01-01

113

Comparative analysis of biofilm development among MRSA and MSSA strains.  

PubMed

As the recalcitrance of biofilm-mediated infections to the anti-infective treatment has an adverse effect on patient's health, the main objective of this study was to investigate the capacity of clinical isolates of Staphylococcus aureus with different resistance patterns to form biofilms. S. aureus strains are among the most representative etiology of infections in the health-care environment of Milad hospital in Iran. The results showed that out of 80 analyzed strains, 27 methicillin resistant S. aureus (MRSA) and 29 methicillin susceptible S. aureus (MSSA) were positive for biofilm development ability, without any significant correlation observed between MRSA and biofilm production. PMID:23755699

Ghafourian, Sobhan; Mohebi, Reza; Rezaei, Mitra; Raftari, Mohammad; Sekawi, Zamberi; Kazemian, Hosein; Mohseni, Aghdas; Karimi, Sajedeh; Sadeghifard, Nourkhoda

2012-01-01

114

Aphonia and epiglottitis in neonate with concomitant MRSA skin infection.  

PubMed

We report an unusual case of a neonate with aphonia due to epiglottitis with a concomitant methicillin-resistant S taphylococcus aureus (MRSA) infection of the genitalia and associated septic emboli to the groin area and mouth. We postulate that the MRSA infection caused a transient bacteremia that seeded the epiglottis, likely causing the epiglottitis. In the evaluation of a neonate with aphonia, while the two primary differentials to consider are vocal cord paralysis and laryngeal web, among other considerations is epiglottitis (supraglottitis). PMID:25473587

Noble, Jennifer; Devor, Renee; Rogalski, Francis J; Vergara, Wilfredo; Reddy, Ramalinga P; Bhumbra, Nasreen

2014-09-01

115

Aphonia and epiglottitis in neonate with concomitant MRSA skin infection  

PubMed Central

We report an unusual case of a neonate with aphonia due to epiglottitis with a concomitant methicillin-resistant Staphylococcus aureus (MRSA) infection of the genitalia and associated septic emboli to the groin area and mouth. We postulate that the MRSA infection caused a transient bacteremia that seeded the epiglottis, likely causing the epiglottitis. In the evaluation of a neonate with aphonia, while the two primary differentials to consider are vocal cord paralysis and laryngeal web, among other considerations is epiglottitis (supraglottitis). PMID:25473587

Noble, Jennifer; Devor, Renee; Rogalski, Francis J; Vergara, Wilfredo; Reddy, Ramalinga P; Bhumbra, Nasreen

2014-01-01

116

Nursing home characteristics associated with methicillin-resistant Staphylococcus aureus (MRSA) Burden and Transmission  

E-print Network

c % Residents with Diabetes d High MRSA Admission PrevalenceDiabetes % Skin Lesions % Fecal Incontinence % Indwelling Devices % History of MRSAdiabetes was associated with a 7.2% absolute increase in MRSA

2012-01-01

117

Experiences of carers managing childhood eczema and their views on its treatment: a qualitative study  

PubMed Central

Background Childhood eczema causes significant impact on quality of life for some families, yet non-concordance with treatment is common. Aim To explore parents' and carers' views of childhood eczema and its treatment. Design and setting Qualitative interview study in primary care in the south of England. Method Carers of children aged ?5 years with a recorded diagnosis of eczema, who reported that eczema was still a problem, were invited to participate. Thirty-one parents were interviewed from 28 families. Results Many parents expressed frustration with both medical care and prescribed treatments. They felt their child's suffering was not ‘taken seriously’, and experienced messages about a ‘trial and error’ prescribing approach and assurance that their child would ‘grow out of it’ as a further ‘fobbing off’, or dismissal. Many carers were ambivalent about eczema treatments, mainly topical corticosteroids but also emollients. Dietary exclusions as a potential cure were of interest to most families, although they perceived healthcare professionals as uninterested in this. Families varied in the extent to which they felt able to manage eczema and the length of time taken to gain control. In some instances, this was linked to not understanding advice or receiving conflicting advice from different healthcare providers. Conclusion Poor concordance with treatments seems unsurprising in the presence of such dissonance between carers' and healthcare providers' agendas. Acknowledging the impact of the condition, greater attention to how key messages are delivered and addressing carers' treatment beliefs are likely to improve engagement with effective self-care. PMID:22520913

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

2012-01-01

118

Mild eczema affects self-perceived health among pre-adolescent girls.  

PubMed

The aim was to assess the impact of eczema on health-related quality of life in the population-based birth cohort BAMSE with 2,756 pre-adolescent children. All answered the following questions on self-perceived health; "How are you feeling?", "How healthy do you consider yourself to be?" and "How happy are you with your life right now?". Children with ongoing eczema answered the "Children's Dermatology Life Quality Index (CDLQI)" questionnaire. In total, 350 (12.7%) of the children had eczema. Girls with eczema reported impaired self-perceived health as evaluated in the 3 questions; adjusted OR 1.72 (95% CI 1.16-2.55), 1.89 (95% CI 1.29-2.76) and 1.69 (95% CI 1.18-2.42). Eczema among boys was not associated with impairment of self-perceived health. The mean CDLQI score was 3.98 (95% CI 3.37-4.58). Since eczema affects up to 20% of pre-adolescent girls, the findings have implications both for health care providers and for society as a whole. PMID:24158408

Ballardini, Natalia; Östblom, Eva; Wahlgren, Carl-Fredrik; Kull, Inger

2014-05-01

119

Hand Eczema and Use of Snus (Moist Snuff) - a Population-based Study.  

PubMed

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

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

2015-03-01

120

Tendency to being bitten by insects among patients with eczema and with other dermatoses.  

PubMed Central

In order to ascertain whether patients with eczema are more prone to being bitten by insects than those with other dermatoses, data were collected by interview and questionnaire from 496 patients attending the outpatient department of a hospital in Sydney and a general dermatological practice in Geelong, Australia. Of the 93 patients with eczema 65% claimed they were prone to insect bite and that they were bitten in preference to other people when in a group, compared with 17% of the 403 patients with other chronic dermatoses. Similar proportions of both groups (approximately 50%) had used insect repellents. Excluding those with eczema 30% of the 149 patients with a family history of atopy claimed they were prone to being bitten by insects compared with 8% of the 254 patients without a family history of atopy. There was no difference in the prevalence of eczema or family history of atopy between men and women, but more women felt themselves to be susceptible to insect bites than men. There is evidence that patients with eczema and those with a family history of atopy are prone to being bitten by insects. Further confirmatory work, perhaps using volunteers and mosquitoes, is indicated. However, patients with severe eczema or a family history of atopy should take care when travelling to areas where disease-carrying insects are prevalent. PMID:8251219

Harford-Cross, M

1993-01-01

121

Genome and virulence determinants of high virulence community-acquired MRSA  

Microsoft Academic Search

Summary Background A new type of meticillin-resistant Staphylococcus aureus (MRSA), designated community-acquired MRSA, is becoming increasingly noticeable in the community, some strains of which cause fatal infections in otherwise healthy individuals. By contrast with hospital-acquired MRSA, community-acquired MRSA is more susceptible to non ? -lactam antibiotics. We investigated the high virulence potential of certain strains of this bacterium. Methods We

Tadashi Baba; Fumihiko Takeuchi; Makoto Kuroda; Harumi Yuzawa; Ken-ichi Aoki; Akio Oguchi; Yoshimi Nagai; Natsuko Iwama; Kazuyuki Asano; Timothy Naimi; Hiroko Kuroda; Longzhu Cui; Kenji Yamamoto; Keiichi Hiramatsu

2002-01-01

122

Active Surveillance of the Trachea or Throat for MRSA Is More Sensitive than Nasal Surveillance and a Better Predictor of MRSA Infections among Patients in Intensive Care  

PubMed Central

Background Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common causes of infection in the intensive care unit (ICU). Although surveillance culture for MRSA is recommended for ICU patients, no comparative study investigating the optimal sites and frequency of culture has been performed in this population. Methods A prospective observational cohort study was performed in an 18-bed emergency intensive care unit (EICU) in a tertiary teaching hospital. A total of 282 patients were included. Samples for MRSA detection were obtained at the time of admission, 48 h after admission, and then weekly thereafter. All subjects were routinely monitored for the development of MRSA infection during their stay in the ICU. Results MRSA colonization was detected in 129 (46%) patients over the course of the study. The sensitivity of MRSA surveillance culture was significantly higher in throat or tracheal aspirates (82%; 106/129) than in anterior nares (47%; 61/129) (P<0.001). The sensitivity of MRSA surveillance culture for subsequent MRSA infection and MRSA pneumonia was also higher in the throat/trachea (69 and 93%, respectively) than in the anterior nares (48 and 50%, respectively). The area under the curve for subsequent MRSA infection was higher in trachea/throat (0.675) than in the anterior nares (0.648); however, this difference was not significant (P>0.05). The area under the curve for MRSA pneumonia was significantly higher in trachea/throat (0.791; 95% CI, 0.739-0.837) than anterior nares (0.649; 95% CI, 0.590-0.705) (P?=?0.044). Conclusion MRSA colonization was more common in the trachea/throat than in the anterior nares in ICU patients. Cultures from throat or tracheal aspirates were more sensitive and predictive of subsequent MRSA pneumonia than cultures from the anterior nares in this population. PMID:24911358

Kim, Gwang-Sook; Jang, Mi-Ok; Kang, Seung-Ji; Jung, Sook-In; Shin, Jong-Hee; Chun, Byeong Jo; Park, Kyung-Hwa

2014-01-01

123

Clinical utility of the Xpert MRSA assay for early detection of methicillin-resistant Staphylococcus aureus  

PubMed Central

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for many nosocomial and community-acquired infections, resulting in significant morbidity and mortality. A practical way to limit the spread of MRSA is early detection and proper treatment. However, screening culture for MRSA typically requires 2–3 days. The Xpert MRSA assay (Cepheid, Sunnyvale, CA, USA) is a real-time polymerase chain reaction-based assay developed for screening an MRSA-specific DNA sequence within the staphylococcal cassette chromosome in 2 h. Lower respiratory tract specimens, such as transtracheal aspirates (TTAs) and bronchoalveolar lavage fluid (BALF), are commonly obtained from intubated patients. Therefore, using the lower respiratory tract specimens with the Xpert MRSA assay may be a practical tool for patient care. We performed the Xpert MRSA assay on 108 TTA and 21 BALF specimens from 92 patients and compared the results to those obtained by culture. The two assays showed concordant results in 120 (93.0%) cases and discordant results in 9 (7.0%) cases, which were culture-negative and Xpert MRSA-positive. Among the discordant cases, 5 patients developed culture-positive samples 2–15 days after the Xpert MRSA detected MRSA. We conclude that the Xpert MRSA assay is a rapid, sensitive and clinically useful test, particularly for the early detection of MRSA. PMID:23064681

OH, AE-CHIN; LEE, JIN KYUNG; LEE, HA NA; HONG, YOUNG JUN; CHANG, YOON HWAN; HONG, SEOK-IL; KIM, DONG HO

2013-01-01

124

Public engagement with emerging infectious disease: The case of MRSA in Britain  

Microsoft Academic Search

As a route to providing a framework for elucidating the content of public thinking concerning emerging and re-emerging infectious diseases (EID), this article examines public engagement with methicillin-resistant Staphylococcus aureus (MRSA). It explores how British lay publics represent MRSA utilising a social representations framework. For this group, MRSA is associated primarily with dirty National Health Service (NHS) hospitals that have

Hélène Joffe; Peter Washer; Christian Solberg

2011-01-01

125

Combined use of Pastorex Staph-Plus and either of two new chromogenic agars, MRSA ID and CHROMagar MRSA, for detection of methicillin-resistant Staphylococcus aureus.  

PubMed

We describe the search toward a fast and reliable strategy to detect and confirm the presence of methicillin-resistant Staphylococcus aureus (MRSA) in screening samples. First, we evaluated the sensitivities and specificities of oxacillin resistance screening agar (ORSA) with enrichment (tryptic soy broth [TSB] and ORSA [TSB-ORSA]) and without enrichment (ORSA), MRSA ID (MRSA_ID) plates, and CHROMagar MRSA (C_MRSA) plates, all of which were inoculated with equal volumes of a suspension made by emulsifying screening swabs. Whereas the sensitivities after 48 h were similar for all media tested (77% for MRSA_ID and ORSA; 73% for C_MRSA and ORSA after enrichment [TSB-ORSA]), the specificities of MRSA_ID (98% after 24 h and 94% after 48 h) and C_MRSA (98% after 24 h and 90% after 48 h) were superior to the specificities of ORSAs (92% after 24 h and 83% after 48 h) and TSB-ORSA (86% after 24 h and 81% after 48 h). Subsequently, the performance of the Pastorex Staph-Plus agglutination test with presumptive MRSA isolates taken directly from chromogenic agars (direct_Pastorex agglutination) was compared to that of the Pastorex Staph-Plus agglutination test with isolates from blood agar subcultures (conventional_Pastorex agglutination). When the direct_Pastorex agglutination test on MRSA_ID plates was combined with Gram staining, the direct_Pastorex agglutination test with samples from MRSA_ID plates was as reliable as the conventional_Pastorex agglutination test with samples from blood agar subcultures from MRSA_ID plates. In contrast, the direct_Pastorex agglutination test with samples from C_MRSA plates gave false-negative results. Finally, we calculated the processing times of the four different strategies, namely, (i) enrichment in TSB supplemented with NaCl, subsequent culture on ORSA, and the conventional_Pastorex agglutination test; (ii) direct inoculation of ORSA combined with conventional_Pastorex agglutination test; (iii) direct inoculation of MRSA_ID plates combined with Gram staining and the direct_Pastorex agglutination test; and (iv) direct inoculation of C_MRSA plates combined with Gram staining and the direct_Pastorex agglutination test. We concluded that the use of MRSA_ID in combination with Gram staining and the direct_Pastorex agglutination test is faster and more specific than the other strategies tested. PMID:17093032

Compernolle, Veerle; Verschraegen, Gerda; Claeys, Geert

2007-01-01

126

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

PubMed Central

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

2014-01-01

127

Maternal hookworm modifies risk factors for childhood eczema: results from a birth cohort in Uganda  

PubMed Central

Background Worms may protect against allergy. Early-life worm exposure may be critical, but this has not been fully investigated. Objectives To investigate whether worms in pregnancy and in early childhood are associated with childhood eczema incidence. Methods The Entebbe Mother and Baby Study, an anthelminthic treatment trial, enrolled pregnant women between 2003 and 2005 in Uganda. Mothers were investigated for worms during pregnancy and children annually. Eczema was doctor-diagnosed from birth to age five years. A planned observational analysis was conducted within the trial cohort to investigate associations between worms and eczema. Results Data for 2345 live-born children were analysed. Hookworm was the most prevalent maternal worm (45%). Childhood worms were less prevalent. Eczema incidence was 4.68/100 person-years. Maternal hookworm was associated with reduced eczema incidence [adjusted hazard ratio (95% confidence interval), p-value: 0.71(0.51–0.99), 0.04] and modified effects of known risk factors for eczema: Dermatophagoides-specific IgE in children was positively associated with eczema incidence if the mother had no hookworm [2.72(1.11–6.63), 0.03], but not if the mother had hookworm [0.41(0.10–1.69), 0.22], interaction p-value = 0.03. Similar interactions were seen for maternal history of eczema {[2.87(1.31–6.27, 0.008) vs. [0.73(0.23–2.30), 0.60], interaction p-value = 0.05}, female gender {[1.82(1.22–2.73), 0.004 vs. [0.96(0.60–1.53), 0.87], interaction p-value = 0.04} and allergen-specific IgE. ChildhoodTrichuris trichiura and hookworm were inversely associated with eczema. Conclusions Maternal hookworm modifies effects of known risk factors for eczema. Mechanisms by which early-life worm exposures influence allergy need investigation. Worms or worm products, and intervention during pregnancy have potential for primary prevention of allergy. PMID:25171741

Mpairwe, Harriet; Ndibazza, Juliet; Webb, Emily L; Nampijja, Margaret; Muhangi, Lawrence; Apule, Barbara; Lule, Swaib; Akurut, Hellen; Kizito, Dennison; Kakande, Mohammed; Jones, Frances M; Fitzsimmons, Colin M; Muwanga, Moses; Rodrigues, Laura C; Dunne, David W; Elliott, Alison M

2014-01-01

128

Transferable vancomycin resistance in a community-associated MRSA lineage.  

PubMed

We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern. PMID:24738669

Rossi, Flávia; Diaz, Lorena; Wollam, Aye; Panesso, Diana; Zhou, Yanjiao; Rincon, Sandra; Narechania, Apurva; Xing, Galen; Di Gioia, Thais S R; Doi, André; Tran, Truc T; Reyes, Jinnethe; Munita, Jose M; Carvajal, Lina P; Hernandez-Roldan, Alejandra; Brandão, Denise; van der Heijden, Inneke Marie; Murray, Barbara E; Planet, Paul J; Weinstock, George M; Arias, Cesar A

2014-04-17

129

Transferable Vancomycin Resistance in a Community-Associated MRSA Lineage  

PubMed Central

SUMMARY We report the case of a patient from Brazil with a bloodstream infection caused by a strain of methicillin-resistant Staphylococcus aureus (MRSA) that was susceptible to vancomycin (designated BR-VSSA) but that acquired the vanA gene cluster during antibiotic therapy and became resistant to vancomycin (designated BR-VRSA). Both strains belong to the sequence type (ST) 8 community-associated genetic lineage that carries the staphylococcal chromosomal cassette mec (SCCmec) type IVa and the S. aureus protein A gene (spa) type t292 and are phylogenetically related to MRSA lineage USA300. A conjugative plasmid of 55,706 bp (pBRZ01) carrying the vanA cluster was identified and readily transferred to other staphylococci. The pBRZ01 plasmid harbors DNA sequences that are typical of the plasmid-associated replication genes rep24 or rep21 described in community-associated MRSA strains from Australia (pWBG745). The presence and dissemination of community-associated MRSA containing vanA could become a serious public health concern. PMID:24738669

Rossi, Flávia; Diaz, Lorena; Wollam, Aye; Panesso, Diana; Zhou, Yanjiao; Rincon, Sandra; Narechania, Apurva; Xing, Galen; Di Gioia, Thais S.R.; Doi, André; Tran, Truc T.; Reyes, Jinnethe; Munita, Jose M.; Carvajal, Lina P.; Hernandez-Roldan, Alejandra; Brandão, Denise; van der Heijden, Inneke Marie; Murray, Barbara E.; Planet, Paul J.; Weinstock, George M.; Arias, Cesar A.

2014-01-01

130

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 ...

131

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

ERIC Educational Resources Information Center

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…

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

2007-01-01

132

Evaluation of the IDI-MRSA assay on the SmartCycler real-time PCR platform for rapid detection of MRSA from screening specimens  

Microsoft Academic Search

Rapid accurate detection is a prerequisite for the successful control of meticillin-resistant Staphylococcus aureus (MRSA). The IDI-MRSA real-time polymerase chain reaction (PCR) assay was designed to provide rapid results from nasal specimens\\u000a collected in Stuart’s liquid transport medium. This study has evaluated the IDI-MRSA kit for use in a clinical laboratory\\u000a by investigating the following parameters: (1) limits of detection

A. S. Rossney; C. M. Herra; M. M. Fitzgibbon; P. M. Morgan; M. J. Lawrence; B. O’Connell

2007-01-01

133

Comparative evaluation of a rapid MRSA detection assay based on multiplex real-time PCR versus MRSA screening cultures containing egg yolk  

Microsoft Academic Search

Although the Centers for Disease Control and Prevention (CDC) has been recommending the performance of active surveillance\\u000a culture (ASC) for the prevention of methicillin-resistant Staphylococcus aureus (MRSA) infections and their control since the guideline was issued in 2006, many variant types of MRSA with various characteristics\\u000a have been found recently. As this change in MRSA characteristics makes it harder to

Yuko Sumitani; Yoshio Kobayashi

2009-01-01

134

Reduced vancomycin susceptibility in porcine ST9 MRSA isolates  

PubMed Central

Porcine strains of livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA) have been recognized in many countries and have been shown to be able to cause human infection. Resistance to non-beta lactam antibiotics has been reported but non-susceptibility to vancomycin, which is known to occur in human MRSA, has so far not been observed in LA-MRSA. Such resistance is typically fairly low level involving changes in the cell wall thickness. The development of resistance is usually preceded by presence of a sub-population having an increased MIC, which is selected for by exposure to vancomycin. This study investigated vancomycin susceptibility of one hundred porcine MRSA isolates using three MIC methods including spiral gradient endpoint (SGE) technique which allows visualization of more resistant sub-populations. SGE revealed 16 strains with an MIC above 2.0 mg/L, of which 14 were determined to have MIC 4 mg/L by agar dilution (AD). SGE revealed a further two isolates with MIC < 2 mg/L had a sub-population >2 mg/L. In addition, trailing endpoints not reaching resistance were present in 26 isolates with MIC < 2 mg/L. Sequencing of the genes of the VraSR/GraSR two component systems of ten of the resistant strains for comparison with susceptible strains revealed changes, including the presence of stop codons, in vraS and graR, but these were not consistent in all isolates. Other genetic changes may contribute to vancomycin non-susceptibility and require investigation. As failure to respond to treatment has been reported in clinical isolates with MIC > 1.5 mg/L, the presence of vancomycin non-susceptibility in porcine isolates is of concern and further monitoring of LA-MRSA is essential. PMID:24298270

Kwok, Gabriella M. L.; O'Donoghue, Margaret M.; Doddangoudar, Vijaya C.; Ho, Jeff; Boost, Maureen V.

2013-01-01

135

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

PubMed

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

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

2014-01-01

136

Contact allergy in relation to hand eczema and atopic diseases in north Norwegian schoolchildren.  

PubMed

Patch testing was carried out in 424 schoolchildren (223M, 201F), aged 7-12 years, in northern Norway. In 99 (23.3%) of these children, one or more allergic patch test reactions were demonstrated; 30 children reacted to two and 6 to three or more substances; 53 irritant reactions were recorded in 33 (7.8%) of those tested. From a total of 144 positive tests, the most common allergen was nickel (14.9%), followed by cobalt (5.7%), kathon CG (5.2%), lanolin (1.7%) and neomycin (1.4%). Both allergic and irritant reactions were found twice as frequently in girls as in boys. Positive patch tests were significantly more frequent in atopic (28.8%) than in non-atopic (17.9%) children, being most pronounced in atopic girls (37.4%). Hand eczema was reported to have occurred or to be present in 6.5% of cases. Twenty-nine of 36 children reporting hand eczema participated in the clinical examination. Altogether 15 (3.5%) children had hand eczema at the time of the clinical examination but 12 of these children had no previous history of hand eczema. In 14 of these 15 subjects, the eczema was localized to the back of the hands, with 13 having atopic dermatitis. In 4 of these 15 children, an allergic patch test reaction was found; however, in only 2 of these 4 was the test considered to be clinically relevant for the diagnosis allergic hand eczema. In conclusion, irritant hand eczema may occur in early childhood and is most prevalent in children with atopic dermatitis. PMID:7795349

Dotterud, L K; Falk, E S

1995-04-01

137

[Significance of methicillin resistant S. aureus (MRSA) in geriatrics--epidemiology, therapy and management].  

PubMed

Methicillin-resistant S. aureus (MRSA) has become an important cause of severe infection in hospitalized patients all over the world. In Germany a significant increase of nosocomial infections due to MRSA has occurred during the last 10 years. Especially elderly patients with chronic illnesses are at increased risk of becoming colonized or infected with MRSA. This report focuses on epidemiology and therapy of MRSA, and on the recommendations concerning management and prevention of spread of MRSA in hospitals and nursing homes. PMID:11130190

Albert, S; Wichelhaus, T A; Schäfer, V

2000-10-01

138

Long Term Treatment Concepts and Proactive Therapy for Atopic Eczema  

PubMed Central

Atopic eczema, also known as atopic dermatitis, is a frequent, highly pruritic, chronic skin disease, which is typically running in flares. The traditional treatment mainly consists of the reactive application of topical anti-inflammatory agents such as topical corticosteroids and topical calcineurin inhibitors. The short term benefit of this approach is well known, but long term remission between flares is difficult to achieve. Therefore, innovative long-term treatment strategies targeting flare prevention and skin barrier stabilization are needed. We and others have shown that normal looking, non-lesional skin of atopic dermatitis patients is immunobiologially not normal but characterized by an invisible inflammation and barrier defect. This has led to the novel concept of proactive therapy, which is defined as long-term, low-dose intermittent application of anti-inflammatory therapy to the previously affected skin, together with an ongoing emollient treatment of unaffected skin. This review article describes the most important long-term treatment options for atopic dermatitis, which includes emollient therapy, the novel concept of proactive treatment, the different ultraviolet light modalities and a selection of systemic immunosuppressive drugs and biologics. Current trial data, licensed indications, off-label use and relevant side effects of the different treatment modalities are summarized. PMID:22879707

Ehmann, Laura Maximiliane

2012-01-01

139

The role of sensitization to Malassezia sympodialis in atopic eczema.  

PubMed

Atopic eczema (AE) is a chronic relapsing, highly pruritic inflammation of the skin with a worldwide prevalence of 10-20% in children and of 1-3% in adults. Malassezia sympodialis has been reported as the most frequent skin-colonizing yeast in both AE patients and healthy individuals. Approximately 50% of the AE patients show immediate-type skin reactions or have specific serum IgE against M. sympodialis. Sensitization to the yeast occurs almost exclusively in AE patients. The main cause for this specific sensitization may be the disrupted skin barrier facilitating allergen uptake. So far thirteen allergens of Malassezia have been cloned produced, characterized and partly studied in vitro and in vivo. Phylogenetically conserved allergen structures, such as manganese superoxide dismutase, may play a role as cross-reactive allergens in a subset of AE patients as a result of molecular mimicry and cross-reactivity with structurally related human proteins and might contribute to the perpetuation of the inflammatory skin reactions. The use of recombinant Malassezia allergens will contribute to elucidate the pathways of sensitization occurring in AE, the underlying immunological mechanisms governing IgE- and T-cell-mediated responses and may provide new therapeutic options to alleviate Malassezia-related symptoms in AE. PMID:16354952

Schmid-Grendelmeier, Peter; Scheynius, Annika; Crameri, Reto

2006-01-01

140

Molecular Typing of MRSA and of Clinical Staphylococcus aureus Isolates from Ia?i, Romania  

PubMed Central

Romania is one of the countries with the highest prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the world. To obtain data on affiliation of MRSA to strains and clonal complexes and on the population of methicillin susceptible S. aureus (MSSA), clinical isolates from bloodstream infections, skin and soft tissue infections as well as from screening swabs were collected at hospitals in Ia?i, a city in the North-Eastern part of Romania. Isolates were characterised by microarray hybridisation. Nearly half of all isolates (47%), and about one third (34%) of bloodstream isolates were MRSA. The prevalence of the Panton-Valentine leukocidin (PVL) was also high (31% among MRSA, 14% among MSSA). The most common MRSA strain was a PVL-negative CC1-MRSA-IV that might have emerged locally, as a related MSSA was also common. PVL-positive CC8-MRSA-IV (“USA300”) and PVL-negative ST239-like MRSA-III were also frequently found while other MRSA strains were only sporadically detected. Among MSSA, PVL-positive CC121 as well as PVL-negative CC1, CC22 and CC45 predominated. Although this study provides only a snapshot of S. aureus/MRSA epidemiology in Romania, it confirms the high burden of MRSA and PVL on Romanian healthcare settings. PMID:24846009

Monecke, Stefan; Müller, Elke; Dorneanu, Olivia Simona; Vremer?, Teodora; Ehricht, Ralf

2014-01-01

141

Molecular typing of MRSA and of clinical Staphylococcus aureus isolates from Ia?i, Romania.  

PubMed

Romania is one of the countries with the highest prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the world. To obtain data on affiliation of MRSA to strains and clonal complexes and on the population of methicillin susceptible S. aureus (MSSA), clinical isolates from bloodstream infections, skin and soft tissue infections as well as from screening swabs were collected at hospitals in Ia?i, a city in the North-Eastern part of Romania. Isolates were characterised by microarray hybridisation. Nearly half of all isolates (47%), and about one third (34%) of bloodstream isolates were MRSA. The prevalence of the Panton-Valentine leukocidin (PVL) was also high (31% among MRSA, 14% among MSSA). The most common MRSA strain was a PVL-negative CC1-MRSA-IV that might have emerged locally, as a related MSSA was also common. PVL-positive CC8-MRSA-IV ("USA300") and PVL-negative ST239-like MRSA-III were also frequently found while other MRSA strains were only sporadically detected. Among MSSA, PVL-positive CC121 as well as PVL-negative CC1, CC22 and CC45 predominated. Although this study provides only a snapshot of S. aureus/MRSA epidemiology in Romania, it confirms the high burden of MRSA and PVL on Romanian healthcare settings. PMID:24846009

Monecke, Stefan; Müller, Elke; Dorneanu, Olivia Simona; Vremer?, Teodora; Ehricht, Ralf

2014-01-01

142

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

PubMed Central

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

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

2013-01-01

143

Predictors of agr Dysfunction in Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates among Patients with MRSA Bloodstream Infections ?  

PubMed Central

Despite emerging evidence that dysfunction in the accessory gene regulator (agr) locus is associated with deleterious outcomes among patients treated with vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) infections, factors predictive of agr dysfunction have not been evaluated. This study describes the epidemiology of agr dysfunction, identifies predictors of agr dysfunction in MRSA isolates among those with MRSA bloodstream infections, and describes the relationship between agr dysfunction and other microbiologic phenotypes. A cross-sectional study of patients with MRSA bloodstream infections at two institutions in upstate New York was performed. Clinical data on demographics, comorbidities, disease severity, hospitalization history, and antibiotic history were collected. Microbiologic phenotypes, including agr dysfunction, MIC values by broth microdilution (BMD) and Etest, and vancomycin heteroresistance (hVISA) were tested. Multivariable analyses were performed to identify factors predictive of agr dysfunction. Among 200 patients with an MRSA bloodstream infection, the proportion of strains with agr dysfunction was 31.5%. The distribution of MICs determined by both BMD and Etest were equivalent across agr groups, and there was no association between agr dysfunction and the presence of hVISA. Severity of illness, comorbidities, and hospitalization history were comparable between agr groups. In the multivariate analysis, prior antibiotic exposure was the only factor of variables studied found to be predictive of agr dysfunction. This relationship was predominantly driven by prior beta-lactam and fluoroquinolone administration in the bivariate analysis. Identifying these institution-specific risk factors can be used to develop a process to assess the risk of agr dysfunction and guide empirical antibiotic therapy decisions. PMID:21930887

Butterfield, Jill M.; Tsuji, Brian T.; Brown, Jack; Ashley, Elizabeth Dodds; Hardy, Dwight; Brown, Kristen; Forrest, Alan; Lodise, Thomas P.

2011-01-01

144

Predictors of agr dysfunction in methicillin-resistant Staphylococcus aureus (MRSA) isolates among patients with MRSA bloodstream infections.  

PubMed

Despite emerging evidence that dysfunction in the accessory gene regulator (agr) locus is associated with deleterious outcomes among patients treated with vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) infections, factors predictive of agr dysfunction have not been evaluated. This study describes the epidemiology of agr dysfunction, identifies predictors of agr dysfunction in MRSA isolates among those with MRSA bloodstream infections, and describes the relationship between agr dysfunction and other microbiologic phenotypes. A cross-sectional study of patients with MRSA bloodstream infections at two institutions in upstate New York was performed. Clinical data on demographics, comorbidities, disease severity, hospitalization history, and antibiotic history were collected. Microbiologic phenotypes, including agr dysfunction, MIC values by broth microdilution (BMD) and Etest, and vancomycin heteroresistance (hVISA) were tested. Multivariable analyses were performed to identify factors predictive of agr dysfunction. Among 200 patients with an MRSA bloodstream infection, the proportion of strains with agr dysfunction was 31.5%. The distribution of MICs determined by both BMD and Etest were equivalent across agr groups, and there was no association between agr dysfunction and the presence of hVISA. Severity of illness, comorbidities, and hospitalization history were comparable between agr groups. In the multivariate analysis, prior antibiotic exposure was the only factor of variables studied found to be predictive of agr dysfunction. This relationship was predominantly driven by prior beta-lactam and fluoroquinolone administration in the bivariate analysis. Identifying these institution-specific risk factors can be used to develop a process to assess the risk of agr dysfunction and guide empirical antibiotic therapy decisions. PMID:21930887

Butterfield, Jill M; Tsuji, Brian T; Brown, Jack; Ashley, Elizabeth Dodds; Hardy, Dwight; Brown, Kristen; Forrest, Alan; Lodise, Thomas P

2011-12-01

145

IL5RA polymorphisms, smoking and eczema in Japanese women: the Kyushu Okinawa Maternal and Child Health Study.  

PubMed

The present case-control study examined the relationship between IL5RA SNPs and eczema in young adult Japanese women. Cases and control subjects were selected from pregnant women who participated in the baseline survey of the Kyushu Okinawa Maternal and Child Health Study, which is an ongoing prebirth cohort study. Cases comprised 188 women with eczema in the previous 12 months as defined according to the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC), regardless of the presence of a doctor's diagnosis of atopic eczema. Control subjects comprised 1130 women without eczema as defined according to the ISAAC criteria who also had not been diagnosed with atopic eczema by a doctor. Compared with the AA genotype of IL5RA SNP rs17881144, the AT genotype, but not the TT genotype, was significantly associated with a decreased risk of eczema. The ATTAGA haplotype and the GTAGCA haplotype of rs17882210, rs3804797, rs334809, rs9831572, rs6771148 and rs17881144 were significantly associated with an increased risk of eczema. In contrast, the GCTGCA haplotype was significantly related to a decreased risk of eczema. Multiplicative interactions between IL5RA SNPs rs334809 and rs17881144 and smoking with respect to eczema were marginally significant (P = 0.07 and 0.07, respectively). This is the first study to show significant associations between IL5RA SNP rs17881144, the ATTAGA haplotype, the GTAGCA haplotype, and the GCTGCA haplotype and eczema. Smoking may modify the relationships between SNPs rs334809 and rs17881144 and eczema. PMID:25523412

Miyake, Y; Tanaka, K; Arakawa, M

2015-02-01

146

Role of rasayana in cure and prevention of recurrence of vicharchika (eczema).  

PubMed

Generally, skin diseases run a chronic course and the recurrence is very common. Mandip and Chandola (2009) reported that Shirishadi Decoction administered orally and simultaneously Snuhyadi Lepa applied externally to the patients of Vicharchika (Eczema) provided complete remission to 18.2% patients, marked improvement to 42.4% patients and moderate improvement to 36.4% patients but the recurrence rate was very high i.e. 80%. Charaka, in the context of the treatment of Apasmara mentions that in all the chronic diseases, Rasayana drugs should be prescribed. As eczema is a chronic disease and its recurrences are very common, therefore, it was thought desirable to evaluate the role of the Rasayana drugs in the cure and prevention of the recurrence of Vicharchika (Eczema). In this study, total 38 patients of Vicharchika (Eczema) were registered, among which 31 patients completed the full course of treatment. These patients were first subjected to Koshtha Shuddhi done with Aragvadha (Cassia fistula) Hima administered orally at bedtime for initial eight days. Thereafter 30 ml of Shirishadi Decoction and 6 gm of Guduchi (Tinospora cardifolia) and Bhringaraja (Eclipta alba) powder was given with Ghrita. Both the drugs were given twice daily after meals orally. Simultaneously, Snuhyadi Lepa was applied on the eczematous lesions. Results of the study showed that addition of Rasayana drugs provided complete remission to 22.6% and checked the recurrence of the disease in the 89.5% patients of Vicharchika (Eczema). PMID:22131682

Kaur, Mandip; Chandola, H M

2010-01-01

147

Worldwide variations in the prevalence of symptoms of atopic eczema in the international study of asthma and allergies in childhood  

Microsoft Academic Search

Background: Little is known about the prevalence of atopic eczema outside Northern Europe. Objectives: We sought to describe the magnitude and variation in the prevalence of atopic eczema symptoms throughout the world. Methods: A cross-sectional questionnaire survey was conducted on random samples of schoolchildren aged 6 to 7 years and 13 to 14 years from centers in 56 countries throughout

Hywel Williams; Colin Robertson; Alistair Stewart; Nadia Aït-Khaled; Gabriel Anabwani; Ross Anderson; Innes Asher; Richard Beasley; Bengt Björkstén; Michael Burr; Tadd Clayton; Julian Crane; Philippa Ellwood; Ulrich Keil; Chris Lai; Javier Mallol; Fernando Martinez; Edwin Mitchell; Stephen Montefort; Neil Pearce; Jayant Shah; Bonnie Sibbald; David Strachan; Erika von Mutius; Stephan K. Weiland

1999-01-01

148

Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study  

Microsoft Academic Search

BACKGROUND: The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction

Robin F van Gils; Pieter GM van der Valk; Derk Bruynzeel; Pieter J Coenraads; Cécile RL Boot; Willem van Mechelen; Johannes R Anema

2009-01-01

149

Development of Questionnaires on Coping with Disease and Itching Cognitions for Children and Adolescents with Atopic Eczema  

Microsoft Academic Search

SummaryBackground: There are numerous questionnaires for adults to assess coping with disease and quality of life in patients with atopic eczema, but there are hardly any for children and adolescents. This is surprising because the prevalence of atopic eczema is higher in these age groups than in adults. Moreover, the patients in this age range are in a sensitive phase

J. Kupfer; P. Keins; B. Brosig; U. Darsow; T. L. Diepgen; M. Fartasch; E. Korsch; T. Lob-Corzilius; V. Niemeier; R. Scheidt; G. Schmid-Ott; D. Staab; R. Szczepanski; T. Werfel; M. Wittenmeier; U. Gieler

2003-01-01

150

The Hand Eczema Trial (HET): design of a randomised clinical trial of the effect of classification and individual counselling versus no intervention among health-care workers with hand eczema  

PubMed Central

Background Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema. Methods/Design We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life. Trial registration The trial is registered in ClinicalTrials.Gov, NCT01012453. PMID:20807407

2010-01-01

151

Successful treatment of dyshidrotic hand eczema using tap water iontophoresis with pulsed direct current.  

PubMed

The efficacy of tap water iontophoresis in treating palmoplantar hyperhidrosis has been sufficiently documented and has led to its extensive use in clinical practice. In order to test the efficacy of this treatment modality in cases of dyshidrotic hand eczema, 20 patients were treated with tap water iontophoresis in addition to two-sided steroid-free topical therapy in a randomized half-side-study. A special score for dyshidrotic eczema including objective and subjective criteria was developed to document the success of the therapy. Only those sides treated with tap water iontophoresis showed significant improvement. This significant effect of iontophoresis indicates the efficacy of this treatment in cases of dyshidrotic hand eczema. PMID:8982415

Odia, S; Vocks, E; Rakoski, J; Ring, J

1996-11-01

152

Effect of maternal dietary exclusion on breast fed infants with eczema: two controlled studies.  

PubMed Central

Thirty seven breast fed infants with eczema were studied to see whether changes in their mothers' diets affected their skin condition. Nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows' milk, and 18 took part in open exclusion of 11 foods followed by double blind challenge to those mothers whose infants seemed to respond. Babies were examined at the beginning and end of each dietary period, and the extent and severity of the rash were given a numerical score. The eczema improved in six infants when their mothers avoided egg and cows' milk and worsened again when these were reintroduced. Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows' milk, one developing colitis. Maternal dietary exclusion seems to benefit some breast fed babies with eczema. PMID:3089466

Cant, A J; Bailes, J A; Marsden, R A; Hewitt, D

1986-01-01

153

Fusidic acid in skin infections and infected atopic eczema.  

PubMed

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

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

2014-08-01

154

Comparison of clinical outcome after treatment of hip arthritis caused by MRSA with that caused by non-MRSA in infants.  

PubMed

We compared the results of four patients treated for septic arthritis of the hip caused by methicillin-resistant Staphylococcus aureus (MRSA) with those of five non-MRSA cases. All four patients with MRSA were neonates when infection occurred, and all four had preceding sepsis and marked swelling of the thigh. The mean duration of follow-up was 5.6 years. At the time of most recent follow-up, all four exhibited severe discrepancy in leg length, and their femoral heads exhibited high-grade deformation according to the Choi classification. In contrast, in the non-MRSA cases, the mean age at infection was 2.2 years and the mean duration of follow-up was 2.9 years. At the most recent follow-up, they exhibited no remarkable discrepancy in leg length and only low-grade deformation of the femoral head. In this study, patients with MRSA showed more marked deformity of the hip and discrepancy of leg length because of lower age and to the presence of organisms resistant to antibiotics. Possible strategies for early diagnosis to prevent poor results after MRSA-induced hip arthritis include the following: (i) ensuring that pediatricians are familiar with the early signs of infection of the hip joint, (ii) aggressive puncture and drainage of pus from the affected joint, and (iii) initial use of antibiotics effective in treating MRSA, especially for patients suspected to have MRSA in the neonatal nursery. PMID:19436242

Mortia, Mitsuaki; Nakamura, Hiroaki; Kitano, Toshio

2009-01-01

155

MRSA-surveillance in Germany: data from the Antibiotic Resistance Surveillance System (ARS) and the mandatory surveillance of MRSA in blood.  

PubMed

Data from the German Antibiotic Resistance Surveillance system (ARS) and statutory notification of methicillin-resistant Staphylococcus aureus (MRSA) in blood cultures are presented. ARS is a voluntary laboratory-based surveillance system providing resistance data of all clinical pathogens and sample types from hospitals and ambulatory care. Statutory notification includes MRSA detected in blood and cerebrospinal fluid by microbiological laboratories. Resistance data from 2008 to 2010 and MRSA-bacteraemia incidences from 2010 are presented. From 2008 to 2010, resistance data from 70,935 Staphylococcus aureus isolates were transferred to the national health institution. MRSA proportions in hospitals and outpatient care account for 19.2% and 10.6%, respectively. In hospital care high proportions of MRSA were found in nephrological, geriatric, neurological general wards and surgical ICUs (49.4%, 45.8%, 34.2%, and 27.0%, respectively), while in community outpatient care urological practices (29.2%) account for the highest values. In both healthcare settings urinary tract samples stand out with high proportions of MRSA (hospitals, 32.9%; outpatients, 20.5%). In 2010, 3900 cases of MRSA bacteraemia were reported, accounting for an incidence of MRSA bacteraemia of 4.8/100,000 inhabitants/year. Stratification by federal states shows considerable regional differences (range, 1.0-8.3/100,000 inhabitants/year). Vulnerable areas in hospitals and outpatient care have been pointed out as subjects for further inquiries. PMID:22210264

Schweickert, B; Noll, I; Feig, M; Claus, H; Krause, G; Velasco, E; Eckmanns, T

2012-08-01

156

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

PubMed Central

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

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

1985-01-01

157

MRSA in Africa: Filling the Global Map of Antimicrobial Resistance  

PubMed Central

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

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

2013-01-01

158

Three-Way Comparison of BBL CHROMagar MRSA II, MRSASelect, and Spectra MRSA for Detection of Methicillin-Resistant Staphylococcus aureus Isolates in Nasal Surveillance Cultures  

PubMed Central

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of hospital-acquired and life-threatening infections. Active surveillance programs for MRSA utilize either molecular or culture-based methods. A prospective study was performed to compare the performance of selective and differential chromogenic media, BBL CHROMagar MRSA II (CMRSA II; BD Diagnostics, Sparks, MD), MRSASelect (Bio-Rad Laboratories, Redmond, WA), and Spectra MRSA (Remel, Lenexa, KS), for the detection of MRSA in nasal swab specimens. A total of 515 compliant remnant nasal swab specimens were sequentially used to inoculate BBL Trypticase soy agar with 5% sheep blood (TSA II) and each chromogenic medium. After 24 h of incubation, colony color reactions and morphology on chromogenic media were compared to suspicious colonies on nonselective TSA II. MRSA on TSA II was confirmed by Gram staining, a coagulase test, and a cefoxitin disk test. The overall prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) on TSA II was 12.4% (64/515) and 9.7% (50/515), respectively. When each chromogenic medium was compared to the standard culture method, the sensitivity and specificity, respectively, were as follows: CMRSA II, 87.7% and 98.6%; MRSASelect, 89.0% and 93.4%; and Spectra MRSA, 83.6% and 92.1%. The positive predictive values were highest for CMRSA II (91.4%), followed by MRSASelect (69.1%) and Spectra MRSA (63.5%). False-positive results on chromogenic media were mainly due to color interpretation. The negative predictive values for all three media were greater than 97%. In conclusion, CMRSA II gave the best overall results for detecting MRSA from nasal specimens. PMID:23135930

Renzi, Pamela B.; Koch, Kim M.; Wissel, Carol M.

2013-01-01

159

Methicillin-resistant Staphylococcus aureus (MRSA): a community-based prevalence survey.  

PubMed Central

A prevalence survey of nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage was undertaken on a random sample of adults (aged over 16) resident in the community in Birmingham, UK during 1998. Microbiological samples were taken from the anterior nares at the subjects' general practice or in their home. Information about risk factors for the acquisition of MRSA was obtained via a self-completed questionnaire. A 58% response rate (280/483) was achieved. The prevalence of nasal MRSA colonization was 1.5% [4/274, 95% confidence interval (CI) 0.03-2.9%]. Twenty-three per cent (63/274) of subjects were nasal carriers of S. aureus. Six per cent (4/63) of S. aureus isolates were MRSA and 2 of the 4 MRSA carriers reported previous contact with health facilities. The prevalence of MRSA colonization in the general adult population in Birmingham appears to be low. PMID:11467791

Abudu, L.; Blair, I.; Fraise, A.; Cheng, K. K.

2001-01-01

160

Community-Based Intervention to Manage an Outbreak of MRSA Skin Infections in a County Jail  

PubMed Central

This article describes a community-based intervention to manage an outbreak of communityassociated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections in a midwestern county jail. A systematic investigation conducted by a family medicine residency program identified 64 total cases and 19 MRSA cases between January 1 and December 31, 2007. Factors contributing to MRSA transmission included inadequate surveillance, lack of antibacterial soap, and a defective laundry process. All 19 isolates were CA-MRSA and all seven tested by pulsed-field gel electrophoresis (PFGE) were USA300. Four of the seven isolates showed variation of their PFGE patterns. A primary care approach using community-based resources effectively reduced the number of cases in this heterogeneous outbreak of CA-MRSA, with the last MRSA being isolated in October 2007. PMID:20466702

Elias, Abdallah F.; Chaussee, Michael S.; McDowell, Emily J.; Huntington, Mark K.

2012-01-01

161

Zero tolerance for healthcare-associated MRSA bacteraemia: is it realistic?  

PubMed Central

Background The term ‘zero tolerance’ has recently been applied to healthcare-associated infections, implying that such events are always preventable. This may not be the case for healthcare-associated infections such as methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. Methods We combined information from an epidemiological investigation and bacterial whole-genome sequencing to evaluate a cluster of five MRSA bacteraemia episodes in four patients in a specialist hepatology unit. Results The five MRSA bacteraemia isolates were highly related by multilocus sequence type (ST) (four isolates were ST22 and one isolate was a single-locus variant, ST2046). Whole-genome sequencing demonstrated unequivocally that the bacteraemia cases were unrelated. Placing the MRSA bacteraemia isolates within a local and global phylogenetic tree of MRSA ST22 genomes demonstrated that the five bacteraemia isolates were highly diverse. This was consistent with the acquisition and importation of MRSA from the wider referral network. Analysis of MRSA carriage and disease in patients within the hepatology service demonstrated a higher risk of both initial MRSA acquisition compared with the nephrology service and a higher risk of progression from MRSA carriage to bacteraemia, compared with patients in nephrology or geriatric services. A root cause analysis failed to reveal any mechanism by which three of five MRSA bacteraemia episodes could have been prevented. Conclusions This study illustrates the complex nature of MRSA carriage and bacteraemia in patients in a specialized hepatology unit. Despite numerous ongoing interventions to prevent MRSA bacteraemia in healthcare settings, these are unlikely to result in a zero incidence in referral centres that treat highly complex patients. PMID:24788657

Török, M. Estée; Harris, Simon R.; Cartwright, Edward J. P.; Raven, Kathy E.; Brown, Nicholas M.; Allison, Michael E. D.; Greaves, Daniel; Quail, Michael A.; Limmathurotsakul, Direk; Holden, Matthew T. G.; Parkhill, Julian; Peacock, Sharon J.

2014-01-01

162

Filaggrin loss-of-function mutations and atopic dermatitis as risk factors for hand eczema in apprentice nurses: part II of a prospective cohort study  

PubMed Central

Summary Background/objectives Environmental exposure and personal susceptibility both contribute to the development of hand eczema. In this study, we investigated the effect of loss-of-function mutations in the filaggrin gene (FLG), atopic dermatitis and wet work exposure on the development of hand eczema in apprentice nurses. Methods Dutch apprentice nurses were genotyped for the four most common FLG mutations; atopic dermatitis and hand eczema history were assessed by questionnaire. Exposure and hand eczema during traineeships were assessed with diary cards. Results The prevalence of hand eczema during traineeships was higher among subjects with a history of hand eczema reported at inclusion. Hand washing during traineeships and at home increased the risk of hand eczema. After adjustment for the effects of exposure and FLG mutations, an odds ratio of 2.5 (90% confidence interval 1.7–3.7) was found for a history of atopic dermatitis. In this study, an increased risk of hand eczema conferred by FLG mutations could not be shown, but subjects with concomitant FLG mutations and atopic dermatitis showed the highest risk of hand eczema during traineeships. Conclusion A history of atopic dermatitis, a history of hand eczema and wet work exposure were the most important factors increasing the risk of hand eczema during traineeships. PMID:24102300

Visser, Maaike J; Verberk, Maarten M; Campbell, Linda E; McLean, W H Irwin; Calkoen, Florentine; Bakker, Jan G; van Dijk, Frank J H; Bos, Jan D; Kezic, Sanja

2014-01-01

163

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

PubMed Central

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

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

164

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

PubMed Central

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

Kurosu, Michio; Siricilla, Shajila; Mitachi, Katsuhiko

2013-01-01

165

tst1-positive ST22-MRSA-IVa in healthy Italian preschool children.  

PubMed

A survey was performed in May 2013 to assess methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in healthy children attending 26 municipal daycare centres in Palermo, Italy. Of the 500 children, ten (2 %) tested positive. Eight MRSA isolates were tst1-positive ST22-MRSA-IVa, spa t223; the other two isolates were identified as ST1-IVa and ST398-V, respectively. tst1-positive ST22-MRSA, spa t223 has been previously identified only in the Middle Eastern area. PMID:24448875

Geraci, D M; Bonura, C; Giuffrè, M; Aleo, A; Saporito, L; Graziano, G; Valenti, R M; Mammina, C

2014-06-01

166

Occurrence of MRSA in air and housing environment of pig barns.  

PubMed

A high prevalence of MRSA among farm animals, especially pigs, has been observed for some time. However, knowledge on transmission routes of MRSA in livestock production is still scarce. Therefore, the aim of this study was to determine the occurrence of MRSA in pig house air as well as in samples from pigs and their housing environment in 27 MRSA positive pig barns of different sizes and production types. In 85.2% of all barns MRSA was detected in the animal house air. Impingement turned out to be a more sensitive sampling technique than filtration. Other environmental samples such as boot swabs or faeces showed prevalences of MRSA from 55.6% to 85.2% at sample level. The level of MRSA was 88.3% for pooled and 82.1% for single nasal swabs, in skin swabs the one was 87.7%, the others was 78.7%. Spa typing of isolates from air and nasal swabs showed predominantly spa types t011 and t034. MRSA prevalences in pigs as well as in various environmental samples were significantly higher in fattening farms than in breeding farms. This study provides good reference that there could be an airborne transmission of MRSA within pig herds indicating a potential contamination of the environment of barns. PMID:22386671

Friese, Anika; Schulz, Jochen; Hoehle, Laura; Fetsch, Alexandra; Tenhagen, Bernd-Alois; Hartung, Joerg; Roesler, Uwe

2012-07-01

167

Risk factors and gene type for infections of MRSA in diabetic foot patients in Tianjin, China.  

PubMed

The objective was to study risk factors and gene type of DF patients infected with MRSA. A total of 429 DF patients were recruited. The patients with S aureus infections were divided into MRSA and MSSA groups. MRSA were genotyped by SCCmec. pvl and lukE-lukD were detected. A total of 559 pathogens were isolated from them, with G+ bacteria firstly(59.0%), followed G- bacilli (37.7%) and true fungi (3.3%). The 3 most frequently isolated pathogens were S aureus (35.2%), S epidermidis (12.3%), and Pseudomonas aeruginosa (11.2%). SCCmec III MRSA and SCCmec IVa MRSA had the same antibacterial spectrum. mecA positive rate was 100%. lukE-lukD and pvl positive rates were 100% and 0%, respectively. 28 strains belonged to SCCmec III and the others belonged to SCCmec IVa. The G+ cocci were the main pathogens, S aureus and S epidermidis were predominant among them. Antibiotic usage in 6 months prior to hospitalization, long course of ulcer, osteomyelitis and hypoproteinemia are risk factors for MRSA. SCCmec IVa is high in proportion to MRSA isolates, suggesting that CA-MRSA has become major pathogen of DF infection. All the MRSA were harboring lukE-lukD, which has been reported to present poor leucotoxin compared to pvl, and may be a response to atypical local inflammatory reaction in DF infection. PMID:23771611

Feng, Shu-Hong; Chu, Yue-Jie; Wang, Peng-Hua; Jun, Xu; Min, Ding; Li, Xue-Mei

2013-06-01

168

Dureza del agua de consumo doméstico y prevalencia de eczema atópico en escolares  

Microsoft Academic Search

Water hardness has been associated with atopic eczema (AE) prevalence in two epidemiologic studies carried out on schoolchildren in England and Japan. Objective. To estimate the association between the prevalence of AE and domestic water hardness. Methods. The prevalence of AE was obtained from The International Study of Asthma and Allergies in Child - hood, carried out in six towns

Artero-Civera A; Campos-Cruañes JB; Pac-Sa; Villamarín-Vázquez JL; Rosario Pac-Sa; Jose Luis Villamarín-Vázquez; Carlos Felis-Dauder; Felis-Dauder C. Dureza; Arnedo-Pena A; Bellido-Blasco J; Puig-Barbera J

2007-01-01

169

Serum fatty acid profile does not reflect seafood intake in adolescents with atopic eczema  

PubMed Central

Aim Long-chain polyunsaturated fatty acids (LCPUFAs) are immunomodulatory, but their role in allergy development is controversial. We investigated whether proportions of LCPUFAs in serum phospholipids were related to allergic diagnosis, seafood intake and LCPUFA proportions in cord blood. Methods Serum was obtained from 148 birth cohort children at 13 years of age. Forty had atopic eczema, 53 had respiratory allergy, and 55 were nonallergic. Proportions of LCPUFAs were determined in serum phospholipids; cord blood from 128 of the individuals was previously analysed. Seafood intake was estimated using questionnaires. Results Allergic and nonallergic individuals did not differ significantly regarding individual LCPUFAs. However, arachidonic acid over docosahexaenoic acid (DHA) ratio was higher in allergic, compared with nonallergic, adolescents. In nonallergic individuals, LCPUFA proportions in cord serum and adolescent serum correlated weakly. In individuals with atopic eczema and respiratory allergy, these correlations were weak or absent. A moderate correlation between seafood intake and serum DHA was seen in nonallergic individuals and those with respiratory allergy, but not in those with atopic eczema. Conclusion Serum LCPUFA pattern was similar in allergic and nonallergic adolescents. Fatty acid metabolism may be altered in atopic eczema subjects, suggested by poor correlations between fatty acid intake and serum levels. PMID:24837739

Barman, Malin; Jonsson, Karin; Sandin, Anna; Wold, Agnes E; Sandberg, Ann-Sofie

2014-01-01

170

The immunogenetics of asthma and eczema: a new focus on the epithelium  

Microsoft Academic Search

Asthma and eczema (atopic dermatitis) are the most common chronic diseases of childhood. These diseases are characterized by the production of high levels of immunoglobulin E in response to common allergens. Their development depends on both genetic and environmental factors. Over the past few years, several genes and genetic loci that are associated with increased susceptibility to asthma and atopic

William Cookson

2004-01-01

171

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

PubMed

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

Fatima, Saba; Rafiq, Ali; Majid, Zain

2015-04-01

172

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 ...

173

Role of Virechana Karma in cure and prevention of recurrence of Vicharchika (Eczema)  

PubMed Central

Mandip and Chandola reported that administration of Rasayana (Guduchi and Bhringaraja) after Koshtha Shuddhi with Aragvadha Hima and simultaneous giving of Shirishadi decoction orally and applying of Snuhyadi Lepa externally provided complete remission to 22.6% patients of Vicharchika (Eczema) and checked the recurrences of the disease in the 89.5% patients. As in this group, cure rate was not up to the expectation; therefore, it was thought desirable to see whether performing of Virechana Karma instead of Koshtha Shuddhi prior to the administration of the above drugs enhances the cure rate for the Vicharchika (Eczema) patients. For the present study, 39 patients of Vicharchika (Eczema) were registered, of which 32 patients completed the full course of the treatment. These patients were given Virechana after preparing with the proper internal Snehana, Abhyanga, and Svedana as per classical method. After the Samsarjana Krama, they were administered the Shirishadi decoction and Guduchi-Bhringraja Rasayana powder orally with simultaneous local application of Snuhyadi Lepa on the eczematous lesions. The results of this study showed that when Virechana Karma was performed prior to the administration of Guduchi-Bhringaraja Rasayana and Shirishadi decoction orally and SnuhyadiLepa externally, it not only increased the cure rate to 81.3% in the patients of Vicharchika (Eczema) but also checked the recurrences to great extent as only negligible number of the patients reported the recurrence. PMID:23723667

Kaur, Mandip; Chandola, Harimohan

2012-01-01

174

Pollen Grains Induce a Rapid and Biphasic Eczematous Immune Response in Atopic Eczema Patients  

Microsoft Academic Search

Introduction: Eczematous reactions to type I allergy-inducing antigens are documented in a subgroup of patients with atopic eczema. Yet, the underlying immunological mechanisms are not well understood. Material and Methods: To delineate the effect of native pollen grains on human skin of healthy and atopic individuals we performed patch tests (atopy patch test with native pollen grains, PPT). Nickel patch

Kilian Eyerich; Johannes Huss-Marp; Ulf Darsow; Andreas Wollenberg; Stefanie Foerster; Johannes Ring; Heidrun Behrendt; Claudia Traidl-Hoffmann

2008-01-01

175

Goeckerman Therapy for the Treatment of Eczema: A Practical Guide and Review of Efficacy  

PubMed Central

The Goeckerman regimen, consisting of the application of crude coal tar combined with exposure to ultraviolet radiation, was formulated in 1925 for the treatment of psoriasis. While some centers have adapted the Goeckerman regimen for the treatment of eczema, there are no published reports of its efficacy in this condition. Here, we explain how the Goeckerman regimen has been modified for use in an eczema population at the University of California San Francisco (UCSF). We reviewed the treatment records of eczema patients treated with the modified Goeckerman regimen over a 6 year period at UCSF. We found that the Goeckerman regimen was effective in treating patients with severe baseline disease, inducing a mean remission period of 7.2 months. The treatment was tolerated well with mild folliculitis and occasional UVB phototoxicity noted as the only adverse reactions. Since the use of Goeckerman as a treatment for severe eczema is both effective and safe, it should be considered an excellent alternative or adjunct to the systemic therapies currently being used. PMID:21797807

Dennis, Madison; Bhutani, Tina; Koo, John; Liao, Wilson

2013-01-01

176

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

PubMed Central

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

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

2015-01-01

177

Predictors of clinical and microbiological treatment failure in patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia: a retrospective cohort study in a region with low MRSA prevalence.  

PubMed

Invasive infections with methicillin-resistant Staphylococcus aureus (MRSA) have been associated with increased morbidity and mortality. The aim of the present study was to identify independent predictors of early mortality and treatment failure in patients with MRSA bacteraemia. A total of 132 adult patients who developed MRSA bacteraemia during hospitalization in the University Hospital of Vienna between 2000 and 2011 were screened and 124 were included in a retrospective cohort study. Patient demographics, source of bacteraemia, antimicrobial treatment and microbiological characteristics were evaluated. The 28-day crude mortality was 30.6%. Predictors of early mortality identified in multivariate Cox regression analysis included higher patient age (adjusted hazard ratio (aHR) 1.03, 95% CI 1.01-1.06, p 0.006), pneumonia (aHR 3.86, 95% CI 1.83-8.12, p <0.001) and failure to use MRSA active treatment (aHR 8.77, 95% CI 3.50-21.93, p <0.001). Ninety-one (73.4%) patients received glycopeptides as specific MRSA treatment. Of 63 patients treated with vancomycin, only 14 (22.6%) patients had aimed trough levels of 15-20 mg/L. Vancomycin MIC ?2 mg/L was detected in 28.2% and was associated with glycopeptide pretreatment (p 0.001). All MRSA isolates were susceptible to linezolid and tigecycline. Persistent bacteraemia ?7 days was documented in 25 (20.2%) patients. Independent determinants for microbiological eradication failure in patients with MRSA bacteraemia included endocarditis (p <0.001) and vancomycin trough levels (p 0.014), but not vancomycin MIC. Failure of clinical and microbiological eradication of MRSA among patients with MRSA bacteraemia was associated with clinical entity rather than with bacterial traits. Pharmacokinetic parameters seem to be decisive on microbiological and clinical success. PMID:23490021

Forstner, C; Dungl, C; Tobudic, S; Mitteregger, D; Lagler, H; Burgmann, H

2013-07-01

178

A cosmeceutical formulation based on boswellic acids for the treatment of erythematous eczema and psoriasis  

PubMed Central

Background Boswellic acids (BAs) show anti-inflammatory properties in a variety of inflammatory diseases, including rheumatoid arthritis, osteoarthritis, and asthma. A topical administration route is currently used to deliver active compounds in psoriatic and eczematous patients. In this double-blind study we compare a novel BA formulation (containing Bosexil®, INCI [International Nomenclature of Cosmetic Ingredients]: lecithin, Boswellia serrata resin extract) with a placebo formulation. A third arm of the trial received a formulation of Vaccinium myrtillus seed oil, previously demonstrated as an effective local treatment for psoriatic lesions. Methods Patients with psoriasis or erythematous eczema were randomly assigned, in a 1:1:1 ratio, to Bosexil®, V. myrtillus seed oil, or placebo. In order to evaluate the effects of treatment, the changes of scales and erythema from diagnosis to the end of treatment were scored in psoriatic patients, while changes in itch and erythema were analyzed for erythematous eczema patients. Psoriasis Area Severity Index and Eczema Area and Severity Index scores were also calculated. Results In patients with psoriasis, scales and erythema improved both with Bosexil® and the V. myrtillus seed oil treatment in comparison with placebo. In particular, the treatment with Bosexil® formulation improved scales (70% of cases) and erythema (50% of cases) without any case of worsening. In patients with eczema, the administration of placebo did not result in any improvement in 90% of cases, and in the remaining 10% worsened both itch and erythema. Bosexil® formulation improved both itch (60% of cases) and erythema (60% of cases) without any case of worsening. V. myrtillus seed oil improved itch and erythema in 66.7% and 77.8% of patients, respectively. Conclusion A topical formulation of Bosexil® may be promising for the treatment of psoriasis and erythematous eczema. Long-term studies are recommended to evaluate the adherence to this topical treatment and its clinical benefits in real life. PMID:25419153

Togni, Stefano; Maramaldi, Giada; Di Pierro, Francesco; Biondi, Massimo

2014-01-01

179

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

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

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

2013-01-01

180

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

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

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

2013-01-01

181

How to reduce the negative psychological impact of MRSA isolation on patients.  

PubMed

MRSA is contagious and difficult to treat, and the isolation of infected patients is recommended by the Department of Health. However, isolation can have a negative psychological impact on patients and is controversial. This literature review explores the effects of isolation based on three themes: isolation environment and psychological impact; stigma of MRSA; and nursing care. PMID:21086832

Jones, Donna

182

Methicillin-resistant staphylococcus aureus (MRSA) colonization in patients with spinal cord injury  

Microsoft Academic Search

Methicillin-resistant Staphylococcus aureus (MRSA) colonization has been a problem in the Rancho Los Amigos Medical Center (RLAMC) since 1978. This study reviews the latest 2 years' use of a protocol to prevent the spread of MRSA while allowing spinal cord injured patients to continue to participate in the rehabilitation program. The protocol included management in a private room, bathing with

K Maeder; V J Ginunas; J Z Montgomerie; H N Canawati

1993-01-01

183

The Economic Burden of Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA)  

PubMed Central

The economic impact of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) remains unclear. We developed an economic simulation model to quantify the costs associated with CA-MRSA infection from the societal and third-party payer perspectives. A single CA-MRSA case costs third-party payers $2,277 – $3,200 and society $7,070 – $20,489, depending on patient age. In the United States (US), CA-MRSA imposes an annual burden of $478 million - 2.2 billion on third-party payers and $1.4 billion - 13.8 billion on society, depending on the CA-MRSA definitions and incidences. The US jail system and Army may be experiencing annual total costs of $7 – 11 million ($6 – 10 million direct medical costs) and $15 – 36 million ($14 – 32 million), respectively. Hospitalization rates and mortality are important cost drivers. CA-MRSA confers a substantial economic burden to third-party payers and society, with CA-MRSA-attributable productivity losses being major contributors to the total societal economic burden. Although decreasing transmission and infection incidence would decrease costs, even if transmission were to continue at present levels, early identification and appropriate treatment of CA-MRSA infections before they progress could save considerable costs. PMID:22712729

Lee, Bruce Y.; Singh, Ashima; David, Michael Z.; Bartsch, Sarah M.; Slayton, Rachel B.; Huang, Susan S.; Zimmer, Shanta M.; Potter, Margaret A.; Macal, Charles M.; Lauderdale, Diane S.; Miller, Loren G.; Daum, Robert S.

2012-01-01

184

The Acquisition of Methicillin-resistant Staphylococcus aureus (MRSA) in Vascular Patients  

Microsoft Academic Search

Objective: the aim of this study was to establish at which point during a hospital admission MRSA acquisition occurs in vascular patients.Method: a consecutive series of 100 patients undergoing arterial surgery were screened for MRSA carriage on admission to hospital, on exit from theatre, on discharge from ITU, weekly whilst an inpatient and on hospital discharge. Screening was with moistened

J. M Scriven; P Silva; R. A Swann; M. M Thompson; A. R Naylor; P. R. F Bell; N. J. M London

2003-01-01

185

STAPH AND MRSA RECOGNITION AND PREVENTION What is "Staph" (Staphylococcus aureus)?  

E-print Network

STAPH AND MRSA RECOGNITION AND PREVENTION What is "Staph" (Staphylococcus aureus)? Staphylococcus-resistant Staphylococcus aureus)? In the past, most serious staph bacterial infections were treated with a certain type. These bacteria are called methicillin-resistant Staphylococcus aureus (MRSA). According to the Centers

de Lijser, Peter

186

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

PubMed Central

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

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

2012-01-01

187

The High Diversity of MRSA Clones Detected in a University Hospital in Istanbul  

PubMed Central

Background: To characterize the methicillin-resistant Staphylococcus aureus (MRSA) clones present in Istanbul, 102 MRSA isolates collected during a 5-year period at the Istanbul Medical Faculty Hospital were characterized using microarray analysis and phenotypic resistance profiles. Methods: Resistance to methicillin was detected with a cefoxitin disk diffusion assay and confirmed with a MRSA-agar and MRSA detection kit. Antimicrobial susceptibility testing was performed by a disk diffusion assay and interpreted according to the 2012 guidelines of the Antibiogram Committee of the French Society for Microbiology. Decreased susceptibility to glycopeptides was confirmed using the population analysis profile-area under the curve (PAP-AUC) method. The presence of the mecA gene was detected by polymerase chain reaction. Bacterial DNA was extracted according to the manufacturer's recommended protocol using commercial extraction kits. Strains were extensively characterized using the DNA microarray. Results: Isolates were grouped into six clonal complexes. The most frequently detected clone was the Vienna/Hungarian/Brazilian clone (ST239-MRSA-III), which accounted for 53.9% of the isolates. These isolates were resistant to multiple antibiotics, particularly penicillin, tetracycline, rifampicin, kanamycin, tobramycin, gentamicin, levofloxacin, erythromycin, lincomycin and fosfomycin. Furthermore, three isolates were detected by population analysis profile as heterogeneous vancomycin-intermediate S. aureus (hVISA). The UK-EMRSA-15 clone (ST22-MRSA-IV PVL negative) was detected in 9.8% of the isolates and was mainly susceptible to all anti-staphylococcal antibiotics. Seven isolates (6.9%) were positive for PVL genes and were assigned to the CC80-MRSA-IV clone (European CA-MRSA clone, three isolates), ST8-MRSA-IV clone (USA300 clone, two isolates, one ACME-positive) or ST22-MRSA-IV clone (“Regensburg EMRSA” clone, two isolates). All other clones were detected in one to six isolates and corresponded to well-known clones (e.g., Pediatric clone, Dublin EMRSA clone, WA MRSA-54/63, WA MRSA-1/57). Conclusions: This work highlighted both the high prevalence of ST239-MRSA-III clone and the large diversity of the other MRSA clones detected in a university hospital in Istanbul. PMID:24151444

Oksuz, Lutfiye; Dupieux, Celine; Tristan, Anne; Bes, Michele; Etienne, Jerome; Gurler, Nezahat

2013-01-01

188

High-Density Livestock Production and Molecularly Characterized MRSA Infections in Pennsylvania  

PubMed Central

Background: European studies suggest that living near high-density livestock production increases the risk of sequence type (ST) 398 methicillin-resistant Staphylococcus aureus (MRSA) colonization. To our knowledge, no studies have evaluated associations between livestock production and human infection by other strain types. Objectives: We evaluated associations between MRSA molecular subgroups and high-density livestock production. Methods: We conducted a yearlong 2012 prospective study on a stratified random sample of patients with culture-confirmed MRSA infection; we oversampled patients from the Geisinger Health System with exposure to high-density livestock production in Pennsylvania. Isolates were characterized using S. aureus protein A (spa) typing and detection of Panton-Valentine leukocidin (PVL) and scn genes. We compared patients with one of two specific MRSA strains with patients with all other strains of MRSA isolates, using logistic regression that accounted for the sampling design, for two different exposure models: one based on the location of the animals (livestock model) and the other on crop field application of manure (crop field model). Results: Of 196 MRSA isolates, we identified 30 spa types, 47 PVL-negative and 15 scn-negative isolates, and no ST398 MRSA. Compared with quartiles 1–3 combined, the highest quartiles of swine livestock and dairy/veal crop field exposures were positively associated with community-onset-PVL-negative MRSA (CO-PVL-negative MRSA vs. all other MRSA), with adjusted odds ratios of 4.24 (95% CI: 1.60, 11.25) and 4.88 (95% CI: 1.40, 17.00), respectively. The association with CO-PVL-negative MRSA infection increased across quartiles of dairy/veal livestock exposure (trend p = 0.05). Conclusions: Our findings suggest that other MRSA strains, beyond ST398, may be involved in livestock-associated MRSA infection in the United States. Citation: Casey JA, Shopsin B, Cosgrove SE, Nachman KE, Curriero FC, Rose HR, Schwartz BS. 2014. High-density livestock production and molecularly characterized MRSA infections in Pennsylvania. Environ Health Perspect 122:464–470;?http://dx.doi.org/10.1289/ehp.1307370 PMID:24509131

Casey, Joan A.; Shopsin, Bo; Cosgrove, Sara E.; Nachman, Keeve E.; Curriero, Frank C.; Rose, Hannah R.

2014-01-01

189

DNA methylation of the filaggrin gene adds to the risk of eczema associated with loss-of-function variants  

PubMed Central

Background Loss-of-function variants within the filaggrin gene (FLG) are associated with a dysfunctional skin barrier that contributes to the development of eczema. Epigenetic modifications, such as DNA methylation, are genetic regulatory mechanisms that modulate gene expression without changing the DAN sequence. Objectives To investigate whether genetic variants and adjacent differential DNA methylation within the FLG gene synergistically act on the development of eczema. Methods A subsample (n = 245, only females aged 18 years) of the Isle of Wight birth cohort participants (n = 1,456) had available information for FLG variants R501X, 2282del4, and S3247X and DNA methylation levels for 10 CpG sites within the FLG gene. Log-binomial regression was used to estimate the risk ratios (RRs) of eczema associated with FLG variants at different methylation levels. Results The period prevalence of eczema was 15.2% at age 18 years and 9.0% of participants were carriers (heterozygous) of FLG variants. Of the 10 CpG sites spanning the genomic region of FLG, methylation levels of CpG site ‘cg07548383’ showed a significant interaction with FLG sequence variants on the risk for eczema. At 86% methylation level, filaggrin haploinsufficient individuals had 5.48-fold increased risk of eczema when compared to those with wild type FLG genotype (p-value = 0.0008). Conclusions Our novel results indicated that the association between FLG loss-of-function variants and eczema is modulated by DNA methylation. Simultaneously assessing the joint effect of genetic and epigenetic factors within the FLG gene further highlights the importance of this genomic region for eczema manifestation. PMID:23003573

Ziyab, A. H.; Karmaus, W.; Holloway, J. W.; Zhang, H.; Ewart, S.; Arshad, S. H.

2012-01-01

190

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

PubMed Central

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

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

191

High prevalence of nasal MRSA carriage in slaughterhouse workers in contact with live pigs in The Netherlands  

Microsoft Academic Search

Livestock-associated MRSA has been found in various animals, livestock farmers and retail meat. This study aimed to determine the prevalence and determinants of nasal MRSA carriage in pig slaughterhouse workers. Three large pig slaughterhouses in The Netherlands were studied in 2008 using human and environmental samples. The overall prevalence of nasal MRSA carriage in employees of pig slaughterhouses was 5·6%

Cleef van B. A. G. L; E. M. Broens; A. Voss; X. W. Huijsdens; L. Zuchner; B. H. B. VAN BENTHEM; J. A. J. W. Kluijtmans; M. N. Mulders; A. W. Van De Giessen

2010-01-01

192

Virulence strategies of the dominant USA300 lineage of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious threat to worldwide health. Historically, MRSA clones have strictly been associated with hospital settings, and most hospital-associated MRSA (HA-MRSA) disease resulted from a limited number of virulent clones. Recently, MRSA has spread into the community causing disease in otherwise healthy people with no discernible contact with healthcare environments. These community-associated MRSA clones (CA-MRSA) are phylogenetically distinct from traditional HA-MRSA clones, and CA-MRSA strains seem to exhibit hypervirulence and more efficient host : host transmission. Consequently, CA-MRSA clones belonging to the USA300 lineage have become dominant sources of MRSA infections in North America. The rise of this successful USA300 lineage represents an important step in the evolution of emerging pathogens and a great deal of effort has been exerted to understand how these clones evolved. Here, we review much of the recent literature aimed at illuminating the source of USA300 success and broadly categorize these findings into three main categories: newly acquired virulence genes, altered expression of common virulence determinants and alterations in protein sequence that increase fitness. We argue that none of these evolutionary events alone account for the success of USA300, but rather their combination may be responsible for the rise and spread of CA-MRSA. PMID:22309135

Thurlow, Lance R; Joshi, Gauri S; Richardson, Anthony R

2012-06-01

193

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

PubMed Central

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

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

2012-01-01

194

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

PubMed Central

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

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

2014-01-01

195

Treatment Following an Evidence-Based Algorithm versus Individualised Symptom-Oriented Treatment for Atopic Eczema  

Microsoft Academic Search

Background: Evidence-based treatment algorithms, successfully established for asthma, are missing for atopic eczema (AE). Objectives: To investigate whether treatment according to an evidence-based algorithm is an effective and applicable concept for the management of AE. Methods: Based on a systematic literature review, we developed an evidence-based severity-score-oriented treatment algorithm for AE and compared its effectiveness to that of an individualised

Jochen Schmitt; Michael Meurer; Uta Schwanebeck; Xina Grählert; Knut Schäkel

2008-01-01

196

Clinical and Laboratory Issues in Community-acquired MRSA  

PubMed Central

The prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) has steadily increased over the past 40 years. Today, intravenous clindamycin or vancomycin is recommended for anti-staphylococcal coverage. Failure to identify resistant strains could result in the overuse of vancomycin and subsequent resistance to that antibiotic. Concerns over the emergence of this pathogen has caused many hospital laboratories to reassess their ability to identify antibiogram patterns and epidemiological shifts, determine appropriate laboratory testing, and review empiric therapy guidelines. Reliance on automated instrumentation to detect these isolates can result in major errors that cause false susceptible interpretations. The emergence of methicillin/oxacillin resistant strains has required additional laboratory analysis. This paper will review these tests and will focus on the role of the “D-test” in directing antibiotic therapy. PMID:23118693

Beavers-May, Toni; Jacobs, Richard F.

2004-01-01

197

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

PubMed

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

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

2014-07-10

198

Hailey-Hailey disease associated with herpetic eczema—the value of the Tzanck smear test  

PubMed Central

Background: Herpetic eczema is a herpetic superinfection of a preexisting skin disease. Hailey-Hailey disease is an autosomal dominant dermatosis that is clinically characterized by flaccid vesicles and rashes in intertriginous areas. The coexistence of those findings is a rare condition; only five cases have been published in literature. Purpose: To report the rare coexistence between Hailey-Hailey disease and herpetic eczema and to highlight the importance of cytology for a quick diagnosis. Case report: A 38-year-old man had been diagnosed with Hailey-Hailey disease for 13 years. His condition evolved into what could be herpetic eczema, which was later confirmed by skin cytology and histopathology. The man showed remission in the infection after 10 days under treatment with acyclovir. Conclusion: Research on the concomitance of infection by the herpes virus must be performed in the exacerbations of Hailey-Hailey disease, and, in those situations, the quick diagnosis through skin cytology makes the early treatment possible. PMID:25396081

de Aquino Paulo Filho, Thomás; deFreitas, Yara Kelly Rodrigues; da Nóbrega, Mylenne Torres Andrade; Lima, Carlos Bruno Fernandes; Carriço, Barbara Luiza Medeiros Francelino; Silva, Maria Aurora Pinto Leite e; Paulo, Filipe Lauria; Neto, Pedro Bezerra da Trindade

2014-01-01

199

Methicillin resistant Staphylococcus aureus (MRSA) carriage in different free-living wild animal species in Spain.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) is a life-threatening pathogen in humans and its presence in animals is a public health concern. The aim of this study was to measure the prevalence of MRSA in free-living wild animals. Samples from red deer (n=273), Iberian ibex (n=212), Eurasian Griffon vulture (n=40) and wild boar (n=817) taken from different areas in Spain between June 2008 and November 2011 were analyzed. Characterization of the isolates was performed by spa typing, multi-locus sequence typing (MLST) and antimicrobial susceptibility testing. A low prevalence of MRSA was found with 13 isolates obtained from 12 animals (0.89%; 95% CI: 0.46-1.56). All MRSA sequence types belonged to ST398 (t011 and t1451) and ST1 (t127). Genotypes and antimicrobial susceptibility patterns (tetracycline resistance in ST398 and clindamycin-erythromycin-tetracycline resistance in ST1) suggest that the MRSA found probably originated in livestock (ST398) or humans (ST1). This is the first report of MRSA carriers in free-living wild animals in Europe. Although our data showed that MRSA prevalence is currently low, free-living wild animals might act as reservoir and represent a potential risk for human health. PMID:23846031

Porrero, M Concepción; Mentaberre, Gregorio; Sánchez, Sergio; Fernández-Llario, Pedro; Gómez-Barrero, Susana; Navarro-Gonzalez, Nora; Serrano, Emmanuel; Casas-Díaz, Encarna; Marco, Ignasi; Fernández-Garayzabal, José-Francisco; Mateos, Ana; Vidal, Dolors; Lavín, Santiago; Domínguez, Lucas

2013-10-01

200

[Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) infections in Latin America].  

PubMed

After the first reports of the emergence of MRSA in the 1970s, numerous measures intended to prevent its transmission were initiated in hospitals. However, in most cases, large-scale measures failed to be implemented and the transmission of MRSA has since led to a global pandemic. Presently, doubts still remain about the best approach to prevent and control MRSA and more often than not, control measures are not implemented. Therefore, we review here the current situation in Latin America with respect to existing policies for control of MRSA, and evaluate the evidence for control measures in hospitals and the community. We look at the risk factors for infection and transmission of MRSA between hospital patients and within specific populations in the community, and at the effect of antibiotic usage on the spread of MRSA in these settings. Finally, we summarize recommendations for the prevention and control of MRSA, which can be applied to the Latin American hospital environment and community setting. PMID:21137163

Alvarez, Carlos; Labarca, Jaime; Salles, Mauro

2010-08-01

201

Antimicrobial treatment of nosocomial meticillin-resistant Staphylococcus aureus (MRSA) pneumonia: current and future options.  

PubMed

Meticillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of nosocomial pneumonia. Inadequate or inappropriate antimicrobial therapy, often caused by antimicrobial resistance, is associated with increased mortality for these infections. Agents currently recommended for the treatment of MRSA pneumonia include vancomycin and linezolid in the USA, and vancomycin, linezolid, teicoplanin and quinupristin/dalfopristin in Europe. Antimicrobials such as tigecycline and daptomycin, although approved for the treatment of some MRSA infections, have not demonstrated efficacy equivalent to the approved agents for MRSA pneumonia. Further agents lack data from randomised controlled trials (e.g. fosfomycin, fusidic acid or rifampicin in combination with vancomycin). Antimicrobial agents that have recently been approved or are being investigated as treatments for MRSA infections include the lipoglycopeptides telavancin (approved for the treatment of complicated skin and skin-structure infections in the USA and Canada), dalbavancin and oritavancin, the cephalosporins ceftobiprole and ceftaroline, and the dihydrofolate reductase inhibitor iclaprim. To be an effective treatment for MRSA pneumonia, antimicrobial agents must have activity against antimicrobial-resistant S. aureus, penetrate well into the lung, have a low potential for resistance development and have a good safety profile. Here, the available data for current and potential future MRSA pneumonia antimicrobials are reviewed and discussed. PMID:20724119

Welte, Tobias; Pletz, Mathias W

2010-11-01

202

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

PubMed Central

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

Marshall, Caroline; Richards, Michael; McBryde, Emma

2013-01-01

203

Prevalence and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) among subjects working on bovine dairy farms.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections worldwide and has recently been identified as an emerging pathogen in livestock and companion animals. Livestock-associated MRSA (LA-MRSA) may be responsible for increased rates of colonization and/or infection among people working on farms. We evaluated the prevalence and molecular characteristics of MRSA among dairy farmers in the province of Ragusa, South-Eastern Sicily, their animals and bulk tank milk samples. A surprisingly high number of samples tested positive for MRSA: 36% of human nasal swabs, 61% of bovine nasal swabs and 44% of bulk tank milk samples. MRSA carrier prevalence in humans significantly correlated with the percentage of positive cows on the farm, the number of livestock units and the presence of consensual positive bulk tank milk samples. Prospective studies are needed to investigate MRSA transmission between animals and humans and implement preventive strategies. PMID:23774976

Antoci, Eugenio; Pinzone, Marilia Rita; Nunnari, Giuseppe; Stefani, Stefania; Cacopardo, Bruno

2013-06-01

204

High prevalence of methicillin-resistant Staphylococcus aureus (MRSA) on doctors' neckties.  

PubMed

We set out to investigate whether neckties worn by doctors are more likely to be contaminated with Methicillin resistant Staphylococcus aureus (MRSA) compared to neckties worn by preclinical medical undergraduates who have never been exposed to a hospital environment. We discovered that more than half (52%) of neckties worn by doctors were contaminated with Staphylococcus and out of these, 62% of them were identified as MRSA. In contrast, none of the student's ties were contaminated with MRSA. Due to the high prevalence of staphylococcus detected on doctors' neckties, we recommend that health care workers do not wear neckties. PMID:20527275

Koh, K C; Husni, S; Tan, J E; Tan, C W; Kunaseelan, S; Nuriah, S; Ong, K H; Morad, Z

2009-09-01

205

Knowing prior methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization status increases the empirical use of glycopeptides in MRSA bacteraemia and may decrease mortality.  

PubMed

To compare the management and outcome of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in patients known to be MRSA-colonized/infected (C-patients) with the management and outcome in those not known to be colonized/infected (NC-patients), we conducted a 10-year retrospective review of MRSA bacteraemia in an adult tertiary hospital. Clinical data were obtained by chart review, and mortality data from linked databases. Prior MRSA colonization/infection status was available to treating clinicians at the time of the bacteraemia as a 'Micro-Alert' tag on the patient's labels, in medical charts, and in electronic information systems. C-patients accounted for 35.4% of all MRSA bacteraemia episodes. C-patients were more likely to be indigenous, to be diabetic, or to have a history of previous S. aureus infection. Markers of illness severity (Simplified Acute Physiology Score (SAPS)-II, need for admission to the intensive-care unit, length of stay, and metastatic seeding) were similar in both groups. Empirical therapy included a glycopeptide in 49.3% of C-patients vs. 18.9% of NC-patients (p <0.01), and contained an antibiotic to which the MRSA isolate tested susceptible in vitro in 56.7% of C-patients vs. 45.1% of NC-patients (p 0.13). All-cause 7-day and 30-day mortality were 7.5% vs. 18.9% (p 0.04), and 22.4% vs. 31.1% (p 0.20), in the C-patient and NC-patient groups, respectively. Knowing MRSA colonization status was significantly associated with lower 30-day mortality in Cox regression analysis (p <0.01). These data suggest that mortality from MRSA bacteraemia is lower in C-patients, which may reflect the earlier use of glycopeptides. The low use of empirical glycopeptides in septic patients known to be previously MRSA-colonized/infected may represent a missed opportunity for infection control to positively impact on clinical management. PMID:24224545

Robinson, J O; Phillips, M; Christiansen, K J; Pearson, J C; Coombs, G W; Murray, R J

2014-06-01

206

Early exposure to solid foods and the development of eczema in children up to 4 years of age.  

PubMed

Early exposure to solid foods in infancy has been associated with the development of allergic diseases. However, scientific evidence for this is conflicting. The aim of this study was to examine the association between early exposure to solid foods in the infant's diet and the development of eczema up to 4 years of age. We conducted an etiologic case-control study nested in the PIPO cohort (Prospective Cohort on the Influence of Perinatal Factors on the Occurrence of Asthma and Allergies). In this cohort data on nutrition, environmental exposures and parent-reported eczema were collected prospectively starting from 5 months pregnancy by means of questionnaires administered during two home visits and semi-annual postal questionnaires. In addition, detailed information on the timing of introduction of solid foods at individual food item level was collected at 1 year of age. Adjusted odds ratios and 95% confidence intervals were computed using logistic regression analysis as a measure of association between eczema and the timing of exposure to solid foods. Early introduction (within the first 4 months) of solid foods was inversely associated with eczema up to 4 years of age (adj OR: 0.49; 95% CI: 0.32-0.74). Moreover, we found that early exposure to solid foods was associated with a reduced risk for eczema only among children with allergic parents (adj OR: 0.35; 95% CI: 0.20-0.63), whereas no significant effect was found among children with non-allergic parents (adj OR: 0.69; 95% CI: 0.37-1.29). The results of this study show that early exposure to solid foods is associated with less parent-reported eczema in children, particularly among children with allergic parents. Therefore, the current study does not support a delayed introduction of solid foods for the prevention of eczema in childhood. PMID:19573205

Sariachvili, Manana; Droste, Jos; Dom, Sandra; Wieringa, Marjan; Hagendorens, Margo; Stevens, Wim; van Sprundel, Marc; Desager, Kristien; Weyler, Joost

2010-02-01

207

Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination  

Microsoft Academic Search

The hospital environment can sometimes harbour methicillin-resistant Staphylococcus aureus (MRSA) but is not generally regarded as a major source of MRSA infection. We conducted a prospective study in surgical wards of a London teaching hospital affected by MRSA, and compared the effectiveness of standard cleaning with a new method of hydrogen peroxide vapour decontamination. MRSA contamination, measured by surface swabbing

G. L. French; J. A. Otter; K. P. Shannon; N. M. T Adams; D Watling; M. J Parks

2004-01-01

208

Experimental colonization of pigs with methicillin-resistant Staphylococcus aureus (MRSA): insights into the colonization and transmission of livestock-associated MRSA.  

PubMed

Two models were used for colonizing pigs under experimental conditions. In the first model, six 5-week old piglets were challenged by nasal and gastrointestinal inoculation with a mixture of four strains representing the most prevalent methicillin-resistant Staphylococcus aureus (MRSA) sequence types (ST398, ST9) and spa types (t08, t011, t034, t899) associated with pig farming. In the second model, the vagina of a pregnant sow was inoculated with the same MRSA mixture shortly before farrowing. While MRSA carriage was unstable following nasal-gastrointestinal inoculation of piglets, vaginal inoculation of the sow resulted in persistent carriage of t011-ST398 and t899-ST9 in all newborn piglets. The results from the two models provide evidence that livestock-associated MRSA can efficiently spread by vertical perinatal transmission and that direct colonization of weaned piglets is hampered by unknown host, bacterial or environmental factors. The vaginal inoculation model described in this study represents a useful tool for studying MRSA-host interactions in pigs having the same genetic background. PMID:21156101

Moodley, A; Latronico, F; Guardabassi, L

2011-10-01

209

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

PubMed Central

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

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

210

Structural insights into the anti-methicillin-resistant Staphylococcus aureus (MRSA) activity of ceftobiprole.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) is an antibiotic-resistant strain of S. aureus afflicting hospitals and communities worldwide. Of greatest concern is its development of resistance to current last-line-of-defense antibiotics; new therapeutics are urgently needed to combat this pathogen. Ceftobiprole is a recently developed, latest generation cephalosporin and has been the first to show activity against MRSA by inhibiting essential peptidoglycan transpeptidases, including the ?-lactam resistance determinant PBP2a, from MRSA. Here we present the structure of the complex of ceftobiprole bound to PBP2a. This structure provides the first look at the molecular details of an effective ?-lactam-resistant PBP interaction, leading to new insights into the mechanism of ceftobiprole efficacy against MRSA. PMID:22815485

Lovering, Andrew L; Gretes, Michael C; Safadi, Susan S; Danel, Franck; de Castro, Liza; Page, Malcolm G P; Strynadka, Natalie C J

2012-09-14

211

Staphylococcus aureus (MSSA) and MRSA (CC398) isolated from post-mortem samples from pigs.  

PubMed

There are many reports on the occurrence of Livestock Associated Methicilline resistant Staphylococcus aureus (LA-MRSA, CC398) in healthy pigs. There are however, very few reports of LA-MRSA being associated with pathological lesions in pigs. With this study we try to find the answers to the questions: (1) how often is S. aureus found in post-mortem material from pigs, (2) how many of these isolates are methicillin resistant, (3) are these equally distributed over the years? Here we report the isolation of MRSA and of methicillin sensitive S. aureus (MSSA) from samples derived from post-mortem examinations at the Animal Health Service in The Netherlands in the period from 2003 through October 2008. The MSSA and MRSA described here were isolated from 159 pathological lesions and from 7 submissions of aborted foetuses derived from a total of 116 animals, representing 103 submissions coming from 92 different herds. This is approximately 0.5% of all pigs submitted for post mortem examination in those years. The proportion of pigs from which S. aureus (both MSSA and MRSA) was isolated from, did not increase over the years. MSSA (N=97) and LA-MRSA CC398 (N=18) were present mainly in (peri)arthritis in over 30% of all cases, but were also isolated from internal organs such as lung, brain, spleen, kidneys, heart, indicating septicaemia. Remarkably, one non-CC398 MRSA (ST1) was isolated in a joint and a kidney of one pig. This isolate was resistant to 5 out of 6 antimicrobials tested. There was no significant difference in the type of lesions in which LA-MRSA was found compared to MSSA. The number of antimicrobials these isolates were resistant to, increased rapidly after 2004. LA-MRSA was isolated for the first time in 2005 and then again in 2007 and 2008, suggesting that this is an emerging pathogen. However, due to changes in the panel of antimicrobials used to test S. aureus for antimicrobial susceptibility in 2005 and 2007, the possibility exists that we may have missed some MRSA isolates. LA-MRSA isolates are resistant to at least three but sometimes five out of six antimicrobials tested. All isolates were susceptible to the combination of Trimethoprim/Sulfamethaxol. PMID:22366049

van der Wolf, P J; Rothkamp, A; Junker, K; de Neeling, A J

2012-07-01

212

Clinical usefulness of multiplex PCR lateral flow in MRSA detection: a novel, rapid genetic testing method.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) with exogenous cassette DNA containing the methicillin-resistant gene mecA (SCCmec) poses a problem as a drug-resistant bacterium responsible for hospital- and community-acquired infections. The frequency of MRSA detection has recently been increasing rapidly in Japan, and SCCmec has also been classified more diversely into types I-V. A rapid test is essential for early diagnosis and treatment of MRSA infections, but detection by conventional methods requires at least two days. The newly developed multiplex PCR lateral flow method allows specific amplification of femA to detect S. aureus, mecA to detect SCCmec, and kdpC to detect SCCmec type II; moreover, PCR products can be evaluated visually in about 3 h. In the present study, we developed a PCR lateral flow method for MRSA using this method and investigated its clinical usefulness in the detection of MRSA. The results showed a diagnostic concordance rate of 91.7% for MRSA and methicillin-susceptible S. aureus between bacteriological examination and PCR lateral flow, and a high level of specificity in PCR lateral flow. In addition, a higher detection rate for S. aureus using the same sample was observed for PCR lateral flow (70.2%) than for bacteriological tests (48.6%). The above results show that PCR lateral flow for MRSA detection has high sensitivity, specificity, and speed, and its clinical application as a method for early diagnosis of MRSA infections appears to be feasible. PMID:21994180

Nihonyanagi, Shin; Kanoh, Yuhsaku; Okada, Kiyomi; Uozumi, Toshiki; Kazuyama, Yukumasa; Yamaguchi, Tokiko; Nakazaki, Nobuhiko; Sakurai, Keizou; Hirata, Yasuyoshi; Munekata, Shinichi; Ohtani, Shinichi; Takemoto, Tsuyoshi; Bandoh, Yuki; Akahoshi, Tohru

2012-06-01

213

MRSA carriage in a tertiary governmental hospital in Thailand: emphasis on prevalence and molecular epidemiology  

Microsoft Academic Search

We investigated prevalence and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) in a case-control study performed in a 900-bed tertiary governmental healthcare facility in Bangkok, Thailand. Multivariate\\u000a unconditional logistic regression was used to identify risk profiles for MRSA carriage. Phage typing, pulsed-field gel electrophoresis\\u000a (PFGE), polymorphisms of the coa and spa genes, hypervariable region (HVR) of SCCmec, multi-locus sequence typing

T. Jariyasethpong; C. Tribuddharat; S. Dejsirilert; A. Kerdsin; P. Tishyadhigama; S. Rahule; P. Sawanpanyalert; P. Yosapol; N. Aswapokee

2010-01-01

214

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

PubMed Central

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

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

2015-01-01

215

Chronic hand eczema - self-management and prognosis: a study protocol for a randomised clinical trial  

PubMed Central

Background Hand eczema has a one-year prevalence of approximately 10 % in the general Danish population. Often the disease becomes chronic with numerous implications for the individual’s daily life, occupation and quality of life. However, no guidelines of self-management recommendations beyond the acute stage are given. Self-management of the disease is pivotal and involves self-monitoring of the condition, medication adherence, and preventive behaviour. Interventions best to support the individual in this ongoing process need to be developed. Methods/design This paper describes the design of a randomised clinical trial to test a newly developed intervention of individual counselling versus conventional information. 300 patients consecutively referred to dermatologic treatment at two different settings are individually randomised to either the intervention programme, named ‘The Healthy Skin Clinic’ or to the control group. Block-wise randomisation according to setting and gender is carried out. The intervention offers a tool for self-monitoring; basic and specific individual counselling; the possibility of asynchronous communication with the intervention team; and an electronic patient dialogue forum. Primary outcome variable is objective assessment of the hand eczema severity performed at baseline prior to randomisation, and repeated at six months follow-up. Secondary outcome variables are dermatology related life quality and perceived global burden of disease. Discussion The trial aims at evaluating a newly developed guidance programme which is expected to support self-management of patients referred to dermatology treatment due to chronic hand eczema. The design of the protocol is pragmatic with blinding of neither participants nor the investigator. Thus, in the interpretation of the results, the investigator takes into account effects that may be attributed to actors of the interventions rather than the intervention per se as well of potential observer bias. Inclusion criterions are wide in order to increase transferability of the results. Trial registration The trial is registered in ClinicalTrials.Gov with registration number NCT01482663. PMID:22691871

2012-01-01

216

Hygiene levels in a contemporary population cohort are associated with wheezing and atopic eczema in preschool infants  

PubMed Central

Background: The hygiene hypothesis states that insufficient exposure to certain infectious agents during childhood increases the risk of developing asthma and atopic diseases. Improvements in hygiene levels may be partly responsible for this decline in exposure. Aims: To assess whether hygiene levels in infancy are associated with wheeze and/or atopic eczema, independent of a number of possible confounding factors. Methods: Data were gathered from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental self completion questionnaires provided symptom data on infant wheeze and atopic eczema at 0–6 months and 30–42 months, respectively. A simple hygiene score was derived using questionnaire responses at 15 months, which ranged from least hygienic to most hygienic. Multivariable logistic regression models analysed the effect of hygiene scores on health outcomes, while adjusting for a number of important confounding variables. Results: Increasing hygiene scores were independently associated with wheezing (OR = 1.04; 95% CI: 1.00 to 1.08) and atopic eczema (OR = 1.04; 95% CI: 1.01 to 1.07) between 30 and 42 months, but not in the first six months. The odds ratio was higher for atopic eczema if the rash was reported to have become sore and oozy (OR = 1.09; 95% CI: 1.02 to 1.16). Conclusions: High levels of hygiene at 15 months of age were independently associated with wheeze and atopic eczema reported between 30 and 42 months, and there was an increased risk for children with more severe eczema during this period. The importance of hygiene in public health should not be dismissed; however, the creation of a sterile environment through excessive cleanliness may potentially be harmful to the immune system. PMID:12089117

Sherriff, A; Golding, J; The, A

2002-01-01

217

Mobile Genetic Element SCCmec-encoded psm-mec RNA Suppresses Translation of agrA and Attenuates MRSA Virulence  

PubMed Central

Community acquired-methicillin resistant Staphylococcus aureus (CA-MRSA) is a socially problematic pathogen that infects healthy individuals, causing severe disease. CA-MRSA is more virulent than hospital associated-MRSA (HA-MRSA). The underlying mechanism for the high virulence of CA-MRSA is not known. The transcription product of the psm-mec gene, located in the mobile genetic element SCCmec of HA-MRSA, but not CA-MRSA, suppresses the expression of phenol-soluble modulin ? (PSM?), a cytolytic toxin of S. aureus. Here we report that psm-mec RNA inhibits translation of the agrA gene encoding a positive transcription factor for the PSM? gene via specific binding to agrA mRNA. Furthermore, 25% of 325 clinical MRSA isolates had a mutation in the psm-mec promoter that attenuated transcription, and 9% of the strains had no psm-mec. In most of these psm-mec-mutated or psm-mec-deleted HA-MRSAs, PSM? expression was increased compared with strains carrying intact psm-mec, and some mutated strains produced high amounts of PSM? comparable with that of CA-MRSA. Deletion of psm-mec from HA-MRSA strains carrying intact psm-mec increased the expression of AgrA protein and PSM?, and virulence in mice. Thus, psm-mec RNA suppresses MRSA virulence via inhibition of agrA translation and the absence of psm-mec function in CA-MRSA causes its high virulence property. PMID:23592990

Kaito, Chikara; Saito, Yuki; Ikuo, Mariko; Omae, Yosuke; Mao, Han; Nagano, Gentaro; Fujiyuki, Tomoko; Numata, Shunsuke; Han, Xiao; Obata, Kazuaki; Hasegawa, Setsuo; Yamaguchi, Hiroki; Inokuchi, Koiti; Ito, Teruyo; Hiramatsu, Keiichi; Sekimizu, Kazuhisa

2013-01-01

218

Population Structure of a Hybrid Clonal Group of Methicillin-Resistant Staphylococcus aureus, ST239-MRSA-III  

Microsoft Academic Search

The methicillin-resistant Staphylococcus aureus (MRSA) clonal group known as ST239-MRSA-III is notable for its hybrid origin and for causing sustained hospital epidemics worldwide since the late 1970s. We studied the population structure of this MRSA clonal group using a sample of 111 isolates that were collected over 34 years from 29 countries. Genetic variation was assessed using typing methods and

Davida S. Smyth; Linda K. McDougal; Frode W. Gran; Anand Manoharan; Mark C. Enright; Jae-Hoon Song; Herminia de Lencastre; D. Ashley Robinson; Frank R. Deleo

2010-01-01

219

Vancomycin-Impregnated polymethylmethacrylate beads for methicillin-resistant Staphylococcus aureus (MRSA) infection: Report of two cases  

Microsoft Academic Search

:   Two patients with methicillin-resistant Staphylococcus aureus (MRSA) infection were treated with vancomycin (VCM)-impregnated polymethylmethacrylate (PMMA) beads. One patient, who had\\u000a a history of polycystic kidney and diabetes mellitus, who was receiving hemodialysis due because of non-functional kidney,\\u000a underwent resection of an intermediate grade chondrosarcoma in the pelvis. MRSA infection developed and curettage of the lesion\\u000a was performed, but MRSA

Toshifumi Ozaki; Teruhito Yoshitaka; Toshiyuki Kunisada; Tomoyuki Dan'ura; Noriko Naito; Hajime Inoue

1998-01-01

220

Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Real-Time PCR: A Predictive Tool for Contamination of the Hospital Environment.  

PubMed

OBJECTIVE We sought to determine whether the bacterial burden in the nares, as determined by the cycle threshold (CT) value from real-time MRSA PCR, is predictive of environmental contamination with MRSA. METHODS Patients identified as MRSA nasal carriers per hospital protocol were enrolled within 72 hours of room admission. Patients were excluded if (1) nasal mupirocin or chlorhexidine body wash was used within the past month or (2) an active MRSA infection was suspected. Four environmental sites, 6 body sites and a wound, if present, were cultured with premoistened swabs. All nasal swabs were submitted for both a quantitative culture and real-time PCR (Roche Lightcycler, Indianapolis, IN). RESULTS At study enrollment, 82 patients had a positive MRSA-PCR. A negative correlation of moderate strength was observed between the CT value and the number of MRSA colonies in the nares (r=-0.61; P<0.01). Current antibiotic use was associated with lower levels of MRSA nasal colonization (CT value, 30.2 vs 27.7; P<0.01). Patients with concomitant environmental contamination had a higher median log MRSA nares count (3.9 vs 2.5, P=0.01) and lower CT values (28.0 vs 30.2; P<0.01). However, a ROC curve was unable to identify a threshold MRSA nares count that reliably excluded environmental contamination. CONCLUSIONS Patients with a higher burden of MRSA in their nares, based on the CT value, were more likely to contaminate their environment with MRSA. However, contamination of the environment cannot be predicted solely by the degree of MRSA nasal colonization. Infect Control Hosp Epidemiol 2014;36(1): 34-39. PMID:25627759

Livorsi, David J; Arif, Sana; Garry, Patricia; Kundu, Madan G; Satola, Sarah W; Davis, Thomas H; Batteiger, Byron; Kressel, Amy B

2015-01-01

221

New insights into meticillin-resistant Staphylococcus aureus (MRSA) pathogenesis, treatment and resistance.  

PubMed

Meticillin-resistant Staphylococcus aureus (MRSA) remains one of the principal multiply resistant bacterial pathogens causing serious healthcare-associated and community-onset infections. This paper reviews recent studies that have elucidated the virulence strategies employed by MRSA, key clinical trials of agents used to treat serious MRSA infections, and accumulating data regarding the implications of antibacterial resistance in MRSA for clinical success during therapy. Recent pre-clinical data support a species-specific role for Panton-Valentine leukocidin in the development of acute severe S. aureus infections and have elucidated other virulence mechanisms, including novel modes of internalisation, varying post-invasion strategies (featuring both upregulation and downregulation of virulence factors) and phenotypic switching. Recent double-blind, randomised, phase III/IV clinical trials have demonstrated the efficacy of linezolid and telavancin in hospital-acquired pneumonia (HAP) and complicated skin and skin-structure infections (cSSSIs) caused by MRSA. Tigecycline was non-inferior to imipenem/cilastatin in non-ventilator-associated HAP but was inferior in ventilator-associated pneumonia and has shown a higher rate of death than comparators on meta-analysis. Ceftaroline was clinically and microbiologically non-inferior to vancomycin/aztreonam in the treatment of MRSA cSSSI. Key resistance issues include a rise in vancomycin minimum inhibitory concentrations in MRSA, reports of clonal isolates with linezolid resistance mediated by acquisition of the chloramphenicol/florfenicol resistance gene, and case reports of daptomycin resistance resulting in clinical failure. Novel antimicrobial targets must be identified with some regularity or we will face the risk of untreatable S. aureus infections. PMID:22196394

Gould, Ian M; David, Michael Z; Esposito, Silvano; Garau, Javier; Lina, Gerard; Mazzei, Teresita; Peters, Georg

2012-02-01

222

Universal screening and decolonization for control of MRSA in nursing homes: a cluster randomized controlled study.  

PubMed

OBJECTIVE The risk of carrying methicillin-resistant Staphylococcus aureus (MRSA) is higher among nursing home (NH) residents than in the general population. However, control strategies are not clearly defined in this setting. In this study, we compared the impact of standard precautions either alone (control) or combined with screening of residents and decolonization of carriers (intervention) to control MRSA in NHs. DESIGN Cluster randomized controlled trial SETTING NHs of the state of Vaud, Switzerland PARTICIPANTS Of 157 total NHs in Vaud, 104 (67%) participated in the study. INTERVENTION Standard precautions were enforced in all participating NHs, and residents underwent MRSA screening at baseline and 12 months thereafter. All carriers identified in intervention NHs, either at study entry or among newly admitted residents, underwent topical decolonization combined with environmental disinfection, except in cases of MRSA infection, MRSA bacteriuria, or deep skin ulcers. RESULTS NHs were randomly allocated to a control group (51 NHs, 2,412 residents) or an intervention group (53 NHs, 2,338 residents). Characteristics of NHs and residents were similar in both groups. The mean screening rates were 86% (range, 27%-100%) in control NHs and 87% (20%-100%) in intervention NHs. Prevalence of MRSA carriage averaged 8.9% in both control NHs (range, 0%-43%) and intervention NHs (range, 0%-38%) at baseline, and this rate significantly declined to 6.6% in control NHs and to 5.8% in intervention NHs after 12 months. However, the decline did not differ between groups (P=.66). CONCLUSION Universal screening followed by decolonization of carriers did not significantly reduce the prevalence of the MRSA carriage rate at 1 year compared with standard precautions. Infect Control Hosp Epidemiol 2015;00(0): 1-8. PMID:25782894

Bellini, Cristina; Petignat, Christiane; Masserey, Eric; Büla, Christophe; Burnand, Bernard; Rousson, Valentin; Blanc, Dominique S; Zanetti, Giorgio

2015-04-01

223

Antibacterial activity of extracellular compounds produced by a Pseudomonas strain against methicillin-resistant Staphylococcus aureus (MRSA) strains  

PubMed Central

Background The emergence of multidrug-resistant bacteria is a world health problem. Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA) strains, is one of the most important human pathogens associated with hospital and community-acquired infections. The aim of this work was to evaluate the antibacterial activity of a Pseudomonas aeruginosa-derived compound against MRSA strains. Methods Thirty clinical MRSA strains were isolated, and three standard MRSA strains were evaluated. The extracellular compounds were purified by vacuum liquid chromatography. Evaluation of antibacterial activity was performed by agar diffusion technique, determination of the minimal inhibitory concentration, curve of growth and viability and scanning electron microscopy. Interaction of an extracellular compound with silver nanoparticle was studied to evaluate antibacterial effect. Results The F3 (ethyl acetate) and F3d (dichloromethane- ethyl acetate) fractions demonstrated antibacterial activity against the MRSA strains. Phenazine-1-carboxamide was identified and purified from the F3d fraction and demonstrated slight antibacterial activity against MRSA, and synergic effect when combined with silver nanoparticles produced by Fusarium oxysporum. Organohalogen compound was purified from this fraction showing high antibacterial effect. Using scanning electron microscopy, we show that the F3d fraction caused morphological changes to the cell wall of the MRSA strains. Conclusions These results suggest that P. aeruginosa-produced compounds such as phenazines have inhibitory effects against MRSA and may be a good alternative treatment to control infections caused by MRSA. PMID:23773484

2013-01-01

224

Protocol for a randomised trial on the effect of group education on skin-protective behaviour versus treatment as usual among individuals with newly notified occupational hand eczema – the Prevention of Hand Eczema (PREVEX) Trial  

PubMed Central

Background The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed. Methods/Design Trial design: The PREVEX trial is a randomised, parallel-group, superiority trial. Participants: All individuals from the Capital Region of Denmark and Region Zealand with a suspected occupational skin disorder notified to the National Board of Industrial Injuries between June 2012 and December 2013 are invited to participate in the trial. Inclusion criteria are: self-reported hand eczema and informed consent. Exclusion criteria are: age <18 years or >65 years; permanent exclusion from the workforce; inability to understand the Danish language; any serious medical condition; and lack of written informed consent. We plan to randomise 742 participants. Interventions: The experimental intervention is an educational course in skin-protective behaviour and written information about skin care related to the participants' specific occupation. Also, a telephone hotline is available and a subgroup will be offered a work-place visit. The experimental and the control group have access to usual care and treatment. All participants are contacted every eighth week with questions regarding number of days with sick leave or other absence from work. 12 months after randomisation follow-up is completed. Objective: To assesses the effect of an educational course versus treatment as usual in participants with newly notified occupational hand eczema. Randomisation: Participants are centrally randomised according to a computer-generated allocation sequence with a varying block size concealed to investigators. Blinding: It is not possible to blind the participants and investigators, however, data obtained from registers, data entry, statistical analyses, and drawing of conclusions will be blinded. Outcomes: The three co-primary outcomes, assessed at 12 months, are: total number of self-reported days with sick leave; health-related quality of life; and subjective assessment of hand eczema severity. Explorative outcomes are: self-reported eczema-related sick leave, absence from work registered by the DREAM-register and by self-report, risk behaviour, knowledge of skin protection and performance management (self-efficacy; and self-evaluated ability to self-care). Discussion The PREVEX trial will be the first individually randomised trial to investigate the benefits and harms of group-based education in patients with newly notified occupational hand eczema. Trial registration ClinicalTrials.gov Identifier: NCT01899287 PMID:24245553

2013-01-01

225

Detection of methicillin-resistant Staphylococcus aureus (MRSA) in backyard pigs and their owners, Michigan, USA.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) have been reported in commercially raised pigs and their human handlers, raising concerns of zoonotic transmission. To determine whether MRSA in backyard-raised pigs is commonly transmitted to their human owners, a matched study of this type of pigs and their owners was conducted in selected counties in Michigan. Nasal swabs from matched owner-pig pairs (n = 50 pairs) with a few unmatched pig (n = 3) and human (n = 4) samples were collected and processed using standard isolation and identification protocols. No matched owner-pig pair was found; however, MRSA was isolated from 1/54 (1.9%) human samples and 2/53(3.8%) of the pigs. The single human isolate was not strain type USA100-1100 by pulsed-field gel electrophoresis (PFGE), was sequence type (ST) 8 by multilocus sequence typing (MLST), possessed SCCmec type IVb and agr I and was negative for the Panton-Valentine leukocidin (PVL) toxin gene. The two pig isolates were indistinguishable by PFGE (not USA100-1100), and both isolates were ST5 by MLST, possessed SCCmec type III and agr II and were negative for the PVL gene. Persons raising backyard swine from the selected Michigan counties had MRSA carriage rates similar to that of the general US population, suggesting that their avocational pig exposure did not increase their risk of MRSA. PMID:21914153

Gordoncillo, M J; Abdujamilova, N; Perri, M; Donabedian, S; Zervos, M; Bartlett, P

2012-05-01

226

Staphylococcal Enterotoxin B Affects in vitro IgE Synthesis, Interferon-?, lnterleukin-4 and lnterleukin-5 Production in Atopic Eczema  

Microsoft Academic Search

Peripheral blood mononuclear cells from patients with atopic eczema (AE) stimulated with the ‘superantigen’ Staphylococcus enterotoxin B (SEB) secreted signifïcantly more interleukin (IL)-4 and IL-5 as well as IgE, and markedly less interferon-? than those from healthy controls. Our results support the assumption that SEB produced by S. aureus colonizing the skin of patients with AE may induce expansion of

K. Neuber; K. Steinrücke; J. Ring

1995-01-01

227

The isolation and cultivation of some fungi from soils and pastures associated with facial eczema disease of sheep  

Microsoft Academic Search

Some fungi, isolated from soil and pasture grasses, have been examined in investigations relating to facial eczema disease of sheep.Cultures of fungi were submitted to Ruakura Animal Research Station for the “beaker test”, which had frequently been found to give positive results with toxic grass. A positive test was given by a high-sporing strain of Sporidesmium bakeri Syd., isolated from

R. H. Thornton; D. J. Ross

1959-01-01

228

Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants  

Microsoft Academic Search

OBJECTIVE--To examine the effects of maternal diet during lactation and the use of formula feeds on the development of atopic eczema in infants at risk. DESIGN--Mothers who planned to breast feed exclusively were randomly allocated to either a restricted diet (avoiding milk and other dairy products, eggs, fish, peanuts, and soybeans) or a diet without restrictions. Mothers who did not

R. K. Chandra; S. Puri; A. Hamed

1989-01-01

229

Rapid Detection of Staphylococcus aureus and Methicillin-Resistant S. aureus (MRSA) in Wound Specimens and Blood Cultures: Multicenter Preclinical Evaluation of the Cepheid Xpert MRSA/SA Skin and Soft Tissue and Blood Culture Assays?  

PubMed Central

A multicenter preclinical evaluation was conducted to evaluate the performance of two Cepheid Xpert assays for detection of methicillin-resistant Staphylococcus aureus (MRSA) and S. aureus. Sensitivity was 97.1% and 98.3% for MRSA in wound and blood culture specimens, respectively. Sensitivity was 100% for S. aureus from both specimen types. PMID:19144803

Wolk, D. M.; Struelens, M. J.; Pancholi, P.; Davis, T.; Della-Latta, P.; Fuller, D.; Picton, E.; Dickenson, R.; Denis, O.; Johnson, D.; Chapin, K.

2009-01-01

230

Financial Implications of Plans to Combat Methicillin-Resistant Staphylococcus aureus (MRSA) in an Orthopaedic Department  

PubMed Central

INTRODUCTION The aim of this study was to calculate retrospectively the cost of MRSA infections in the elective and trauma orthopaedic population in Rotherham District General Hospital in a 3-month period during 2005. PATIENTS AND METHODS A total of 686 patients were admitted to the orthopaedic wards and the surgical wounds 10 patients became infected with MRSA. RESULTS The cost of these infections when extrapolated over 12 months was £384,000 excluding staff costs. CONCLUSIONS The key in the fight against MRSA in the hospital setting is multifactorial and requires a combination of measures. Our solution is: cohort nursing; non-selective screening of all admissions to the orthopaedic wards; use of a polymerase chain reaction as a diagnostic tool; ring-fencing of beds; and separate wound dressing rooms for each ward. The total cost is projected to be £301,000. PMID:17959002

Hassan, K; Koh, C; Karunaratne, D; Hughes, C; Giles, SN

2007-01-01

231

Hospital hairdresser as a potential source of cross-infection with MRSA.  

PubMed

Following medical staff concerns about patients screening positive for methicillin-resistant Staphylococcus aureus (MRSA) from the hairline site only, it was suggested that the hospital hairdresser could be a possible source for cross-contamination. Analysis of her procedures and decontamination practices confirmed her to be a potential source. Swabbing of her equipment after a day's session with her normal cleansing practice revealed the presence of MRSA, confirmed by phage typing as an epidemic strain within the hospital. This provided putative evidence for a vehicle of transmission. A review of advice for hairdressers in hospitals was obtained from the literature and via a telephone survey of infection control nurses in London. A composite policy was produced for hairdressers attending MRSA-positive patients in hospital to minimize this potential risk. PMID:11716642

Ruddy, M; Cummins, M; Drabu, Y

2001-11-01

232

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

PubMed Central

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

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

2015-01-01

233

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

PubMed Central

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

2014-01-01

234

Eczema: Complications  

MedlinePLUS

... atopic dermatitis should not receive the currently licensed smallpox vaccine, even if their disease is in remission, ... caused when the live vaccinia virus in the smallpox vaccine reproduces and spreads throughout the body. Furthermore, ...

235

The Standard One Gram Dose of Vancomycin is not Adequate Prophylaxis for MRSA  

PubMed Central

Introduction The indications for vancomycin prophylaxis to prevent Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infections are increasing. The recommended dose of vancomycin has traditionally been 1 gram intravenous. However, the increasing prevalence of obesity in our population coupled with increasing resistance of MRSA to vancomycin has resulted in recent recommendations for weight-based dosing of vancomycin at 15mg/kg. We hypothesize that the standard one gram dose of vancomycin is inadequate to meet the recently recommended dosage of 15mg/kg. Methods We performed a retrospective chart review on 216 patients who were screened positive for MRSA prior to undergoing elective total joint or spine surgeries between January 2009 to January 2012. All patients were given 1 gram of vancomycin within an hour prior to surgical incision as prophylaxis. Using the revised dosing protocol of 15mg/kg of body weight for vancomycin, proper dosage was calculated for each patient. These values were then compared to the 1 gram dose given to the patients at time of surgery. Patients were assessed as either underdosed (a calculated weight-based dose >1 gram) or overdosed (a calculated weight-based dose <1 gram). Additionally, we used actual case times and pharmacokinetic equations to determine the vancomycin (VAN) levels at the end of the procedures. Results Out of 216 patients who tested positive for MRSA, 149 patients (69%) were determined to be underdosed and 22 patients (10%) patients were determined to be overdosed. The predicted VAN level at the end of procedure was <15 mg/L in 60% of patients with 1 gram dose compared to 12% (p=0.0005) with weight base dose. Six patients developed post-operative MRSA surgical site infections (SSI). Of these six patients; four had strains of MRSA with vancomycin minimum inhibitory concentration of >1.0mg/L. Based on 1g dosing, 5/6 patients with MRSA positive SSIs had wound closure levels of <15 mg/L and all six were <20 mg/L. Conclusion In settings such as hospitals, where the risk for resistant bacteria, especially MRSA, is high, it is becoming increasingly important to accurately dose patients who require vancomycin. In order to avoid incorrect dosing of vancomycin health care providers must use weight-based dosing. PMID:25328469

Catanzano, Anthony; Phillips, Michael; Dubrovskaya, Yanina; Hutzler, Lorraine; Bosco, Joseph

2014-01-01

236

Das Problem der MRSA-Infektionen bei der Behandlung des Diabetischen Fußsyndroms  

Microsoft Academic Search

Zusammenfassung  \\u000a An Hand eines ausgewählten Patientenkollektivs wurde das Phänomen der Kolonisation\\/Infektion von Patienten der Klinik für\\u000a Technische Orthopädie und Rehabilitation (TO) am Universitätsklinikum Münster (UKM) mit Methicillin-resistenten Staphylococcusaureus-Stämmen\\u000a (MRSA) retrospektiv erfasst. Das Untersuchungskollektiv setzt sich aus 28 Patienten zusammen,bei denen im Untersuchungszeitraum\\u000a (Januar 1997 bis Juni 2000) MRSA mikrobiologisch nachgewiesen wurde.16 Patienten waren lediglich kolonisiert, bei 12 Patienten\\u000a konnte eine

C. Hornberg; T. R. Schäfer; A. Koller; H. H. Wetz

2003-01-01

237

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...

238

Analysis of nosocomial outbreaks with multiply and methicillin-resistant Staphylococcus aureus (MRSA) in Germany: Implications for hospital hygiene  

Microsoft Academic Search

Summary Two outbreaks of nosocomial infections with MRSA, one in a urological unit in connection with transurethral prostatectomy and the other in an orthopaedic clinic with infections after implantation of prosthetic hips, have been analyzed on the basis of typing MRSA by phagepatterns, plasmid profiles and genomic DNA fragment patterns. Main reasons for these outbreaks were obviously mistakes in hospital

W. Witte; Christine Braulke; D. Heuck; Christa Cuny

1994-01-01

239

Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature  

Microsoft Academic Search

Objective To evaluate the evidence for the effectiveness of isolation measures in reducing the incidence of methicillin resistant Staphylococcus aureus (MRSA) colonisation and infection in hospital inpatients. Design Systematic review of published articles. Data sources Medline, Embase, CINAHL, Cochrane Library, System for Information on Grey Literature in Europe (SIGLE), and citation lists (1966-2000). Review methods Articles reporting MRSA related outcomes

B S Cooper; S P Stone; C C Kibbler; B D Cookson; J A Roberts; G F Medley; G Duckworth; R Lai; S Ebrahim

2004-01-01

240

Livestock-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) as Causes of Human Infection and Colonization in Germany  

PubMed Central

Pigs, cattle and poultry are colonized with MRSA and the zoonotic transmission of such MRSA to humans via direct animal contact, environmental contaminations or meat are a matter of concern. Livestock-associated (LA) MRSA are mostly belonging to clonal complex (CC) 398 as defined by multilocus sequence typing. However, MRSA of other clonal lineages including CC5, CC9 and CC97 have also been detected in livestock animals in Germany. Within the framework of a Dutch-German network project (EUREGIO), 14,036 MRSA isolated from clinical and screening specimens (January 2008 - June 2012) derived from human patients in hospitals as well as general or specialized practices in a German region characterized by a high density of livestock production, were subjected to S. aureus protein A (spa) sequence typing. The prevalence of putative LA-MRSA among the human MRSA isolates was determined by analyzing the detection of livestock-indicator (LI) spa types which had already been reported in German livestock. Overall, 578 spa types were detected among the MRSA isolates. LI spa types t011, t034, t108, t1451, t2011, t571, t1456, t1250, t1255, t1580, t2970, t2346, t1344, t2576, t2330 and t2510 (all of which are indicative for LA-MRSA CC398) accounted for 18.6% of all human isolates. The LI spa types t1430 (CC9), t3992 (CC97), t002 (CC5) and t007 (CC30) were found in 0.14%, 0.01%, 1.01% and 0.04% of all human MRSA isolates, respectively. LI spa types associated with CC398 represented 23% of all MRSA from screening samples and a varying proportion among isolates from clinical specimens ranging between 0% in cerebrospinal fluid, 8% in blood cultures and 14% in deep respiratory fluids. Our findings indicate that LA-MRSA are a major cause for human infection and stress the need for close surveillance. Although LA-MRSA CC398 predominates, the occurrence of putative LA-MRSA from other clonal lineages should be monitored. PMID:23418434

Köck, Robin; Schaumburg, Frieder; Mellmann, Alexander; Köksal, Mahir; Jurke, Annette; Becker, Karsten; Friedrich, Alexander W.

2013-01-01

241

Admission prevalence and acquisition of nasal carriage of meticillin-resistant Staphylococcus aureus (MRSA) in German rehabilitation centres.  

PubMed

This prospective multi-centre study assessed nasal colonization with meticillin-resistant Staphylococcus aureus (MRSA) among patients on admission to and discharge from 11 rehabilitation centres in Germany. On admission, 71 of 5896 patients (1.2%) carried MRSA. History of MRSA carriage [odds ratio (OR) 4.3, 95% confidence interval (CI) 1.8-10.6], hospitalization within the previous six months (OR 2.5, 95% CI 1.2-5.2), contact with pigs (OR 22.5, 95% CI 11.1-45.7) and presence of chronic wounds (OR 4.7, 95% CI 1.9-12.0) were independently associated with MRSA. On discharge, 0.3% of the patients had acquired MRSA. PMID:24792577

Köck, R; Winner, K; Schaumburg, F; Jurke, A; Rossen, J W; Friedrich, A W

2014-06-01

242

Controlled Evaluation of the IDI-MRSA Assay for Detection of Colonization by Methicillin-Resistant Staphylococcus aureus in Diverse Mucocutaneous Specimens  

Microsoft Academic Search

Rapid and reliable detection of methicillin-resistant Staphylococcus aureus (MRSA) carriers is crucial for the effective control of MRSA transmission in healthcare facilities. The aim of this study was to verify the performance of the IDI-MRSA real-time PCR assay for direct MRSA detection in diverse mucocutaneous swabs from hospitalized patients. Swabs from nares (n 522) and skin or other superficial sites

Nour de San; Olivier Denis; Marie-Fabrice Gasasira; Ricardo De Mendonca; Claire Nonhoff; Marc J. Struelens

2007-01-01

243

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

PubMed

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

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

2014-07-01

244

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

PubMed Central

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

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

245

Improved Exposure Characterization with Robotic (PIPER) Sampling and Association with Children's Respiratory Symptoms, Asthma and Eczema  

PubMed Central

Background/objectives 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 particulate matter a recently developed methodology has been employed. The goal of this study is 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 through improved correlation with respiratory symptoms in young children. Methods Seventy-five households with children between 3-59 months of age were recruited from clinics in central New Jersey. Demographic information and 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. Results Univariate and multivariate analyses were carried out. History of wheeze [’recent’ (<1 year) and ’ever’], cough, asthma, and eczema were 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 to measurements by SIM (Odds Ratio = 0.7; 95% Confidence Interval 0.2 – 2.6). Conclusions Measurement of PM and its constituents with PIPER are more strongly associated with asthma, eczema and wheeze than 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

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

2015-01-01

246

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

PubMed Central

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

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

247

Gene-Environment Interaction in the Onset of Eczema in Infancy: Filaggrin Loss-of-Function Mutations Enhanced by Neonatal Cat Exposure  

Microsoft Academic Search

BackgroundLoss-of-function variants in the gene encoding filaggrin (FLG) are major determinants of eczema. We hypothesized that weakening of the physical barrier in FLG-deficient individuals may potentiate the effect of environmental exposures. Therefore, we investigated whether there is an interaction between FLG loss-of-function mutations with environmental exposures (pets and dust mites) in relation to the development of eczema.Methods and FindingsWe used

Hans Bisgaard; Angela Simpson; Colin N. A Palmer; Klaus Bønnelykke; Irwin Mclean; Somnath Mukhopadhyay; Christian B Pipper; Liselotte B Halkjaer; Brian Lipworth; Jenny Hankinson; Ashley Woodcock; Adnan Custovic

2008-01-01

248

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

ERIC Educational Resources Information Center

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…

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

2008-01-01

249

Decolonization of Children After Incision and Drainage for MRSA Abscess: A Retrospective Cohort Study.  

PubMed

Background/Purpose. Whether decolonization following incision and drainage (I&D) for methicillin-resistant Staphylococcus aureus (MRSA) abscess decreases repeat I&D and MRSA-positive cultures in children is unknown. Materials/Methods. Referral to the Pediatric Infectious Disease Service (PIDS) for decolonization was determined for eligible children (2003-2010), with outcomes studied over 12 months. Results. We identified 653 children; 54 had been seen by PIDS. In the PIDS group, no patients (0/54, 0%) had a repeat I&D. In the no PIDS group 36/599 (6%) had a repeat I&D, P = .06. Logistic regression modeling for repeat I&D showed no significant effect, odds ratio = 0.29; 95% confidence interval = 0.04-2.15; P = .23. In the PIDS group, 3 patients (3/54, 5.6%) had a repeat MRSA-positive culture. In the no PIDS group, 58/599 (9.7%) had a positive repeat culture, P = .46. Logistic regression modeling for positive culture showed no significant effect (odds ratio = 0.55; 95% confidence interval = 0.17-1.81; P = .32). Conclusions. We detected no statistically significant association between decolonization and repeat I&D or MRSA-positive culture. PMID:25385929

Finnell, S Maria E; Rosenman, Marc B; Christenson, John C; Downs, Stephen M

2014-11-10

250

Managing skin and soft-tissue infection and nosocomial pneumonia caused by MRSA: a 2014 follow-up survey.  

PubMed

As a follow-up to our 2009 survey, in order to explore opinion and practice on the epidemiology and management of meticillin-resistant Staphylococcus aureus (MRSA) in Europe, we conducted a second survey to elicit current opinions on this topic, particularly around antibiotic choice, dose, duration and route of administration. We also aimed to further understand how the management of MRSA has evolved in Europe during the past 5 years. Members of an expert panel of infectious diseases specialists convened in London (UK) in January 2014 to identify and discuss key issues in the management of MRSA. Following this meeting, a survey was developed comprising 36 questions covering a wide range of topics on MRSA complicated skin and soft-tissue infection and nosocomial pneumonia management. The survey instrument, a web-based questionnaire, was sent to the International Society of Chemotherapy for distribution to registered European infection societies and their members. This article reports the survey results from the European respondents. At the time of the original survey, the epidemiology of MRSA varied significantly across Europe and there were differing views on best practice. The current findings suggest that the epidemiology of healthcare-associated MRSA in Europe is, if anything, even more polarised, whilst community-acquired MRSA has become much more common. However, there now appears to be a much greater knowledge of current treatment/management options, and antimicrobial stewardship has moved forward considerably in the 5 years since the last survey. PMID:25867210

Dryden, Matthew; Andrasevic, Arjana Tambic; Bassetti, Matteo; Bouza, Emilio; Chastre, Jean; Baguneid, Mo; Esposito, Silvano; Giamarellou, Helen; Gyssens, Inge; Nathwani, Dilip; Unal, Serhat; Voss, Andreas; Wilcox, Mark

2015-04-24

251

Survey of policy for MRSA screening in English cataract surgical units and changes to practice after updated National guidelines  

PubMed Central

Background National guidelines on MRSA (methicillin-resistant Staphylococcus aureus) screening policy in England have changed on a number of occasions, but there is limited data on its influence at a local level. The aim of this study was to determine if changes in National policy influenced preoperative screening of cataract patients for MRSA. Methods A structured telephone survey was conducted on all 133 ophthalmology units in England in 2004 and again in 2007 for the initial responders, after a change in national policy. Results A total of 74 units (56%) responded in 2004 and 71 units (96% of initial respondents) in 2007. In 2004, 57% of units screened for MRSA. They screened groups at high risk of carriage, including patients with previous MRSA (93%) and patients from Nursing homes (21%). Swab sites included the nose (100%), eyes (31%) and perineum (62%). In 2007, there was no significant change in the number of units that screened for MRSA (57% vs 66%; p?=?0.118; McNemar test). However, more units screened for MRSA in patients from nursing/residential homes (21% vs 51%; p?=?0.004, McNemar test), and in patients who had recent admission to hospital (12% vs 36%; p?=?0.003). In the second survey, 3 units (6%) now screened patients who were close relatives of MRSA carriers. Conclusion This survey has highlighted inconsistences in MRSA screening practice of day-case cataract surgery patients across England after 2 major national policy changes. A change in DoH policy only led to more units screening patients for MRSA from high risk groups. PMID:24341357

2013-01-01

252

Clinical effectiveness of rapid tests for methicillin resistant Staphylococcus aureus (MRSA) in hospitalized patients: a systematic review  

PubMed Central

Background Methicillin resistant Staphylococcus aureus (MRSA) are often resistant to multiple classes of antibiotics. The research objectives of this systematic review were to evaluate the clinical effectiveness of polymerase chain reaction (PCR) versus chromogenic agar for MRSA screening, and PCR versus no screening for several clinical outcomes, including MRSA colonization and infection rates. Methods An electronic literature search was conducted on studies evaluating polymerase chain reaction techniques and methicillin (also spelled meticillin) resistant Staphylococcus aureus that were published from 1993 onwards using Medline, Medline In-Process & Other Non-Indexed Citations, BIOSIS Previews, and EMBASE. Due to the presence of heterogeneity in the selected studies, the clinical findings of individual studies were described. Results Nine studies that compared screening for MRSA using PCR versus screening using chromogenic agar in a hospital setting, and two studies that compared screening using PCR with no or targeted screening were identified. Some studies found lower MRSA colonization and acquisition, infection, and transmission rates in screening with PCR versus screening with chromogenic agar, and the turnaround time for screening test results was lower for PCR. One study reported a lower number of unnecessary isolation days with screening using PCR versus screening with chromogenic agar, but the proportion of patients isolated was similar between both groups. The turnaround time for test results and number of isolation days were lower for PCR versus chromogenic agar for MRSA screening. Conclusions The use of PCR for MRSA screening demonstrated a lower turnaround time and number of isolation days compared with chromogenic agar. Given the mixed quality and number of studies (11 studies), gaps remain in the published literature and the evidence remains insufficient. In addition to screening, factors such as the number of contacts between healthcare workers and patients, number of patients attended by one healthcare worker per day, probability of colonization among healthcare workers, and MRSA status of hospital shared equipment and hospital environment must be considered to control the transmission of MRSA in a hospital setting. PMID:22151575

2011-01-01

253

Maternal body mass index in early pregnancy and offspring asthma, rhinitis and eczema up to 16 years of age  

PubMed Central

Background Maternal obesity has been linked to offspring asthma; however, other allergy-related diseases, as well as the association beyond early school age, are largely unstudied. Objective To examine the associations between maternal body mass index (BMI) in pregnancy and offspring asthma, rhinitis, eczema and sensitization up to 16 years of age. Methods A total of 3294 children from the Swedish birth cohort BAMSE were included in the analyses. Maternal BMI was assessed around week 10 in pregnancy. Information on asthma, rhinitis, eczema, lifestyle factors and environmental exposures was obtained by parental questionnaires at 1, 2, 4, 8, 12 and 16 years. Sensitization was defined from IgE levels of inhalant allergens at 4, 8 and 16 years in a subsample of 2850 children. Generalized estimated equation models were used to analyse the associations between maternal BMI and the outcomes at 1–16 years. Results Maternal BMI was positively associated with overall risk of asthma up to age of 16 years (adj OR per 5 kg/m2 increase: 1.23; 95% CI 1.07–1.40 for prevalent asthma) excluding underweight mothers. In contrast, no significant associations were found for rhinitis, eczema or sensitization. The association with asthma was restricted to obese, rather than overweight mothers, but was attenuated when adjusting for overweight in the offspring. A causal inference test at 16 years further indicated that the child’s own overweight is a mediator in the suggested association between maternal BMI and offspring asthma at 16 years. Conclusions and Clinical Relevance Maternal BMI is associated with an increased risk of asthma, but not rhinitis, eczema or sensitization; however, overweight in the offspring seems to have a mediating role. Prevention strategies of maternal pre-pregnancy and childhood obesity might be important to reduce the prevalence of childhood asthma. PMID:24807420

Ekström, S; Magnusson, J; Kull, I; Lind, T; Almqvist, C; Melén, E; Bergström, A

2015-01-01

254

Eczema and food allergy in an Italian pediatric cohort: no association with TLR-2 and TLR-4 polymorphisms.  

PubMed

Recent studies have indicated that Toll-like receptor polymorphisms or their impaired signalling, specifically TLR-2 and TLR-4, were correlated with a higher risk for allergy. The purpose of this study is to evaluate the associations of TRL-2 and TRL-4 single nucleotide polymorphisms (SNP) and atopic traits in a cohort of 159 Italian allergic children (102 affected by eczema and 57 by IgE-mediated food allergy) and 147 healthy controls recruited in Rome, Italy. DNA was isolated from the peripheral blood and TLR-2 R753Q/TLR-4 D299G polymorphisms were determined by TaqMan MGB probes using Real-Time PCR technique. In the control group, the TLR-2 polymorphism R753Q had a prevalence of 2.5% while the frequency of the TLR-4 D299G was 12%. None of the 159 allergic patients showed the R753Q SNP. By contrast, 7/57 patients with food allergy (12%) and 6/102 subjects with eczema (6%) carried the TLR-4 mutation. In our cohort, no evidence of correlation between TLR-2 or TLR-4 polymorphism and eczema and food allergy incidence and/or severity was found. Further studies are needed to clarify the possible role of TLR-2 and TLR-4 polymorphism in allergic disease, in Italian children. PMID:20646366

Galli, E; Ciucci, A; Cersosimo, S; Pagnini, C; Avitabile, S; Mancino, G; Delle Fave, G; Corleto, V D

2010-01-01

255

Local rhamnosoft, ceramides and L-isoleucine in atopic eczema: a randomized, placebo controlled trial  

PubMed Central

Background A non-steroidal, anti-inflammatory moisturizing cream containing rhamnosoft, ceramides, and L-isoleucine (ILE) (pro-AMP cream) has been recently developed for the specific treatment of atopic eczema (AE) of the face. In this trial, we evaluated the clinical efficacy and tolerability of pro-AMP cream in the treatment of facial AE in children in comparison with an emollient cream. Methods In a randomized, prospective, assessor-blinded, parallel groups (2:1) controlled trial, 107 children (72 allocated to pro-AMP cream and 35 allocated to control group) with mild-to-moderate chronic AE of the face were enrolled. Treatments were applied twice daily for a 6-week period. Facial Eczema Severity Score (ESS) was evaluated at baseline, week 3, and week 6, by an assessor unaware of treatment allocation. Investigator's Global Assessment (IGA) score was assessed at week 3 and at week 6. Tolerability was evaluated at week 3 and at week 6 using a 4-point score (from 0: low tolerability to 3: very good tolerability). Results At baseline ESS, mean (SD) was 6.1 (2.4) in the pro-AMP cream group and 5.3 (3) in the control group. In the pro-AMP group, in comparison with baseline, ESS was significantly reduced to 2.5 (?59%) after 3 wks and to 1.0 (?84%) at week 6 (p = 0.0001). In the control group, ESS was reduced to 3 (?42%) at week 2 and to 2.6 (?50%) at week 6. At week 6, ESS in pro-AMP cream was significantly lower than the control group (1.0 vs. 2.6; p = 0.001). Both products were well tolerated. Conclusion Pro-AMP cream has shown to be effective in the treatment of mild-to-moderate chronic lesion of AE of the face. Clinical efficacy was greater in comparison with an emollient cream. (Clinical trial Registry: NTR4084). PMID:24750568

Marseglia, Alessia; Licari, Amelia; Agostinis, Fabio; Barcella, Antonio; Bonamonte, Domenico; Puviani, Mario; Milani, Massimo; Marseglia, GianLuigi

2014-01-01

256

Integrated, multidisciplinary care for hand eczema: design of a randomized controlled trial and cost-effectiveness study  

PubMed Central

Background The individual and societal burden of hand eczema is high. Literature indicates that moderate to severe hand eczema is a disease with a poor prognosis. Many patients are hampered in their daily activities, including work. High costs are related to high medical consumption, productivity loss and sick leave. Usual care is suboptimal, due to a lack of optimal instruction and coordination of care, and communication with the general practitioner/occupational physician and people involved at the workplace. Therefore, an integrated, multidisciplinary intervention involving a dermatologist, a care manager, a specialized nurse and a clinical occupational physician was developed. This paper describes the design of a study to investigate the effectiveness and cost-effectiveness of integrated care for hand eczema by a multidisciplinary team, coordinated by a care manager, consisting of instruction on avoiding relevant contact factors, both in the occupational and in the private environment, optimal skin care and treatment, compared to usual, dermatologist-led care. Methods The study is a multicentre, randomized, controlled trial with an economic evaluation alongside. The study population consists of patients with chronic, moderate to severe hand eczema, who visit an outpatient clinic of one of the participating 5 (three university and two general) hospitals. Integrated, multidisciplinary care, coordinated by a care manager, including allergo-dermatological evaluation by a dermatologist, occupational intervention by a clinical occupational physician, and counselling by a specialized nurse on optimizing topical treatment and skin care will be compared with usual care by a dermatologist. The primary outcome measure is the cumulative difference in reduction of the clinical severity score HECSI between the groups. Secondary outcome measures are the patient's global assessment, specific quality of life with regard to the hands, generic quality of life, sick leave and patient satisfaction. An economic evaluation will be conducted alongside the RCT. Direct and indirect costs will be measured. Outcome measures will be assessed at baseline and after 4, 12, 26 and 52 weeks. All statistical analyses will be performed on the intention-to-treat principle. In addition, per protocol analyses will be carried out. Discussion To improve societal participation of patients with moderate to severe hand eczema, an integrated care intervention was developed involving both person-related and environmental factors. Such integrated care is expected to improve the patients' clinical signs, quality of life and to reduce sick leave and medical costs. Results will become available in 2011. PMID:19951404

2009-01-01

257

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

PubMed Central

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

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

2015-01-01

258

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...

259

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...

260

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

PubMed Central

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

2014-01-01

261

Sensitizations to allergens of TRUE test in 864 consecutive eczema patients in Israel.  

PubMed

The TRUE test is a widespread diagnostic tool for initial patch testing of patients with contact dermatitis (CD). From 2002 to 2005, 864 patients with eczema were patch-tested using TRUE test in one Israeli allergology clinic. 547 (63.3%) patients were female and 317 (36.7%) were male. 346 (40%) patients had > or =1 positive patch test reactions. The most common allergens were nickel sulfate for 114 (13.2%) patients, potassium dichromate 111 (12.8%), fragrance mix 59 (6.8%), cobalt chloride 12 (1.4%), ethylenediamine dihydrochloride 11 (1.3%), epoxy resin 11 (1.3%), balsam of Peru 9 (1.0%), carba mix 7 (0.8%), thiomersal 6 (0.7%), wool alcohol 5 (0.6%), black rubber (PPD) mix 5 (0.6%), neomycin 4 (0.5%); Kathon CG, Colophony and Quaternium 15 - each 2 (0.2%), other allergens - each 1 (0.1%). In male patients, carba mix, black rubber (PPD) mix and epoxy resin sensitivity was more frequent, whereas nickel sulfate, fragrance mix, ethylenediamine dihydrochloride and cobalt chloride sensitivity was significantly more frequent in female patients. Our results are in general agreement with previously published reports, excluding the low sensitivity rates to cobalt, which maybe is missed by TRUE test. PMID:17101019

Magen, Eli; Mishal, Joseph; Schlesinger, Menachem

2006-12-01

262

Percutaneous Curettage and Continuous Irrigation for MRSA Lumbar Spondylodiscitis: A Report of Three Cases  

PubMed Central

There has been a recent increase in pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus (MRSA) associated with an increasing number of compromised patients. As long as serious paralysis is absent, we recommend percutaneous curettage and continuous irrigation as an effective treatment for MRSA lumbar spondylodiscitis. Under local anesthesia, the affected lumbar discs were curetted using percutaneous nucleotomy, and tubes were placed for continuous irrigation. The period of continuous irrigation was generally 2 weeks. Infection was controlled after one procedure in two cases and after two procedures in one case. Postoperative radiography and magnetic resonance imaging (MRI) showed callus formation, normalized signal intensity in vertebral bodies, and regression of abscesses. Open surgery under general anesthesia has been considered risky in patients with poor performance status or old age. The present method, which is an application of needle biopsy, can be performed under local anesthesia and is minimally invasive. PMID:19718264

Yamagami, Yoshiki; Shibuya, Sei; Komatsubara, Satoshi; Yamamoto, Tetsuji; Arima, Nobuo

2009-01-01

263

Community-acquired MRSA pyomyositis: case report and review of the literature.  

PubMed

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is responsible for a broad range of infections. We report the case of a 46-year-old gentleman with a history of untreated, uncomplicated Hepatitis C who presented with a 2-month history of back pain and was found to have abscesses in his psoas and right paraspinal muscles with subsequent lumbar spine osteomyelitis. Despite drainage and appropriate antibiotic management the patient's clinical condition deteriorated and he developed new upper extremity weakness and sensory deficits on physical exam. Repeat imaging showed new, severe compression of the spinal cord and cauda equina from C1 to the sacrum by a spinal epidural abscess. After surgical intervention and continued medical therapy, the patient recovered completely. This case illustrates a case of CA-MRSA pyomyositis that progressed to lumbar osteomyelitis and a spinal epidural abscess extending the entire length of the spinal canal. PMID:21461362

Olson, Douglas P; Soares, Sarita; Kanade, Sandhya V

2011-01-01

264

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

PubMed

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

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

2015-01-01

265

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

PubMed Central

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

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

2014-01-01

266

Ceftobiprole medocaril is an effective treatment against methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis in a rat model.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis after median sternotomy is a major complication of cardiac surgery with significant morbidity and mortality rates. We evaluated the efficacy of ceftobiprole medocaril in a new rat model of mediastinitis and compared it to vancomycin. The model was induced in 92 rats. Infection was induced immediately after median sternotomy by the injection of MRSA (strain 3020, 1?×?10(7) cfu/rat) into the sternal bone. After 24 h, rats (groups of 6-8) were treated intraperitoneally for 5 days or 14 days by either: (i) saline (control, q8h), (ii) ceftobiprole medocaril (70 or 100 mg/kg, q8h), or (iii) vancomycin (50 mg/kg, q12h). Efficacy was determined by a reduction in bacterial cfu in the sternum and spleen tissues. Comparisons were performed using the Mann-Whitney test. A 5-day treatment course of ceftobiprole at both doses tested lead to a significant reduction in MRSA load in the sternum (p?MRSA from the sternum, similarly to vancomycin. Ceftobiprole also showed a significant effect on eliminating MRSA dissemination to the spleen compared to saline-treated rats. Ceftobiprole was effective in treating MRSA mediastinitis in the rat model. In the 5-day course, ceftobiprole showed a significant reduction in sternal MRSA counts and was superior to vancomycin. After 14 days, both ceftobiprole and vancomycin showed clearance of MRSA from the sternum in more than 50 % of rats and almost complete clearance in the remainder. PMID:24030718

Barnea, Y; Navon-Venezia, S; Kuzmenko, B; Artzi, N; Carmeli, Y

2014-03-01

267

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

PubMed

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

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

268

The Nonantibiotic Small Molecule Cyslabdan Enhances the Potency of ?-Lactams against MRSA by Inhibiting Pentaglycine Interpeptide Bridge Synthesis  

PubMed Central

The nonantibiotic small molecule cyslabdan, a labdan-type diterpene produced by Streptomyces sp. K04-0144, markedly potentiated the activity of the ?-lactam drug imipenem against methicillin-resistant Staphylococcus aureus (MRSA). To study the mechanism of action of cyslabdan, the proteins that bind to cyslabdan were investigated in an MRSA lysate, which led to the identification of FemA, which is involved in the synthesis of the pentaglycine interpeptide bridge of the peptidoglycan of MRSA. Furthermore, binding assay of cyslabdan to FemB and FemX with the function similar to FemA revealed that cyslabdan had an affinity for FemB but not FemX. In an enzyme-based assay, cyslabdan inhibited FemA activity, where as did not affected FemX and FemB activities. Nonglycyl and monoglycyl murein monomers were accumulated by cyslabdan in the peptidoglycan of MRSA cell walls. These findings indicated that cyslabdan primarily inhibits FemA, thereby suppressing pentaglycine interpeptide bridge synthesis. This protein is a key factor in the determination of ?-lactam resistance in MRSA, and our findings provide a new strategy for combating MRSA. PMID:23166602

Koyama, Nobuhiro; Tokura, Yuriko; Münch, Daniela; Sahl, Hans-Georg; Schneider, Tanja; Shibagaki, Yoshio; Ikeda, Haruo; Tomoda, Hiroshi

2012-01-01

269

In vitro activity of beta-lactam antibiotics to community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA).  

PubMed

Community-associated (CA) MRSA often display low MIC values against oxacillin. The in vitro activity of various beta-lactam antibiotics against heterogeneous CA-MRSA (n?=?98) isolated in a low endemic area was determined by Etest, and Mueller-Hinton agar (MUHAP) was compared with Mueller-Hinton agar supplemented with 2% NaCl (MUHSP). In general, the CA-MRSA isolates showed higher MIC values for the various beta-lactam antibiotics on MUHSP compared with MUHAP. MIC values for oxacillin ranged from 1 to >256 mg/L on MUHSP. Cephalothin, representing the first generation of cephalosporins, showed MICs from 0.75 to 96 mg/L and the MIC(50) and MIC(90) for cefuroxime, cefotaxime and cefepime, representing the second, third and fourth generations, respectively, were rather high. However, the MIC(50) and MIC(90) for ceftobiprole (fifth generation) were 1.5 and 2 mg/L, respectively, on MUHSP. The MIC(50) and MIC(90) for imipenem were 0.75 and 2 mg/L, respectively, on MUHSP. Only 3/98 (3%) CA-MRSA isolates showed a MIC >4 mg/L. Consequently, low MIC values for imipenem, lower than those of the newly developed fifth generation cephalosporins, were found among CA-MRSA. These findings may be considered for further studies including clinical trials in order to evaluate carbapenems as a potential treatment option for infections caused by CA-MRSA. PMID:21932140

Germel, C; Haag, A; Söderquist, B

2012-04-01

270

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

PubMed

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

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

2014-12-23

271

Determination of the antibiofilm, antiadhesive, and anti-MRSA activities of seven Salvia species  

PubMed Central

Background: Several Salvia species are indigenous to Jordan and are widely used as beverages and spices and for their medicinal properties. The objective of the study was to establish the antimicrobial activities, including the antiadhesive and antibiofilm effects of seven different Salvia species. Materials and Methods: Methods used for planktonic culture included agar diffusion, broth microdilution, and minimal biocidal concentration determination while viable count was used for the determination of the antibiofilm and antiadhesion activities. Overnight cultures of reference strains of Candida albicans, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus and clinical strains of methicillin-resistant S. aureus (MRSA) were used as test microorganisms. Results: An antimicrobial activity toward planktonic cultures demonstrated a significant bacteriocidal activity (?4 log cycle reduction) for the S. triloba extract against S. aureus including MRSA. Its volatile oil exhibited an antimicrobial activity covering all tested microorganisms with the exception of P. aeruginosa. S. triloba extract and volatile oil were successful in preventing and controlling the biofilm, demonstrating antiadhesion and antibiofilm activities, respectively. Conclusion: These reported activities for S. triloba extract and volatile oil allows their listing as potential antibiofilm and anti-MRSA natural agents. This might suggest their use as an antiseptic in the prophylaxis and treatment of S. aureus-associated skin infections. The antimicrobial activity of the other tested Salvia species was negligible. PMID:21120026

Al-Bakri, Amal G.; Othman, Ghadeer; Afifi, Fatma U.

2010-01-01

272

Economic evaluation of treatment for MRSA complicated skin and soft tissue infections in Glasgow hospitals.  

PubMed

In the UK, methicillin-resistant Staphylococcus aureus (MRSA)-associated skin and soft tissue infections (SSTIs) are predominantly managed in the hospital using intravenous (IV) glycopeptides. We set out to explore the potential for and relative healthcare costs of earlier hospital discharge through switch to oral antibiotic therapy (linezolid or rifampicin and doxycycline) or continuation of IV therapy (teicoplanin) via an outpatient parenteral antimicrobial therapy (OPAT) service. Over 16 months, 173 patients were retrospectively identified with MRSA SSTI, of whom 82.8 % were treated with IV therapy. Thirty-seven patients were potentially suitable for earlier discharge with outpatient therapy. The model assumed 3 days of inpatient management and a maximum of 14 days of outpatient therapy. For the status quo, where patients received only inpatient care with IV therapy, hospital costs were calculated at £12,316 per patient, with 97 % of costs accounted for by direct bed day costs. The mean total cost savings achievable through OPAT or oral therapy was estimated to be £6,136 and £6,159 per patient treated, respectively. A significant proportion of patients with MRSA SSTI may be suitable for outpatient management with either oral therapy or via OPAT, with the potential for significant reduction in healthcare costs. PMID:23995977

Seaton, R A; Johal, S; Coia, J E; Reid, N; Cooper, S; Jones, B L

2014-03-01

273

Control of spread of Methicillin Resistant Staphylococcus aureus (MRSA) in Burns Units.  

PubMed

Results of four years' studies from a number of hospitals in Kenya have shown that nosocomial infections in burns units are due to Methicillin Resistant Staphylococcus aureus (MRSA). Through chromosomal DNA and plasmid DNA, the stain is highly resistant to sulphonamide ointment and other antibiotics. 90% of patients admitted in burns units get colonized or infected with MRSA. The strain prolongs the duration of patients in hospitals. The burns degenerate to second and third degree burns, thereby necessitating skin grafting. The environment has been found to be contaminated with this strain with some staff members having chronic throat infections. Minocycline was found to be effective in treating the infected staff members. Cleaning this environment with Sodium dichloroisocyanurate (precepts)/Sodium hypochlorite (JIK) reduced drastically the mechanical transmission of bacteria in the units. The duration of stay of the patient was reduced. This shows that MRSA which is spread in government and private hospitals can cheaply be controlled by the proper use of disinfectants, antiseptics, and use of effective antibiotics when necessary. PMID:12160450

Muthotho, James N.; Waiyaki, Peter G.; Mbalu, Michael; Wairugu, Anne; Mwanthi, Beth; Odongo, Ben

1995-02-01

274

MRSA: a density-equalizing mapping analysis of the global research architecture.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) has evolved as an alarming public health thread due to its global spread as hospital and community pathogen. Despite this role, a scientometric analysis has not been performed yet. Therefore, the NewQIS platform was used to conduct a combined density-equalizing mapping and scientometric study. As database, the Web of Science was used, and all entries between 1961 and 2007 were analyzed. In total, 7671 entries were identified. Density equalizing mapping demonstrated a distortion of the world map for the benefit of the USA as leading country with a total output of 2374 publications, followed by the UK (1030) and Japan (862). Citation rate analysis revealed Portugal as leading country with a rate of 35.47 citations per article, followed by New Zealand and Denmark. Country cooperation network analyses showed 743 collaborations with US-UK being most frequent. Network citation analyses indicated the publications that arose from the cooperation of USA and France as well as USA and Japan as the most cited (75.36 and 74.55 citations per collaboration article, respectively). The present study provides the first combined density-equalizing mapping and scientometric analysis of MRSA research. It illustrates the global MRSA research architecture. It can be assumed that this highly relevant topic for public health will achieve even greater dimensions in the future. PMID:25272080

Addicks, Johann P; Uibel, Stefanie; Jensen, Anna-Maria; Bundschuh, Matthias; Klingelhoefer, Doris; Groneberg, David A

2014-01-01

275

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

PubMed Central

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

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

2013-01-01

276

Synergism between Medihoney and rifampicin against methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

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

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

2013-01-01

277

Methicillin-resistant Staphylococcus aureus (MRSA)-active metabolites from Platanus occidentalis (American Sycamore).  

PubMed

One known and three new potent, selective, and nontoxic anti-MRSA metabolites, kaempferol 3-O-alpha-l-(2'',3''-di-E-p-coumaroyl)rhamnoside (1) (IC(50) 2.0 microg/mL), kaempferol 3-O-alpha-l-(2''-E-p-coumaroyl-3''-Z-p-coumaroyl)rhamnoside (2) (IC(50) 0.8 microg/mL), kaempferol 3-O-alpha-l-(2''-Z-p-coumaroyl-3''-E-p-coumaroyl)rhamnoside (3) (IC(50) 0.7 microg/mL), and kaempferol 3-O-alpha-l-(2'',3''-di-Z-p-coumaroyl)rhamnoside (4) (IC(50) 0.4 microg/mL), were isolated from the leaves of the common American sycamore, Platanus occidentalis. Compounds 2-4 are new. Due to the unusual selectivity, potency, and safety of the pure compounds and the semipure glycoside mixture against MRSA, it is clear that this represents a viable class of inhibitors to prevent growth of MRSA on surfaces and systemically. PMID:19904995

Ibrahim, Mohamed A; Mansoor, Arsala A; Gross, Amanda; Ashfaq, M Khalid; Jacob, Melissa; Khan, Shabana I; Hamann, Mark T

2009-12-01

278

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

PubMed Central

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

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

279

MRSA: A Density-Equalizing Mapping Analysis of the Global Research Architecture  

PubMed Central

Methicillin-resistant Staphylococcus aureus (MRSA) has evolved as an alarming public health thread due to its global spread as hospital and community pathogen. Despite this role, a scientometric analysis has not been performed yet. Therefore, the NewQIS platform was used to conduct a combined density-equalizing mapping and scientometric study. As database, the Web of Science was used, and all entries between 1961 and 2007 were analyzed. In total, 7671 entries were identified. Density equalizing mapping demonstrated a distortion of the world map for the benefit of the USA as leading country with a total output of 2374 publications, followed by the UK (1030) and Japan (862). Citation rate analysis revealed Portugal as leading country with a rate of 35.47 citations per article, followed by New Zealand and Denmark. Country cooperation network analyses showed 743 collaborations with US-UK being most frequent. Network citation analyses indicated the publications that arose from the cooperation of USA and France as well as USA and Japan as the most cited (75.36 and 74.55 citations per collaboration article, respectively). The present study provides the first combined density-equalizing mapping and scientometric analysis of MRSA research. It illustrates the global MRSA research architecture. It can be assumed that this highly relevant topic for public health will achieve even greater dimensions in the future. PMID:25272080

Addicks, Johann P.; Uibel, Stefanie; Jensen, Anna-Maria; Bundschuh, Matthias; Klingelhoefer, Doris; Groneberg, David A.

2014-01-01

280

Distinct SPINK5 and IL-31 polymorphisms are associated with atopic eczema and non-atopic hand dermatitis in Taiwanese nursing population.  

PubMed

The term 'hand dermatitis' describes inflammatory skin condition localized to the hands. Nurses working at hospital settings are prone to develop hand dermatitis. The current study aimed to evaluate whether certain genetic polymorphisms were associated with the development of atopic eczema or non-atopic hand dermatitis in Taiwanese population. Nurses of Kaohsiung Medical University Hospital were recruited. Atopic eczema, non-atopic hand dermatitis and normal control groups were identified. The serine protease inhibitor Kazal type 5 (SPINK5), filaggrin and interleukin-31 (IL-31) gene variants were compared between the diseased and control groups. Our results showed that rs2303070 T allele of SPINK5 (assuming recessive model; OR=3.58, 95% CI 1.63-7.84; P=0.0014) and rs7977932?G allele of IL-31 (assuming recessive model; OR=18.25, 95% CI?=3.27-101.94; P=0.0009) were associated with increased risks of developing atopic eczema, while rs6892205?G allele of SPINK5 (assuming dominant model; OR=3.79, 95% CI 1.55-9.28; P=0.0036) was associated with the development of non-atopic hand dermatitis. In summary, our results showed that distinct SPINK5 and IL-31 gene variants were associated with the development of atopic eczema and non-atopic hand dermatitis. The barrier function, particularly those regulated by SPINK5, may play an important role in the development of both atopic eczema and non-atopic hand dermatitis. PMID:22017185

Lan, Cheng-Che E; Tu, Hung-Pin; Wu, Ching-Shuang; Ko, Ying-Chin; Yu, Hsin-Su; Lu, Yi-Wei; Li, Wan-Chen; Chen, Yin-Chun; Chen, Gwo-Shing

2011-12-01

281

[Are mothers of children with neurodermatitis psychologically conspicuous? Critique and replication of a study of the "psychosomatic aspects of the parent-child relationship in pediatric atopic eczema"].  

PubMed

A study concerning some "psychosomatic aspects of the parent-child relationship and atopic eczema in childhood" was published in this journal in 1986 [8]. The authors concluded that mothers of children suffering from atopic eczema "were shown to be less 'spontaneous', more 'under control' and less 'emotional' than the normal population." They showed "characteristic features indicating difficulties in emotional relationships with their children." These conclusions were based on the answers of 14 mothers to a popular German personality questionnaire (Freiburger Persönlichkeitsinventar, FPI). We analyzed the investigation cited, judged it to be unsatisfactory and attempted to duplicate the study. Two parallel samples of mothers with healthy and ill children (n = 50 and n = 47) were tested with the same questionnaire. The previous results could not be verified. Therefore, we reject the interpretation that mothers of children suffering from atopic eczema have unique psychological characteristics. PMID:7591765

Langfeldt, H P

1995-09-01

282

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

PubMed

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

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

2013-07-01

283

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

PubMed Central

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

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

2014-01-01

284

Successful joint arthroplasty after treatment of destructive MRSA arthritis of the knee using antibiotic-loaded hydroxyapatite blocks: a case report  

Microsoft Academic Search

Methicillin-resistant Staphylococcus aureus (MRSA) septic arthritis is frequently associated with a poor clinical outcome. Joint reconstruction may be worth attempting\\u000a in patients with a history of persistent MRSA infection. Here we report an unusual case of MRSA septic arthritis of the knee\\u000a joint that was treated successfully by joint replacement after initial placement of antibiotic-loaded hydroxyapatite (HA)\\u000a blocks.

Kazu Matsumoto; Mansho Itokazu; Shuichi Uemura; Iori Takigami; Toshitaka Naganawa; Katsuji Shimizu

2007-01-01

285

The bactericidal effect of 470-nm light and hyperbaric oxygen on methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

It has been shown that, in vitro, hyperbaric oxygen (HBO) suppresses 28 % bacterial growth, while 470-nm blue light alone suppresses up to 92 % methicillin-resistant Staphylococcus aureus (MRSA) in one application in vitro. Therefore, we determined if combined 470-nm light (55 J/cm(2)) and HBO will yield 100 % bacterial suppression in experimental simulation of mild, moderate or severe MRSA infection. We cultured MRSA at 3?×?10(6), 5?×?10(6), 7?×?10(6), 8?×?10(6), or 12?×?10(6) CFU/ml and treated each concentration in four groups as follows: (1) control (no treatment) (2) photo-irradiation only, (3) photo-irradiation then HBO, (4) HBO only, and (5) HBO then photo-irradiation. Bacteria colonies were then quantified. The results showed that at each bacterial concentration, HBO alone was significantly less effective in suppressing MRSA than photo-irradiation or combined HBO and photo-irradiation (p??0.05), neither did HBO treatment either before or after irradiation make a difference. Furthermore, at no bacterial concentration was 100 % MRSA suppression achieved. Indeed, the maximum bacterial suppression attained was in the mild infection model (3?×?10(6) CFU/ml), with blue light producing 97.3?±?0.2 % suppression and HBO?+?55 J/cm(2) yielding 97.5?±?2.5 % suppression. We conclude that (1) HBO and 470-nm light individually suppress MRSA growth; (2) 470-nm blue light is more effective in suppressing MRSA than HBO; and (3) HBO did not act synergistically to heighten the bactericidal effect of 470-nm light. PMID:25700768

Bumah, Violet Vakunseh; Whelan, Harry Thomas; Masson-Meyers, Daniela Santos; Quirk, Brendan; Buchmann, Ellen; Enwemeka, Chukuka Samuel

2015-04-01

286

Production of a compound against methicillin resistant Staphylococcus aureus (MRSA) from Streptomyces rubrolavendulae ICN3 & its evaluation in zebrafish embryos  

PubMed Central

Background & objectives: Antibiotic resistance in pathogens has become a serious problem worldwide. Therefore, the search for new antibiotics for drug resistanct pathogens is an important endeavor. The present study deals with the production of anti-methicillin resistant Staphylococcus aureus (MRSA) potential of Streptomyces rubrolavendulae ICN3 and evaluation of anti-MRSA compound in zebrafish embryos. Methods: The antibiotic production from S. rubrolavendulae ICN3 was optimized in solid state fermentation and extracted. The antagonistic activity was confirmed against MRSA and purified in silica gel column and reverse phase - HPLC with an absorption maximum at 215 nm. Minimal inhibitory concentration of the compound was determined by broth microdilution method. Zebrafish embryos were used to evaluate the extract/compound for its minimal inhibition studies, influences on heart beat rates, haematopoietic blood cell count and lethal dose values. Results: Streptomyces rubrolavendulae ICN3 showed potent antagonistic activity against MRSA with a zone of 42 mm. The minimum inhibitory concentration was calculated as 500 ?g/ml of the crude extract and the purified C23 exhibited 2.5 ?g/ml in in vitro assay. The LC50 value of the anti MRSA compound C23 was calculated as 60.49 ?g/ml and the MRSA treated embryos survived in the presence of purified compound C23 at a dose of 10 ?g/ml. Interpretation & conclusions: Our results suggested that the compound was potent with less toxic effects in zebrafish embryonic model system for MRSA infection. Further structural evaluation and analysis in higher mammalian model system may lead to a novel drug candidate for drug resistant Staphylococcus aureus. PMID:25109726

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

2014-01-01

287

Rapid and robust phylotyping of spa t003, a dominant MRSA clone in Luxembourg and other European countries  

PubMed Central

Background spa typing is a common genotyping tool for methicillin-resistant Staphylococcus aureus (MRSA) in Europe. Given the high prevalence of dominant clones, spa-typing is proving to be limited in its ability to distinguish outbreak isolates from background isolates. New molecular tools need to be employed to improve subtyping of dominant local MRSA strains (e.g., spa type t003). Methods Phylogenetically critical, or canonical, SNPs (can-SNPs) were identified as subtyping targets through sequence analysis of 40 MRSA whole genomes from Luxembourg. Real-time PCR assays were designed around target SNPs and validated using a repository of 240 previously sub-typed and epidemiologically characterized Luxembourg MRSA isolates, including 153 community and hospital isolates, 69 isolates from long term care (LTC) facilities, and 21 prospectively analyzed MRSA isolates. Selected isolates were also analyzed by whole genome SNP typing (WGST) for comparison to the SNP assays and other subtyping techniques. Results Fourteen real-time PCR assays were developed and validated, including two assays to determine presence of spa t003 or t008. The other twelve assays successfully provided a high degree of resolution within the t003 subtype. WGST analysis of the LTC facility isolates provided greater resolution than other subtyping tools, identifying clusters indicative of ongoing transmission within LTC facilities. Conclusions canSNP-based PCR assays are useful for local level MRSA phylotyping, especially in the presence of one or more dominant clones. The assays designed here can be easily adapted for investigating t003 MRSA strains in other regions in Western Europe. WGST provides substantially better resolution than other typing methods. PMID:23879266

2013-01-01

288

Trends in annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in HIV-infected and HIV-uninfected patients.  

PubMed

We describe trends in incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected and HIV-uninfected patients enrolled in a large northern California Health Plan, and the ratio of MRSA to methicillin-susceptible S. aureus (MSSA) case counts. Between 1995 and 2010, 1549 MRSA infections were diagnosed in 14060 HIV-infected patients (11·0%) compared to 89546 MRSA infections in 6597396 HIV-uninfected patients (1·4%) (P = 0·00). A steady rise in MRSA infection rates began in 1995 in HIV-uninfected patients, peaking at 396·5 infections/100000 person-years in 2007. A more rapid rise in MRSA infection rates occurred in the HIV-infected group after 2000, peaking at 3592·8 infections/100000 in 2005. A declining trend in MRSA rates may have begun in 2008-2009. Comparing the ratio of MRSA to MSSA case counts, we observed that HIV-infected patients shouldered a greater burden of MRSA infection during most years of study follow-up compared to HIV-uninfected patients. PMID:23419708

Delorenze, G N; Horberg, M A; Silverberg, M J; Tsai, A; Quesenberry, C P; Baxter, R

2013-11-01

289

Interactive effect of STAT6 and IL13 gene polymorphisms on eczema status: results from a longitudinal and a cross-sectional study  

PubMed Central

Background Eczema is a prevalent skin disease that is mainly characterized by systemic deviation of immune response and defective epidermal barrier. Th2 cytokines, such as IL-13 and transcription factor STAT6 are key elements in the inflammatory response that characterize allergic disorders, including eczema. Previous genetic association studies showed inconsistent results for the association of single nucleotide polymorphisms (SNPs) with eczema. Our aim was to investigate whether SNPs in IL13 and STAT6 genes, which share a biological pathway, have an interactive effect on eczema risk. Methods Data from two independent population-based studies were analyzed, namely the Isle of Wight birth cohort study (IOW; n?=?1,456) and for the purpose of replication the Swansea PAPA (Poblogaeth Asthma Prifysgol Abertawe; n?=?1,445) cross-sectional study. Log-binomial regressions were applied to (i) account for the interaction between IL13 (rs20541) and STAT6 (rs1059513) polymorphisms and (ii) estimate the combined effect, in terms of risk ratios (RRs), of both risk factors on the risk of eczema. Results Under a dominant genetic model, the interaction term [IL13 (rs20541)?×?STAT6 (rs1059513)] was statistically significant in both studies (IOW: adjusted Pinteraction?=?0.046; PAPA: Pinteraction?=?0.037). The assessment of the combined effect associated with having risk genotypes in both SNPs yielded a 1.52-fold increased risk of eczema in the IOW study (95% confidence interval (CI): 1.05 – 2.20; P?=?0.028) and a 2.01-fold higher risk of eczema (95% CI: 1.29 – 3.12; P?=?0.002) in the PAPA study population. Conclusions Our study adds to the current knowledge of genetic susceptibility by demonstrating for the first time an interactive effect between SNPs in IL13 (rs20541) and STAT6 (rs1059513) on the occurrence of eczema in two independent samples. Findings of this report further support the emerging evidence that points toward the existence of genetic effects that occur via complex networks involving gene-gene interactions (epistasis). PMID:23815671

2013-01-01

290

Risk factors for MRSA infection in companion animals: results from a case-control study within Germany.  

PubMed

Increasing numbers of companion animals suffering from infections with methicillin-resistant Staphylococcus aureus (MRSA) have been reported in the recent past. These infections are of particular concern because of the limited treatment options for MRSA and their transferability to humans. Since MRSA lineages isolated from infected companion animals often mirror typical human epidemic strains circulating in the same region, successful strategies to combat MRSA need strong and coordinated efforts from both, the human and the veterinary field according to the "One Health" concept. Hence, to identify potential risk factors related to MRSA infections in dogs, cats and horses, a case-control study was conducted, including data on 106 MRSA-infected animal patients as cases and 102 MSSA-infected animals as controls, originating from 155 different veterinary settings within Germany. Demographic data on animal patients, patient history and administration of antibiotics as well as practice/clinic specific parameters were assessed as putative risk factors. Multivariable logistic regression identified the following variables as risk factors for MRSA infection compared to MSSA infection: number of employees working at the veterinary setting (n>10; p<0.001), antibiotic treatment prior to sampling (systemic: p=0.002; local: p=0.049, both: p=0.011) and surgical site infection (p<0.001). Spa typing revealed predominantly clonal complexes well-known for hospital-associated lineages spreading in human health-care settings in Germany (CC5 and CC22) for isolates of dog and cat origin. CC398-MRSA dominated among equine isolates, a CC that was described as a nosocomial pathogen in equine clinical settings before. The identified risk factors and genotyping results are in accordance with numerous study outcomes from the field of human medicine and point towards reasonable problems with nosocomial spread of MRSA, especially within companion animal veterinary clinics. To define targeted infection control strategies against nosocomial pathogens, it is important to accomplish intervention studies addressing routes of transmission in companion animal veterinary settings. PMID:25130703

Vincze, Szilvia; Brandenburg, Anja G; Espelage, Werner; Stamm, Ivonne; Wieler, Lothar H; Kopp, Peter A; Lübke-Becker, Antina; Walther, Birgit

2014-10-01

291

Methicillin-resistant Staphylococcus aureus (MRSA) pyruvate kinase as a target for bis-indole alkaloids with antibacterial activities.  

PubMed

Novel classes of antimicrobials are needed to address the emergence of multidrug-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA). We have recently identified pyruvate kinase (PK) as a potential novel drug target based upon it being an essential hub in the MRSA interactome (Cherkasov, A., Hsing, M., Zoraghi, R., Foster, L. J., See, R. H., Stoynov, N., Jiang, J., Kaur, S., Lian, T., Jackson, L., Gong, H., Swayze, R., Amandoron, E., Hormozdiari, F., Dao, P., Sahinalp, C., Santos-Filho, O., Axerio-Cilies, P., Byler, K., McMaster, W. R., Brunham, R. C., Finlay, B. B., and Reiner, N. E. (2011) J. Proteome Res. 10, 1139-1150; Zoraghi, R., See, R. H., Axerio-Cilies, P., Kumar, N. S., Gong, H., Moreau, A., Hsing, M., Kaur, S., Swayze, R. D., Worrall, L., Amandoron, E., Lian, T., Jackson, L., Jiang, J., Thorson, L., Labriere, C., Foster, L., Brunham, R. C., McMaster, W. R., Finlay, B. B., Strynadka, N. C., Cherkasov, A., Young, R. N., and Reiner, N. E. (2011) Antimicrob. Agents Chemother. 55, 2042-2053). Screening of an extract library of marine invertebrates against MRSA PK resulted in the identification of bis-indole alkaloids of the spongotine (A), topsentin (B, D), and hamacanthin (C) classes isolated from the Topsentia pachastrelloides as novel bacterial PK inhibitors. These compounds potently and selectively inhibited both MRSA PK enzymatic activity and S. aureus growth in vitro. The most active compounds, cis-3,4-dihyrohyrohamacanthin B (C) and bromodeoxytopsentin (D), were identified as highly potent MRSA PK inhibitors (IC(50) values of 16-60 nM) with at least 166-fold selectivity over human PK isoforms. These novel anti-PK natural compounds exhibited significant antibacterial activities against S. aureus, including MRSA (minimal inhibitory concentrations (MIC) of 12.5 and 6.25 ?g/ml, respectively) with selectivity indices (CC(50)/MIC) >4. We also report the discrete structural features of the MRSA PK tetramer as determined by x-ray crystallography, which is suitable for selective targeting of the bacterial enzyme. The co-crystal structure of compound C with MRSA PK confirms that the latter is a target for bis-indole alkaloids. It elucidates the essential structural requirements for PK inhibitors in "small" interfaces that provide for tetramer rigidity and efficient catalytic activity. Our results identified a series of natural products as novel MRSA PK inhibitors, providing the basis for further development of potential novel antimicrobials. PMID:22030393

Zoraghi, Roya; Worrall, Liam; See, Raymond H; Strangman, Wendy; Popplewell, Wendy L; Gong, Huansheng; Samaai, Toufiek; Swayze, Richard D; Kaur, Sukhbir; Vuckovic, Marija; Finlay, B Brett; Brunham, Robert C; McMaster, William R; Davies-Coleman, Michael T; Strynadka, Natalie C; Andersen, Raymond J; Reiner, Neil E

2011-12-30

292

Natural history of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE): a systematic review  

PubMed Central

Background No published systematic reviews have assessed the natural history of colonization with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE). Time to clearance of colonization has important implications for patient care and infection control policy. Methods We performed parallel searches in OVID Medline for studies that reported the time to documented clearance of MRSA and VRE colonization in the absence of treatment, published between January 1990 and July 2012. Results For MRSA, we screened 982 articles, identified 16 eligible studies (13 observational studies and 3 randomized controlled trials), for a total of 1,804 non-duplicated subjects. For VRE, we screened 284 articles, identified 13 eligible studies (12 observational studies and 1 randomized controlled trial), for a total of 1,936 non-duplicated subjects. Studies reported varying definitions of clearance of colonization; no study reported time of initial colonization. Studies varied in the frequency of sampling, assays used for sampling, and follow-up period. The median duration of total follow-up was 38 weeks for MRSA and 25 weeks for VRE. Based on pooled analyses, the model-estimated median time to clearance was 88 weeks after documented colonization for MRSA-colonized patients and 26 weeks for VRE-colonized patients. In a secondary analysis, clearance rates for MRSA and VRE were compared by restricting the duration of follow-up for the MRSA studies to the maximum observed time point for VRE studies (43 weeks). With this restriction, the model-fitted median time to documented clearance for MRSA would occur at 41 weeks after documented colonization, demonstrating the sensitivity of the pooled estimate to length of study follow-up. Conclusions Few available studies report the natural history of MRSA and VRE colonization. Lack of a consistent definition of clearance, uncertainty regarding the time of initial colonization, variation in frequency of sampling for persistent colonization, assays employed and variation in duration of follow-up are limitations of the existing published literature. The heterogeneity of study characteristics limits interpretation of pooled estimates of time to clearance, however, studies included in this review suggest an increase in documented clearance over time, a result which is sensitive to duration of follow-up. PMID:24678646

2014-01-01

293

The prevalence and source of methicillin-resistant Staphylococcus aureus (MRSA) in the community in Hong Kong.  

PubMed Central

Although reports of isolation of methicillin-resistant Staphylococcus aureus (MRSA) from patients admitted from the community have increased, few studies have investigated colonization of healthy subjects. This study aimed to determine community levels of MRSA in Hong Kong. Nasal swabs from a cross section of young adults and family units were cultured for MRSA. Antibiotic sensitivities and risk factors for carriage were determined and clonal relationships were investigated by pulsed-field gel electrophoresis (PFGE). Overall carriage was low (1.4%), and associated with health-care exposures (OR 13.56, 95% CI 1.11-165.21). Subjects working in health care yielded multi-resistant MRSA strains, but isolates from non-hospital-exposed subjects were methicillin-resistant only. Strains indistinguishable by PFGE were carried by subjects working together, and some spread to other contacts was observed. MRSA colonization in the community is rare in Hong Kong and is largely associated with working in health care. Community-acquired staphylococcal infections may be treated with agents effective against methicillin-sensitive strains. PMID:15635966

O'Donoghue, M. M.; Boost, M. V.

2004-01-01

294

Predominant Dissemination of PVL-Negative CC89 MRSA with SCCmec Type II in Children with Impetigo in Japan  

PubMed Central

Background. The ratio of CA-MRSA in children with impetigo has been increasing in Japan. Methods. Antimicrobial susceptibilities of 136 S. aureus isolates from children with impetigo were studied. Furthermore, molecular epidemiological analysis and virulence gene analysis were performed. Results. Of the 136 S. aureus isolates, 122 (89.7%) were MSSA and 14 (10.3%) were MRSA. Of the 14 MRSA strains, 11 belonged to CC89 (ST89, ST91, and ST2117) and carried diverse types of SCCmec: type II (IIb: 3 strains; unknown subtype: 4 strains), type IVa (2 strains), and unknown type (2 strains). The remaining three strains exhibited CC8 (ST-8)-SCCmec type VIa, CC121 (ST121)-SCCmec type V, and CC5 (ST5)-nontypeable SCCmec element, respectively. None were lukS-PV-lukF-PV gene positive. Gentamicin- and clarithromycin-resistant strains were frequently found in both MRSA and MSSA. Conclusions. PVL-negative CC89-SCCmec type II strains are the most predominant strains among the CA-MRSA strains circulating in the community in Japan. PMID:22187567

Kikuta, H.; Shibata, M.; Nakata, S.; Yamanaka, T.; Sakata, H.; Akizawa, K.; Kobayashi, K.

2011-01-01

295

Methicillin-resistant Staphylococcus aureus (MRSA) in rehabilitation and chronic-care-facilities: what is the best strategy?  

PubMed Central

Background The risk associated with methicillin-resistant Staphylococcus aureus (MRSA) has been decreasing for several years in intensive care departments, but is now increasing in rehabilitation and chronic-care-facilities (R-CCF). The aim of this study was to use published data and our own experience to discuss the roles of screening for MRSA carriers, the type of isolation to be implemented and the efficiency of chemical decolonization. Discussion Screening identifies over 90% of patients colonised with MRSA upon admission to R-CCF versus only 50% for intensive care units. Only totally dependent patients acquire MRSA. Thus, strict geographical isolation, as opposed to "social reinsertion", is clearly of no value. However, this should not lead to the abandoning of isolation, which remains essential during the administration of care. The use of chemicals to decolonize the nose and healthy skin appeared to be of some value and the application of this procedure could make technical isolation unnecessary in a non-negligible proportion of cases. Summary Given the increase in morbidity associated with MRSA observed in numerous hospitals, the emergence of a community-acquired disease associated with these strains and the evolution of glycopeptide-resistant strains, the voluntary application of a strategy combining screening, technical isolation and chemical decolonization in R-CCF appears to be an urgent matter of priority. PMID:14672540

Minary-Dohen, Patrica; Bailly, Pascale; Bertrand, Xavier; Talon, Daniel

2003-01-01

296

Livestock-Associated MRSA Carriage in Patients without Direct Contact with Livestock  

PubMed Central

Background Livestock-associated MRSA (MC398) has emerged and is related to an extensive reservoir in pigs and veal calves. Individuals with direct contact with these animals and their family members are known to have high MC398 carriage rates. Until now it was assumed that MC398 does not spread to individuals in the community without pig or veal calf exposure. To test this, we identified the proportion of MC398 in MRSA positive individuals without contact with pigs/veal calves or other known risk factors (MRSA of unknown origin; MUO). Methods In 17 participating hospitals, we determined during two years the occurrence of MC398 in individuals without direct contact with livestock and no other known risk factor (n?=?271) and tested in a post analysis the hypothesis whether hospitals in pig-dense areas have higher proportions of MC398 of all MUO. Results Fifty-six individuals (20.7%) without animal contact carried MC398. In hospitals with high pig-densities in the adherence area, the proportion of MC398 of all MUO was higher than this proportion in hospitals without pigs in the surroundings. Conclusions One fifth of the individuals carrying MUO carried MC398. So, MC398 is found in individuals without contact to pigs or veal calves. The way of transmission from the animal reservoir to these individuals is unclear, probably by human-to-human transmission or by exposure to the surroundings of the stables. Further research is needed to investigate the way of transmission. PMID:25000521

van Rijen, Miranda M. L.; Bosch, Thijs; Verkade, Erwin J. M.; Schouls, Leo; Kluytmans, Jan A. J. W.

2014-01-01

297

Spa Diversity among MRSA and MSSA Strains of Staphylococcus aureus in North of Iran  

PubMed Central

Protein A of Staphylococcus aureus is a pathogenic factor whose encoding gene, spa, shows a variation in length in different strains. In this study the spa gene variation in S. aureus isolated from healthy carriers and patients was studied, We also compared this variation among MRSA with MSSA strains. 208 strains of Staphylococcus aureus which we were isolated from Gorgan, north of Iran were studied, 121 cases from patients and 87 cases from healthy carriers, 59 out of them were MRSA and 149 MSSA. Samples DNA were extracted and amplified by specific primer of spa gene. In 4 (3.8%) strains of them no spa gene was detected, and 10.6% had a dual band (1200 and 1400?bp). In strains with one band, the length of spa gene differed from 1150 to 1500?bp. The most prevalent length was 1350–1400?bp (37%). The frequencies of short spa bands (1150–1200?bp) in patients strains were significantly higher. In 4 (3.8%) strains of them no spa gene was detected, and 10.6% had a dual band (1200 and 1400?bp). In strains with one band, the length of spa gene differed from 1150 to 1500?bp. The most prevalent length was 1350–1400?bp (37%). The frequencies of short spa bands (1150–1200?bp) in patients strains were significantly higher. The spa gene length of 1350–1400?bp in MSSA was more than in MRSA strains (P < .05). The average length of spa in isolated strains from urinary tract infections was more than others. It is concluded that the length of spa gene depends either on resistance to Methicillin or the source of S. aureus isolation. PMID:20862383

Shakeri, Fatemeh; Shojai, Abolfath; Golalipour, Masoud; Rahimi Alang, Somaye; Vaez, Hamid; Ghaemi, Ezzat Allah

2010-01-01

298

Immunofluorescence microscopy for the detection of surface antigens in methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

Immunofluorescence microscopy is a widely used laboratory method which allows detection and visualization of specific antigens. The method employs the specificity of antibodies to deliver fluorophore to a specific target and then visualize it with a microscope. The power of the technique is that it requires relatively little manipulation and relatively few bacterial cells, enabling the detection of antigen expression where other methods cannot, such as during an actual infection in an animal. Here, we apply the method to follow antigen expression on the surface of MRSA cells over time in in vivo infection models. PMID:24085690

Timofeyeva, Yekaterina; Scully, Ingrid L; Anderson, Annaliesa S

2014-01-01

299

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

PubMed Central

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

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

2011-01-01

300

Dirty hands: photodynamic killing of human pathogens like EHEC, MRSA and Candida within seconds.  

PubMed

Hand hygiene is one of the most important interventions for reducing transmission of nosocomial life-threatening microorganisms, like methicillin resistant Staphylococcus aureus (MRSA), enterohemorrhagic Escherichia coli (EHEC) or Candida albicans. All three pathogens have become a leading cause of infections in hospitals. Especially EHEC is causing severe diarrhoea and, in a small percentage of cases, haemolytic-uremic syndrome (HUS) as reported for E. coli 104:H4 in Germany 2011. We revealed the possibility to inactivate very fast and efficiently MRSA, EHEC and C. albicans using the photodynamic approach. MRSA, EHEC and C. albicans were incubated in vitro with different concentrations of TMPyP for 10 s and illuminated with visible light (50 mW cm(-2)) for 10 and 60 s. 1 ?mol l(-1) of TMPyP and an applied radiant exposure of 0.5 J cm(-2) achieved a photodynamic killing of ?99.9% of MRSA and EHEC. Incubation with higher concentrations (up to 100 ?mol l(-1)) of TMPyP caused bacteria killing of >5 log(10) (?99.999%) after illumination. Efficient Candida killing (?99.999%) was achieved first at a higher light dose of 12 J cm(-2). Different rise and decay times of singlet oxygen luminescence signals could be detected in Candida cell suspensions for the first time, indicating different oxygen concentrations in the surrounding for the photosensitizer and singlet oxygen, respectively. This confirms that TMPyP is not only found in the water-dominated cell surrounding, but also within the C. albicans cells. Applying a water-ethanol solution of TMPyP on ex vivo porcine skin, fluorescence microscopy of histology showed that the photosensitizer was exclusively localized in the stratum corneum regardless of the incubation time. TMPyP exhibited a fast and very effective killing rate of life-threatening pathogens within a couple of seconds that encourages further testing in an in vivo setting. Being fast and effective, antimicrobial photodynamic applications might become acceptable as a tool for hand hygiene procedures and also in other skin areas. PMID:22855122

Eichner, Anja; Gonzales, Fernanda Pereira; Felgenträger, Ariane; Regensburger, Johannes; Holzmann, Thomas; Schneider-Brachert, Wulf; Bäumler, Wolfgang; Maisch, Tim

2013-01-01

301

[Control of methicillin resistant staphylococci at the Sahlgrenska hospital. Successful control program against MRSA outbreak].  

PubMed

In 1998-1999 a strain of methicillin resistant Staphylococcus aureus (MRSA) infected 147 patients in 40 out of 160 ward units at Sahlgrenska University Hospital, Gothenburg. The strain originated from a patient who had been treated in a hospital in Cyprus. In order to control this outbreak a plan of action was decided upon and carried out, including extensive information to the hospital staff, screening for carriers, and establishing a hospital infection control committee. Furthermore, a policy for screening all patients readmitted to the hospital was established in November 1999. This screening could be discontinued on July 1, 2001. PMID:11763628

Haglind, E; Brantervik, A; Friman, S; Jertborn, M; Rödjer, S; Seeberg, S

2001-11-21

302

Implementation of recommendations for hand eczema through a multifaceted strategy. A process evaluation among health care workers.  

PubMed

Process data give important insights into how an intervention is implemented. The aim of the present study is to conduct a process evaluation, alongside a randomised controlled trail, on the implementation of recommendations for the prevention of hand eczema. The intervention was carried out in healthcare workers' departments and consisted of working groups and role models. The role models were selected based on their representativeness, their influence on colleagues, and their motivation. The focus of the working group was to implement recommendations for hand eczema at the department by choosing solutions to overcome barriers for implementation. Out of the 104 solutions, 87 were realised. Solutions regarding moisturisers and use of cotton under gloves, were used by 90.9% and 30.8% of the employees, respectively. Of all participants, 58.2% actively engaged with the role models. This process evaluation showed that the intervention was executed according to protocol and that the solutions were implemented well. However, the role model component in the intervention should be improved. PMID:24572935

van der Meer, Esther W C; Boot, Cécile R L; Jungbauer, Frank H W; Coenraads, Pieter Jan; van der Gulden, Joost W J; Anema, Johannes R

2014-11-01

303

The Harmonizing Outcome Measures for Eczema (HOME) roadmap: a methodological framework to develop core sets of outcome measurements in dermatology.  

PubMed

Core outcome sets (COSs) are consensus-derived minimum sets of outcomes to be assessed in a specific situation. COSs are being increasingly developed to limit outcome-reporting bias, allow comparisons across trials, and strengthen clinical decision making. Despite the increasing interest in outcomes research, methods to develop COSs have not yet been standardized. The aim of this paper is to present the Harmonizing Outcomes Measures for Eczema (HOME) roadmap for the development and implementation of COSs, which was developed on the basis of our experience in the standardization of outcome measurements for atopic eczema. Following the establishment of a panel representing all relevant stakeholders and a research team experienced in outcomes research, the scope and setting of the core set should be defined. The next steps are the definition of a core set of outcome domains such as symptoms or quality of life, followed by the identification or development and validation of appropriate outcome measurement instruments to measure these core domains. Finally, the consented COS needs to be disseminated, implemented, and reviewed. We believe that the HOME roadmap is a useful methodological framework to develop COSs in dermatology, with the ultimate goal of better decision making and promoting patient-centered health care. PMID:25186228

Schmitt, Jochen; Apfelbacher, Christian; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric L; Furue, Masutaka; Chalmers, Joanne; Williams, Hywel C

2015-01-01

304

Evaluation of the Xpert Methicillin-Resistant Staphylococcus aureus (MRSA) Assay Using the GeneXpert Real-Time PCR Platform for Rapid Detection of MRSA from Screening Specimens ?  

PubMed Central

The need for rapid methods to accurately detect methicillin-resistant Staphylococcus aureus (MRSA) is widely acknowledged, and a number of molecular assays are commercially available. This study evaluated the Xpert MRSA assay, which is run on the GeneXpert real-time PCR platform (Cepheid) for use in a clinical laboratory. The following parameters were investigated: (i) the limits of detection (LoDs) for four MRSA strains; (ii) the ability to detect isolates of MRSA from a collection representative of MRSA in Ireland since 1974 (n = 114) and the ability to detect control strains with staphylococcal cassette chromosome mec types IVa (IV.1.1.1), IVb (IV.2.1.1), IVc (IV.3.1.1), IVd (IV.4.1.1), V (V.1.1.1), VT, and VI; and (iii) performance in a clinical trial with swabs from nose, throat, and groin/perineum sites from 204 patients, where results were compared with those obtained by direct and enrichment cultures. The average LoD of the four test strains was 610 CFU/ml (equivalent to 58 CFU/swab). All 114 MRSA isolates and 7 control strains tested were detected. Sensitivity, specificity, and positive and negative predictive values for clinical specimens from all sites investigated were 90%, 97%, 86%, and 98%, respectively, but throat specimens yielded poor sensitivity (75%). Sensitivity, specificity, and positive and negative predictive values for nasal specimens were 95%, 98%, 90%, and 99%, respectively. Overall, the assay was rapid and easy to perform, but performance might be enhanced by the inclusion of an equivocal interpretive category based on analysis of all available amplification data. PMID:18685003

Rossney, Angela S.; Herra, Celine M.; Brennan, Gráinne I.; Morgan, Pamela M.; O'Connell, Brian

2008-01-01

305

Multicenter evaluation of the LightCycler MRSA advanced test, the Xpert MRSA Assay, and MRSASelect directly plated culture with simulated workflow comparison for the detection of methicillin-resistant Staphylococcus aureus in nasal swabs.  

PubMed

Rapid detection of nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) followed by appropriate infection control procedures reduces MRSA infection and transmission. We compared the performance and workflow of two Food and Drug Administration-approved nucleic acid amplification assays, the LightCycler MRSA Advanced Test and the Xpert MRSA test, with those of directly plated culture (MRSASelect) using 1202 nasal swabs collected at three U.S. sites. The sensitivity of the LightCycler test (95.2%; 95% CI, 89.1% to 98.4%) and Xpert assay (99%; 95% CI, 94.8% to 100%) did not differ compared with that of culture; the specificity of the two assays was identical (95.5%; 95% CI, 94.1% to 96.7%) compared with culture. However, sequencing performed on 71 samples with discordant results among the three methods confirmed the presence of MRSA in 40% of samples that were positive by both molecular methods but negative by culture. Workflow analysis from all sites including batch runs revealed average hands-on sample preparation times of 1.40, 2.35, and 1.44 minutes per sample for the LightCycler, Xpert, and MRSASelect methods, respectively. Discrete event simulation analysis of workflow efficiencies revealed that the LightCycler test used less hands-on time for the assay when greater than eight batched samples were run. The high sensitivity and specificity, low hands-on time, and efficiency gains using batching capabilities make the LightCycler test suitable for rapid batch screening of MRSA colonization. PMID:22584139

Arcenas, Rodney C; Spadoni, Stacey; Mohammad, Amin; Kiechle, Frederick L; Walker, Kimberly; Fader, Robert C; Perdreau-Remington, Francoise; Osiecki, John; Liesenfeld, Oliver; Hendrickson, Shelby; Rao, Arundhati

2012-07-01

306

Screening for methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci: an evaluation of three selective media and Mastalex-MRSA latex agglutination.  

PubMed

Laboratory confirmation of MRSA is important for the implementation of infection control; conventional screening culture methods take up to five days for confirmation. The purpose of this study is to ascertain the efficiency of three selective media for growth of methicillin-resistant Staphylococcus aureus (MRSA) before and after enrichment in salt broth, and to evaluate the Mastalex-MRSA latex agglutination kit for detection of methicillin resistance. Screening swabs were collected from 63 patients, yielding 125 S. aureus isolates and 40 coagulase-negative staphylococcus (CNS) isolates. Selective media used were mannitol salt agar (MSA), Baird-Parker agar with ciprofloxacin (BPC) and bromocresol purple (BCPA). Polymerase chain reaction (PCR) for mecA gene detection was used as the reference standard for evaluation of the Mastalex-MRSA assay, which was also evaluated on colonies of S. aureus from the selective media. No significant difference was found in efficiency of MRSA isolation among the selective media. Pre-enrichment in the salt broth did not enhance isolation of MRSA. Methicillin-sensitive S. aureus and CNS were significantly inhibited in all selective media (P<0.05). Only BPC significantly selected out methicillin-resistant CNS (P<0.01). Mastalex-MRSA was 97% specific and sensitive for the detection of MRSA. It was 65% sensitive and 100% specific in detecting methicillin resistance in CNS. In conclusion, all selective media performed equally well (MRSA isolation rate of approximately 80%). Mastalex-MRSA provided rapid and reliable detection of MRSA from selective media, reducing the time required for confirmation of this organism. PMID:12866912

Bowers, K M; Wren, M W D; Shetty, N P

2003-01-01

307

Prevalence and antibiotic susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) among primary school children and prisoners in Jimma Town, Southwest Ethiopia  

PubMed Central

Background Staphylococcus aureus infections are increasingly reported from both health institutions and communities around the world. In particular, infections due to methicillin-resistant Staphylococcus aureus (MRSA) strains have been detected worldwide. If MRSA becomes the most common form of S. aureus in a community, it makes the treatment of common infections much more difficult. But, report on the current status of community acquired MRSA in the study area is scanty. Methods Community-based cross sectional study was conducted to evaluate the current prevalence and antibiotic susceptibility pattern of MRSA among primary school children and prisoners in Jimma town. MRSA was detected using Cefoxitin (30?g) disc; and epidemiologic risk factors were assessed using pre-designed questionnaires distributed to the children’s parents and prisoners. A total of 354 nasal swabs were collected from primary school children and prisoners from December 2010 to March 2011 following standards microbiological methods. Results A total of 169 S. aureus isolates were recovered. The overall prevalence of MRSA among the study population was 23.08 % (39/169). Specifically, the prevalence of MRSA among primary school children and prisoners were 18.8% (27/144) and 48% (12/25), respectively. The isolated S. aureus and MRSA displayed multiple drug resistance (MDR) to 2 to 10 antibiotics. The most frequent MDR was Amp/Bac/Ery/Pen/Fox (resistance to Ampicillin, Bacitracin, Erythromycin, Penicillin, and Cefoxitin). Conclusion The present study revealed that MRSA could be prevalent in the healthy community, transmitted from hospital to the community. The high distribution of MRSA could be favored by potential risk factors. Thus, for comprehensive evaluation of the current prevalence of MRSA and design control measures, consideration need to be given to the healthy community besides data coming from health institutions. PMID:23731679

2013-01-01

308

Inhibition of Transcription Factor Specificity Protein 1 Alters the Gene Expression Profile of Keratinocytes Leading to Upregulation of Kallikrein-Related Peptidases and Thymic Stromal Lymphopoietin  

Microsoft Academic Search

Transcription factor specificity protein 1 (Sp1) is involved in diverse cellular functions. We recently found that Sp1 was significantly decreased in skin biopsy samples obtained from patients with atopic dermatitis (AD) and had an even greater reduction in AD patients with a history of eczema herpeticum. In the current study, we sought to better understand the role of Sp1 in

Lianghua Bin; Byung E Kim; Clifton F Hall; Sonia M Leach; Donald Y M Leung

2011-01-01

309

Isolation of a potent antibiotic producer bacterium, especially against MRSA, from northern region of the Persian Gulf  

PubMed Central

Nowadays, emergence and prevalence of MRSA (Methicillin Resistant Staphylococcus aureus) strain have become a great global concern in 21st century, so, it is necessary to discover new antibiotics against this pathogen. The aim of this study was isolation and evaluation marine bacteria from the Persian Gulf in order to finding antibiotic compounds against some pathogenic bacteria. For this purpose, water and sediment samples were collected from the Persian Gulf during March to October 2009. The antibacterial activity of the isolated bacteria was assessed using disc diffusion method. The Growth Curve Interference (GCI) parameter against MRSA was determined for the high potential antibiotic producing strain. The most important factors affecting fermentation conditions in antibiotic production were also optimized. Definite identification of intended isolate was confirmed by 16S rRNA sequencing. Altogether, 51 bacterial colony was isolated and among them only 3 bacterium showed antibacterial activity. Pseudoalteromonaspiscicida PG-01 isolated from a sediment sample was chosen as the best antibiotic producing strain. This strain was effective against all tested Gram-positive bacteria, had good anti-MRSA activity and also GCI value against MRSA was two times lower than MIC value. Among the optimized fermentation parameters, carbon and nitrogen sources play major role in efficacy of optimized antibiotic production. Ultrastructural study on the effect of intended antibiotic compounds on MRSA using TEM revealed that the target site for this compound is cell wall. Considering the antibacterial effect of PG-01 strain especially against MRSA, intended antibiotic compounds can gives hope for treatment of diseases caused by multi-drug resistant bacteria. PMID:22642595

Darabpour, Esmaeil; Ardakani, Mohammad Roayaei; Motamedi, Hossein; Ronagh, Mohammad Taghi

2012-01-01

310

Isolation of a potent antibiotic producer bacterium, especially against MRSA, from northern region of the Persian Gulf.  

PubMed

Nowadays, emergence and prevalence of MRSA (Methicillin Resistant Staphylococcus aureus) strain have become a great global concern in 21st century, so, it is necessary to discover new antibiotics against this pathogen. The aim of this study was isolation and evaluation marine bacteria from the Persian Gulf in order to finding antibiotic compounds against some pathogenic bacteria. For this purpose, water and sediment samples were collected from the Persian Gulf during March to October 2009. The antibacterial activity of the isolated bacteria was assessed using disc diffusion method. The Growth Curve Interference (GCI) parameter against MRSA was determined for the high potential antibiotic producing strain. The most important factors affecting fermentation conditions in antibiotic production were also optimized. Definite identification of intended isolate was confirmed by 16S rRNA sequencing. Altogether, 51 bacterial colony was isolated and among them only 3 bacterium showed antibacterial activity. Pseudoalteromonas piscicida PG-01 isolated from a sediment sample was chosen as the best antibiotic producing strain. This strain was effective against all tested Gram-positive bacteria, had good anti-MRSA activity and also GCI value against MRSA was two times lower than MIC value. Among the optimized fermentation parameters, carbon and nitrogen sources play major role in efficacy of optimized antibiotic production. Ultrastructural study on the effect of intended antibiotic compounds on MRSA using TEM revealed that the target site for this compound is cell wall. Considering the antibacterial effect of PG-01 strain especially against MRSA, intended antibiotic compounds can gives hope for treatment of diseases caused by multi-drug resistant bacteria. PMID:22642595

Darabpour, Esmaeil; Roayaei Ardakani, Mohammad; Motamedi, Hossein; Taghi Ronagh, Mohammad

2012-05-01

311

The Mechanism of Heterogeneous Beta-Lactam Resistance in MRSA: Key Role of the Stringent Stress Response  

PubMed Central

All methicillin resistant S. aureus (MRSA) strains carry an acquired genetic determinant – mecA or mecC - which encode for a low affinity penicillin binding protein –PBP2A or PBP2A? – that can continue the catalysis of peptidoglycan transpeptidation in the presence of high concentrations of beta-lactam antibiotics which would inhibit the native PBPs normally involved with the synthesis of staphylococcal cell wall peptidoglycan. In contrast to this common genetic and biochemical mechanism carried by all MRSA strains, the level of beta-lactam antibiotic resistance shows a very wide strain to strain variation, the mechanism of which has remained poorly understood. The overwhelming majority of MRSA strains produce a unique – heterogeneous – phenotype in which the great majority of the bacteria exhibit very poor resistance often close to the MIC value of susceptible S. aureus strains. However, cultures of such heterogeneously resistant MRSA strains also contain subpopulations of bacteria with extremely high beta-lactam MIC values and the resistance level and frequency of the highly resistant cells in such strain is a characteristic of the particular MRSA clone. In the study described in this communication, we used a variety of experimental models to understand the mechanism of heterogeneous beta-lactam resistance. Methicillin-susceptible S. aureus (MSSA) that received the mecA determinant in the laboratory either on a plasmid or in the form of a chromosomal SCCmec cassette, generated heterogeneously resistant cultures and the highly resistant subpopulations that emerged in these models had increased levels of PBP2A and were composed of bacteria in which the stringent stress response was induced. Each of the major heterogeneously resistant clones of MRSA clinical isolates could be converted to express high level and homogeneous resistance if the growth medium contained an inducer of the stringent stress response. PMID:24349368

Kim, Choonkeun; Mwangi, Michael; Chung, Marilyn; Milheirço, Catarina; de Lencastre, Herminia; Tomasz, Alexander

2013-01-01

312

Qualitative and quantitative investigations on the resident bacterial skin flora in healthy persons and in the non-affected skin of patients with seborrheic eczema  

Microsoft Academic Search

The composition of the aerobic and anaerobic bacterial skin flora was investigated quantitatively and qualitatively in 25 patients with seborrheic eczema (SE) and in 35 healthy persons. In SE patients, the geometric mean count for propionibacteria in the pilosebaceous ducts of the forehead was reduced to a statistically significant extent in comparison with the control group. There was the same

U. Höffler; M. Gloor; G. Peters; H. L. Ko; A. Bräutigam; A. Thurn; G. Pulverer

1980-01-01

313

[Therapy of hyperhidrosis with tap water iontophoresis. Positive effect on healing time and lack of recurrence in hand-foot eczema].  

PubMed

Hyperhidrosis is due to an overfunction of eccrine glands (triggered by the autonomous nervous system) and may be a cofactor for palmoplantar eczema (dermatitis). Tapwater iontophoresis was used in 54 patients with hyperhidrosis manuum et pedum. After 10 applications directed by the dermatologist, 89% of patients noted an improvement in their hyperhidrosis. 20 patients suffering from palmoplantar eczema (dermatitis) who continued the treatment at home for at least 6 months were compared with a historical sex- and age-matched group of 20 eczema-patients without iontophoresis: The factors evaluated were the time needed for clearing and the relapse-free interval. Though iontophoresis-treated patients had a slightly faster clearing, this was statistically not significant (20 vs. 22.3 days; p > 0.05). However, the difference for relapse-free interval between the two groups was statistically highly significant (24.8 weeks vs. 8.35 weeks; p < 0.0001). Tapwater iontophoresis seems to be effective not only to control sweating. According to recently published data, galvanization seems to have a capsaicin-like effect as well. Our hypothesis is therefore, that galvanization with tapwater iontophoresis interrupts the neurogenic inflammation and prolongs the relapse-free interval in hyperhidrotic palmoplantar eczema (dermatitis). PMID:9551332

Wollina, U; Uhlemann, C; Elstermann, D; Köber, L; Barta, U

1998-02-01

314

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...

315

Cost-effectiveness of oral alitretinoin in patients with severe chronic hand eczema - a long-term analysis from a Swiss perspective  

Microsoft Academic Search

BACKGROUND: The impact on patients suffering from chronic hand eczema (CHE) is enormous, as no licensed systemic treatment option with proven efficacy for CHE is available. Alitretinoin is a novel agent which showed high clinical efficacy in patients with severe, refractory CHE. We assessed the cost-effectiveness of alitretinoin for CHE patient treatment from a Swiss third party payer perspective. A

Patricia R Blank; Armin A Blank; Thomas D Szucs

2010-01-01

316

A Natural Plasmid Uniquely Encodes Two Biosynthetic Pathways Creating a Potent Anti-MRSA Antibiotic  

PubMed Central

Background Understanding how complex antibiotics are synthesised by their producer bacteria is essential for creation of new families of bioactive compounds. Thiomarinols, produced by marine bacteria belonging to the genus Pseudoalteromonas, are hybrids of two independently active species: the pseudomonic acid mixture, mupirocin, which is used clinically against MRSA, and the pyrrothine core of holomycin. Methodology/Principal Findings High throughput DNA sequencing of the complete genome of the producer bacterium revealed a novel 97 kb plasmid, pTML1, consisting almost entirely of two distinct gene clusters. Targeted gene knockouts confirmed the role of these clusters in biosynthesis of the two separate components, pseudomonic acid and the pyrrothine, and identified a putative amide synthetase that joins them together. Feeding mupirocin to a mutant unable to make the endogenous pseudomonic acid created a novel hybrid with the pyrrothine via “mutasynthesis” that allows inhibition of mupirocin-resistant isoleucyl-tRNA synthetase, the mupirocin target. A mutant defective in pyrrothine biosynthesis was also able to incorporate alternative amine substrates. Conclusions/Significance Plasmid pTML1 provides a paradigm for combining independent antibiotic biosynthetic pathways or using mutasynthesis to develop a new family of hybrid derivatives that may extend the effective use of mupirocin against MRSA. PMID:21483852

Song, Zhongshu; Murphy, Annabel C.; Hothersall, Joanne; Stephens, Elton R.; Gurney, Rachel; Cox, Russell J.; Crosby, John; Willis, Christine L.; Simpson, Thomas J.; Thomas, Christopher M.

2011-01-01

317

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

NASA Astrophysics Data System (ADS)

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.

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

2009-02-01

318

[Effectiveness and risks of isolation precautions in patients with MRSA and other multidrug-resistant bacteria].  

PubMed

The transmission of multidrug-resistant organisms (MRSA, VRE and ESBL producing bacteria) occurs predominantly if health-care workers are not compliant with hand hygiene procedures. The impact of single-room isolation in transmission prevention is often overestimated. As long as hand disinfection is not performed before and after patient contact and gloves are not removed, a single room will not prevent transmission by -itself. Understaffing is additionally worsening the situation. There is no consistent evidence sup-port-ing strict single-room isolation even though data show supportive tendencies. Social isolation is one of the risks that should be considered as well as the economic impact of using shared rooms as a single room. Up-to-date, evidence-based standard operating procedures and individual infection control recommendations should take these considerations into account. In general, contact precautions including isolation in a single room are performed in MRSA and VRE-positive patients. If a single room cannot be provided in a given case (a common problem in intensive care units), contact precautions can be performed in a shared room as an alternative. The problem of establishing an optimal compliance with standard precautions (especially hand hygiene) throughout all professional groups should be addressed. Additional precautions, including single-room isolation, should be implemented critically if indicated. PMID:20379942

Dettenkofer, M; Utzolino, S; Luft, D; Lemmen, S

2010-04-01

319

Novel quercetin glycosides as potent anti-MRSA and anti-VRE agents.  

PubMed

Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections (Threat report 2013). Vancomycin is an FDA approved antibiotic and is growing importance in the treatment of hospital infections, with particular emphasis on its value to fight against methicillin-resistant Staphylococcus aureus (MRSA). The increasing use of vancomycin to treat infections caused by the Gram-positive MRSA in the 1970s selected for drug-resistant enterococci, less potent than staphylococci but opportunistic in the space vacated by other bacteria and in patients with compromised immune systems. The dramatic rise of antibiotic-resistant bacteria over the past two decades has stressed the need for completely novel classes of antibacterial agents. This paper reports the recent patent review on the strategy for finding novel quercetinglycoside type antibacterial agents against vancomycin-resistant bacterial strains. PMID:24320230

Hossion, Abugafar M L; Sasaki, Kenji

2013-12-01

320

Anti-MRSA-acting carbamidocyclophanes H-L from the Vietnamese cyanobacterium Nostoc sp. CAVN2.  

PubMed

The methanol extract of the Vietnamese freshwater cyanobacterium Nostoc sp. CAVN2 exhibited cytotoxic effects against MCF-7 and 5637 cancer cell lines as well as against nontumorigenic FL and HaCaT cells and was active against methicillin-resistant Staphylococcus aureus (MRSA) and Streptococcus pneumoniae. High-resolution mass spectrometric analysis indicated the presence of over 60 putative cyclophane-like compounds in an antimicrobially active methanol extract fraction. A paracyclophanes-focusing extraction and separation methodology led to the isolation of 5 new carbamidocyclophanes (1-5) and 11 known paracyclophanes (6-16). The structures and their stereochemical configurations were elucidated by a combination of spectrometric and spectroscopic methods including HRMS, 1D and 2D NMR analyses and detailed comparative CD analysis. The newly described monocarbamoylated [7.7]paracyclophanes (1, 2, 4 and 5) differ by a varying degree of chlorination in the side chains. Carbamidocyclophane J (3) is the very first reported carbamidocyclophane bearing a single halogenation in both butyl residues. Based on previous studies a detailed phylogenetic examination of cyclophane-producing cyanobacteria was carried out. The biological evaluation of 1-16 against various clinical pathogens highlighted a remarkable antimicrobial activity against MRSA with MICs of 0.1-1.0??M, and indicated that the level of antibacterial activity is related to the presence of carbamoyl moieties. PMID:25182484

Preisitsch, Michael; Harmrolfs, Kirsten; Pham, Hang Tl; Heiden, Stefan E; Füssel, Anna; Wiesner, Christoph; Pretsch, Alexander; Swiatecka-Hagenbruch, Monika; Niedermeyer, Timo Hj; Müller, Rolf; Mundt, Sabine

2015-03-01

321

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

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…

Buss, Bryan F.; Connolly, Susan

2014-01-01

322

Masclaux, F.G.; Sakwinska, O.; Charrire, N.; Swmaani, E.; Oppliger, A. Concentration of airborne Staphylococcus aureus (MRSA and MSSA), total  

E-print Network

Staphylococcus aureus (MRSA and MSSA), total bacteria, and endotoxins in pig farms. Annals of Occupational of airborne Staphylococcus aureus (MRSA and MSSA), total bacteria and endotoxins in pig farms. FREDERIC G: Anne.Oppliger@hospvd.ch #12;3 ABSTRACT Pigs are very often colonized with Staphylococcus aureus

Alvarez, Nadir

323

JOINT EFFECT OF PRENATAL EXPOSURE TO FINE PARTICULATE MATTER AND INTAKE OF PARACETAMOL (ACETAMINOPHEN) IN PREGNANCY ON ONSET OF ECZEMA IN EARLY CHILDHOOD. PROSPECTIVE BIRTH COHORT STUDY  

PubMed Central

Prenatal Paracetamol (Acetaminophen) has been associated with increased risk of allergic disease in early childhood, an association that could be due to increased altered susceptibility induced by air pollutants. The main goal of the study was to test the hypothesis that prenatal Paracetamol exposure increases the risk of developing eczema in early childhood and that this association is stronger for children who are exposed prenatally to higher concentrations of fine particulate matter (PM2.5). The study sample consisted of 322 women recruited from January 2001 to February 2004 in the Krakow inner city area who gave birth to term babies and completed 5-year follow-up. Paracetamol use in pregnancy was collected by interviews and prenatal personal exposure to over 48 hours was measured in all recruited women in the second trimester of PM2.5 pregnancy. After delivery, every three months in the first 24 months of the newborn’s life and every 6 months later, a detailed standardized face-to-face interview on the infant’s health was administered to each mother by a trained interviewer. During the interviews at each of the study periods after birth, a history of eczema was recorded. By Cox proportional hazard regression, prenatal exposure to Paracetamol increased the risk of eczema by 20% and PM2.5 by 6%, albeit non significantly. However, the the joint exposure to Paracetamol and higher prenatal PM2.5 was significant and doubled the risk of eczema symptoms (HR = 2.07, 95%CI: 1.01 – 4.34). The findings suggest that even very small doses of Paracetamol in pregnancy may affect the occurrence of allergy outcomes such as eczema in early childhood but only at the co-exposure to higher fine particulate matter. PMID:21962593

Jedrychowski, Wieslaw; Maugeri, Umberto; Spengler, John D.; Miller, Rachel L.; Mrozek-Budzyn, Dorota; Perzanowski, Matt; Kaim, Irena; Flak, Elzbieta; Mroz, Elzbieta; Majewska, Renata; Perera, Frederica

2011-01-01

324

Quantifying The Impact of Extra-Nasal Testing Body Sites for MRSA Colonization at the Time of Hospital or Intensive Care Unit Admission  

PubMed Central

Objective Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of healthcare-associated infections. Recent legislative mandates require nares screening for MRSA at hospital and ICU admission in many states. However, MRSA colonization at extra-nasal sites is increasingly recognized. We conducted a systematic review of the literature to identify the yield of extra-nasal testing for MRSA. Design We searched MEDLINE from January 1966 through January 2012 for articles comparing nasal and extra-nasal screening for MRSA colonization. Studies were categorized by population tested, specifically those admitted to ICUs, and those admitted to hospitals with a high prevalence (?6%) or low prevalence (<6%) of MRSA carriers. Data were extracted using a standardized instrument. Results We reviewed 4,381 abstracts and 735 manuscripts. Twenty-three manuscripts met criteria for analysis (n=39,479 patients). Extra-nasal MRSA screening increased yield by approximately one-third over nares alone. The yield was similar upon ICU admission (weighted average 33%, range 9%–69%), and hospital admission in high (weighted average 37%, range 9–86%) and low prevalence (weighted average 50%, range 0–150%) populations. Comparing individual extra nasal sites, testing the oropharynx increased MRSA detection by 21% over nares alone; rectum by 20%; wounds by 17%; and axilla by 7%. Conclusions Extra-nasal MRSA screening at hospital or ICU admission in adults will increase MRSA detection by one-third compared to nares screening alone. Findings were consistent among subpopulations examined. Extra-nasal testing may be a valuable strategy for outbreak control or in settings of persistent disease, particularly when combined with decolonization or enhanced infection prevention protocols. PMID:23295562

McKinnell, James A.; Huang, Susan S.; Eells, Samantha J.; Cui, Eric; Miller, Loren G.

2013-01-01

325

Role of previous hospitalization in clinically-significant MRSA infection among HIV-infected inpatients: results of a case-control study  

PubMed Central

Background HIV-infected subjects have high incidence rates of Staphylococcus aureus infections, with both methicillin-susceptible and methicillin-resistant (MRSA) strains. Possible explanations could include the high burden of colonization, the behavioral risk factors, and the frequent exposures to health care facilities of HIV-infected patients. The purpose of the study was to assess the risk factors for clinically- significant methicillin-resistant Staphylococcus aureus (CS-MRSA) infections in HIV-infected patients admitted to Infectious Diseases Units. Methods From January 1, 2002 to December 31, 2005, we conducted a retrospective case-control (1:2) study. We identified all the cases of CS-MRSA infections in HIV-infected patients admitted to the National Institute for Infectious Diseases (INMI) "Lazzaro Spallanzani" in the 4-year study period. A conditional logistic regression model was used to identify risk factors for CS-MRSA infection. Results We found 27 CS-MRSA infections, i.e. 0.9 CS-MRSA infections per 100 HIV-infected individuals cared for in our Institute. At multivariate analysis, independent predictors of CS-MRSA infection were cumulative hospital stay, invasive procedures in the previous year, and low CD4 cell count. Particularly, the risk for CS-MRSA increased by 14% per an increase of 5 days hospitalization in the previous year. Finally, we identified a low frequency of community-acquired MRSA infections (only 1 of 27; 3.7%) among HIV-infected patients. Conclusion Clinicians should be aware of the risk for CS-MRSA infection in the clinical management of HIV-infected patients, especially in those patients with a low CD4 cell count, longer previous hospital stay, and previous invasive procedures. PMID:17470274

Drapeau, Cecilia MJ; Angeletti, Claudio; Festa, Anna; Petrosillo, Nicola

2007-01-01

326

Spread of Epidemic MRSA-ST5-IV Clone Encoding PVL as a Major Cause of Community Onset Staphylococcal Infections in Argentinean Children  

PubMed Central

Background Community-associated methicillin-resistant Staphylococcus aureus-(CA-MRSA) strains have emerged in Argentina. We investigated the clinical and molecular evolution of community-onset MRSA infections (CO-MRSA) in children of Córdoba, Argentina, 2005–2008. Additionally, data from 2007 were compared with the epidemiology of these infections in other regions of the country. Methodology/Principal Findings Two datasets were used: i) lab-based prospective surveillance of CA-MRSA isolates from 3 Córdoba pediatric hospitals-(CBAH1-H3) in 2007–2008 (compared to previously published data of 2005) and ii) a sampling of CO-MRSA from a study involving both, healthcare-associated community-onset-(HACO) infections in children with risk-factors for healthcare-associated infections-(HRFs), and CA-MRSA infections in patients without HRFs detected in multiple centers of Argentina in 2007. Molecular typing was performed on the CA-MRSA-(n: 99) isolates from the CBAH1-H3-dataset and on the HACO-MRSA-(n: 51) and CA-MRSA-(n: 213) isolates from other regions. Between 2005–2008, the annual proportion of CA-MRSA/CA-S. aureus in Córdoba hospitals increased from 25% to 49%, P<0.01. Total CA-MRSA infections increased 3.6 fold-(5.1 to 18.6 cases/100,000 annual-visits, P<0.0001), associated with an important increase of invasive CA-MRSA infections-(8.5 fold). In all regions analyzed, a single genotype prevailed in both CA-MRSA (82%) and HACO-MRSA(57%), which showed pulsed-field-gel electrophoresis-(PFGE)-type-“I”, sequence-type-5-(ST5), SCCmec-type-IVa, spa-t311, and was positive for PVL. The second clone, pulsotype-N/ST30/CC30/SCCmecIVc/t019/PVL+, accounted for 11.5% of total CA-MRSA infections. Importantly, the first 4 isolates of Argentina belonging to South American-USA300 clone-(USA300/ST8/CC8/SCCmecIVc/t008/PVL+/ACME?) were detected. We also demonstrated that a HA-MRSA clone-(pulsotype-C/ST100/CC5) caused 2% and 10% of CA-MRSA and HACO-MRSA infections respectively and was associated with a SCCmec type closely related to SCCmecIV(2B&5). Conclusions/Significance The dissemination of epidemic MRSA clone, ST5-IV-PVL+ was the main cause of increasing staphylococcal community-onset infections in Argentinean children (2003–2008), conversely to other countries. The predominance of this clone, which has capacity to express the h-VISA phenotype, in healthcare-associated community-onset cases suggests that it has infiltrated into hospital-settings. PMID:22291965

Sola, Claudia; Egea, Ana L.; Moyano, Alejandro J.; Garnero, Analia; Kevric, Ines; Culasso, Catalina; Vindel, Ana; Lopardo, Horacio; Bocco, José L.

2012-01-01

327

A Population Based Study of Seasonality of Skin and Soft Tissue Infections: Implications for the Spread of CA-MRSA  

PubMed Central

Methicillin resistant Staphylococcus aureus (MRSA) is currently a major cause of skin and soft tissue infections (SSTI) in the United States. Seasonal variation of MRSA infections in hospital settings has been widely observed. However, systematic time-series analysis of incidence data is desirable to understand the seasonality of community acquired (CA)-MRSA infections at the population level. In this paper, using data on monthly SSTI incidence in children aged 0–19 years and enrolled in Medicaid in Maricopa County, Arizona, from January 2005 to December 2008, we carried out time-series and nonlinear regression analysis to determine the periodicity, trend, and peak timing in SSTI incidence in children at different age: 0–4 years, 5–9 years, 10–14 years, and 15–19 years. We also assessed the temporal correlation between SSTI incidence and meteorological variables including average temperature and humidity. Our analysis revealed a strong annual seasonal pattern of SSTI incidence with peak occurring in early September. This pattern was consistent across age groups. Moreover, SSTIs followed a significantly increasing trend over the 4-year study period with annual incidence increasing from 3.36% to 5.55% in our pediatric population of approximately 290,000. We also found a significant correlation between the temporal variation in SSTI incidence and mean temperature and specific humidity. Our findings could have potential implications on prevention and control efforts against CA-MRSA. PMID:23565281

Wang, Xiaoxia; Towers, Sherry; Panchanathan, Sarada; Chowell, Gerardo

2013-01-01

328

A novel treatment option for MRSA pneumonia: ceftaroline fosamil-yielding new hope in the fight against a persistent infection.  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) hospital-acquired pneumonia (HAP) and healthcare-associated pneumonia (HCAP) patients treated with current antibiotic therapies have exhibited poor outcomes, increased hospital length of stay, and higher costs of care. The optimal management of these infections is undetermined; thus, it is critical to look at ways to improve outcomes in these patients. There is insufficient data on clinical efficacy in patients with MRSA HAP or HCAP infection treated with ceftaroline-fosamil. In a recent pilot study, nearly 90% of patients treated with ceftaroline-fosamil survived, despite the difficulties associated with administrating bactericidal antimicrobial therapy for this increasingly resistant pathogen. These data suggest a possible benefit in the use of ceftaroline-fosamil for MRSA pneumonia. Presently, we have identified cases over a two-year period treated with ceftaroline-fosamil, and will conduct a comparative analysis to controls (those treated with vancomycin and/or cefepime, and linezolid) to determine optimal therapeutic agents; these findings will have important implications for control of further spread of infection, recurrence, readmission, and mortality attributable to MRSA HAP and HCAP. PMID:24898885

Arshad, Samia; Hartman, Pamela; Zervos, Marcus J

2014-07-01

329

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 ...

330

A novel multiplex PCR method for detecting the major clonal complexes of MRSA in nasal isolates from a Pennsylvania hospital.  

PubMed

A novel multiplex PCR was developed which targeted virulence genes associated with the major clonal complexes (CCs) of healthcare- and community-associated methicillin-resistant Staphylococcus aureus (MRSA) in the USA. Most isolates (40/66) were identified as CC 5, while remaining isolates represented CCs 1, 8, 30, 45, 59, 133, and five isolates were not S. aureus. PMID:21672561

Schwalm, Nathan D; Verghese, Bindhu; Knabel, Stephen J

2011-09-01

331

A novel multiplex PCR method for detecting the major clonal complexes of MRSA in nasal isolates from a Pennsylvania hospital  

Microsoft Academic Search

A novel multiplex PCR was developed which targeted virulence genes associated with the major clonal complexes (CCs) of healthcare- and community-associated methicillin-resistant Staphylococcus aureus (MRSA) in the USA. Most isolates (40\\/66) were identified as CC 5, while remaining isolates represented CCs 1, 8, 30, 45, 59, 133, and five isolates were not S. aureus.

Nathan D. Schwalm; Bindhu Verghese; Stephen J. Knabel

2011-01-01

332

MRSA, Clostridium difficile and Other Drug Resistant Bacteria Information for Patients and Families What is Drug Resistant Bacteria?  

E-print Network

MRSA, Clostridium difficile and Other Drug Resistant Bacteria Information for Patients and Families What is Drug Resistant Bacteria? Drug Resistant Bacteria also referred to as Multi Drug Resistant Bacteria? Drug Resistant Bacteria are germs that can not be treated by some antibiotics often used to treat

Oliver, Douglas L.

333

A Systematic Literature Review and Meta-analysis of Factors Associated with MRSA Colonization at Time of Hospital or ICU Admission  

PubMed Central

Objective Screening for methicillin-resistant Staphylococcus aureus (MRSA) in high-risk patients is a legislative mandate in nine U.S. states and has been adopted by many hospitals. Definitions of “high-risk” differ among hospitals and state laws. A systematic evaluation of factors associated with colonization is lacking. We performed a systematic review of the literature to assess factors associated with MRSA colonization at hospital admission. Design We searched MEDLINE from 1966–2012 for articles comparing MRSA colonized and non-colonized patients on hospital or ICU admission. Data were extracted using a standardized instrument. Meta-analyses were performed to identify factors associated with MRSA colonization. Results We reviewed 4,381 abstracts; twenty-nine manuscripts met inclusion criteria (n=76,913 patients). MRSA colonization at hospital admission was associated with recent prior hospitalization (OR=2.4 95%-CI=1.3–4.7;p<0.01), nursing home exposure (OR=3.8 95%-CI=2.3–6.3;p<0.01) and history of exposure to healthcare-associated pathogens (MRSA carriage OR=8.0 95%-CI =4.2–15.1, C. difficile infection OR=3.4 95%-CI=2.2–5.3, vancomycin-resistant Enterococci carriage OR=3.1 95%-CI=2.5–4.0;p<0.01 for all). Select comorbidities were associated with MRSA colonization (congestive heart failure, diabetes, pulmonary disease, immunosuppression and renal failure; p<0.01 for all), while others were not (HIV, cirrhosis, and malignancy). ICU admission was not associated with an increased risk of MRSA colonization (OR=1.1 95%-CI =0.6–1.8;p=0.87). Conclusions MRSA colonization on hospital admission was associated with healthcare contact, previous healthcare-associated pathogens, and select comorbid conditions. ICU admission was not associated with MRSA colonization although this is commonly used in state mandates for MRSA screening. Infection prevention programs utilizing targeted MRSA screening may consider our results to define patients likely to have MRSA colonization. PMID:24018925

McKinnell, James A.; Miller, Loren G.; Eells, Samantha J.; Cui, Eric; Huang, Susan S.

2013-01-01

334

Impact of universal screening on MRSA bacteremias in a single acute NHS organisation (2006–12): interrupted time-series analysis  

PubMed Central

Background In November 2004, a national target was set for the English hospital trusts to reduce the Meticillin-Resistant Staphylococcus aureus (MRSA) bacteremia rate by 60% by April 2008 against the number during 2003/04 (baseline year). In our organisation the number of MRSA bacteremias had risen since 2002 and peaked at 75 in 2005/06. A target was set to reduce the number and series of specific and non- specific interventions was introduced including universal MRSA screening. This study analyzes the impact of universal MRSA screening using a quasi-experimental design using routinely gathered data. Methods This study used data gathered routinely for clinical governance, quality control, financial management and outbreak monitoring purposes. Interrupted Time Series (ITS) analysis of 15 pre- and 19 post- universal MRSA screening (and decolonisation) quarterly numbers of bacteremias was carried out where Meticillin-Sensitive Staphylococcus aureus (MSSA) numbers served as non-equivalent dependent variable (control). Results An immediate sharp fall in MRSA bacteremias was observed following the universal MRSA screening (and decolonisation) commenced in Q2, 2007. The number dropped sharply from 23 (Q2, 2007) to 10 (Q3, 2007) for all MRSA bacteremias, and, from 15 (Q2, 2007) to 6 (Q3, 2007) for bacteremias??48 hours of hospitalization. The declining trend continued reaching zero in Q2, 2009 and Q4, 2010 for those with ?48 hours of hospitalization and all bacteremias, respectively. ITS analysis revealed significant impact of universal MRSA screening on all MRSA bacteremias (?2 -0.554, p 0.000) and those with ?48 of hospitalization (?2 -0.577, p 0.001). Impact estimation predicted 17 and 13 bacteremias for all and those with ?48 hours hospitalization, respectively in the 19th quarter post-intervention, if the intervention did not occur. The number of MRSA isolates from non-blood culture systemic sources as percentage of admissions also dropped significantly from 3.32% in Q2, 2007 to 1.51% in Q3, 2007 (?2 -0.506, p 0.000) which is still running low at 0.33% at the end of Q1, 2012. On the other hand, there was no statistically significant impact of universal screening on MSSA bacteremias. Conclusions We conclude that of all interventions, the universal MRSA screening (and decolonisation) is the most effective intervention associated with significant and sharp drop in MRSA burden. PMID:23316746

2013-01-01

335

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

PubMed Central

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

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

2013-01-01

336

Medical and health economic evaluation of prevention- and control measures related to MRSA infections or -colonisations at hospitals  

PubMed Central

Introduction Methicillin-resistant Staphylococcus aureus (MRSA) are dangerous agents of nosocomial infections. In 2007 the prevalence of MRSA is 20.3% in Germany (Oxacilline-resistance according to EUCAST-criteria [EUCAST = European Committee on Antimicrobial Susceptibility Testing]). Objectives Which measurements are effective in the prevention and control of MRSA-infections in the hospital? How effective are contact precautions, screening, decolonisation, education and surveillance? Which recommendations can be given to health care politics on the basis of cost-effectiveness studies? Have there been any adverse effects on patients and clinical staff? What kind of liability problems exist? Methods Based on a systematic review of the literature studies are included which have been published in German or English language since 2004. Results 1,508 articles have been found. After having surveyed the full text, 33 medical, eight economic and four ethical/juridical studies are included for the Health Technology Assessment (HTA) report. The key result of the HTA report is that different measurements are effective in the prevention and control of MRSA-infections in hospitals, though the majority of the studies has a low quality. Effective are the conduction of differentiated screening measurements if they take into account the specific endemic situation, the use of antibiotic-control programs and the introduction and control of hygienic measurements. The break even point of preventive and control measurements cannot be defined because the study results differ too much. In the future it has to be more considered that MRSA-infections and contact precautions lead to a psycho-social strain for patients. Discussion It is hardly possible to describe causal efficacies because in the majority of the studies confounders are not sufficiently considered. In many cases bundles of measurements have been established but not analyzed individually. The internal and external validity of the studies is too weak to evaluate single interventions. Hygienic measurements prove to be effective in combination with other measurements. But it cannot be said which of the single measurements (gloves, washing hands, wearing gowns or masks) has the strongest effect on the reduction of MRSA. It is irritating that there are high differences in the compliance concerning hand hygiene between different studies. A general decolonisation is questionable for different reasons: first because of the side-effects for patients, second because of the high rate of spontaneous remissions in the untreated control group, third because of the differentiated process from colonisation to infection. Severalfold Hawthorne effects have been reported. One of them is that the competition between hospitals to reduce MRSA-rates leads already to a reduction. Conclusions It is evident that selective screening programs of risk patients considering the particular MRSA-prevalence are of use. The application of rapid tests seems to be only recommendable for risk patients and a high MRSA-prevalence. The improvement of the compliance of hand hygiene should be the basis of any prevention strategy. Training of staff members (with feedback mechanisms) is effective to improve compliance and to optimise the use of antibiotics. Antibiotic management programs are effective as well. Obviously multimodal approaches can lead to overadditive effects. Therefore the catalogue of preventive and control measurements has to be further evaluated. Good cost-efficacy studies are missing in Germany. The psychosocial effects of MRSA-infections are not researched in Germany. There is only punctual information on the risk management of hospitals. PMID:21289877

Korczak, Dieter; Schöffmann, Christine

2010-01-01

337

MRSA-Infected External Iliac Artery Pseudoaneurysm Treated with Endovascular Stenting  

SciTech Connect

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.

Clarke, M.G. [Taunton and Somerset Hospital, Department of Surgery (United Kingdom); Thomas, H.G. [Taunton and Somerset Hospital, Department of Radiology (United Kingdom)], E-mail: Hywel.Thomas@tst.nhs.uk; Chester, J.F. [Taunton and Somerset Hospital, Department of Surgery (United Kingdom)

2005-04-15

338

Evaluation of the BD Max MRSA XT assay for use with different swab types.  

PubMed

We evaluated the performance of the BD Max MRSA XT assay for use with different swab types. The 90% detection rates (95% confidence intervals) were 387 (97 to 1,551), 877 (238 to 3,230), 986 (183 to 5,287), 1,292 (328 to 5,078), 2,400 (426 to 13,518), and 5,848 (622 to 55,021) CFU/swab for Liquid Stuart, Liquid Amies, dry, Amies Gel without charcoal, ESwab collection, and Amies gel with charcoal swabs (Becton Dickinson), respectively. Amies Gel without charcoal, ESwab collection, and Amies gel with charcoal swabs had a tendency to be less sensitive, but none of the differences was statistically significant. PMID:25232162

Dalpke, Alexander H; Hofko, Marjeta; Stock, Christian; Zimmermann, Stefan

2014-12-01

339

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

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

Norbäck, Dan; Lampa, Erik; Engvall, Karin

2014-01-01

340

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

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

Norbäck, Dan; Lampa, Erik; Engvall, Karin

2014-01-01

341

Artesunate has its enhancement on antibacterial activity of ?-lactams via increasing the antibiotic accumulation within methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

Methicillin-resistant Staphylococcus aureus (MRSA) has now emerged as a predominant and serious pathogen because of its resistance to a large group of antibiotics, leading to high morbidity and mortality. Therefore, to develop new agents against resistance is urgently required. Previously, artesunate (AS) was found to enhance the antibacterial effect of ?-lactams against MRSA. In this study, AS was first found to increase the accumulation of antibiotics (daunorubicin and oxacillin) within MRSA by laser confocal microscopy and liquid chromatography-tandem MS method, suggesting the increased antibiotics accumulation might be related to the enhancement of AS on antibiotics. Furthermore, AS was found not to destroy the cell structure of MRSA by transmission electron microscope. AS was found to inhibit gene expressions of important efflux pumps such as NorA, NorB and NorC, but not MepA, SepA and MdeA. In conclusion, our results showed that AS was capable of enhancing the antibacterial activity of ?-lactams via increasing antibiotic accumulations within MRSA through inhibiting gene expressions of efflux pumps such as NorA, NorB and NorC, but did not destroy the cell structure of MRSA. AS could be further investigated as a candidate drug for treatment of MRSA infection. PMID:23549351

Jiang, Weiwei; Li, Bin; Zheng, Xinchuan; Liu, Xin; Pan, Xichun; Qing, Rongxin; Cen, Yanyan; Zheng, Jiang; Zhou, Hong

2013-06-01

342

Prevalence and Antibiotic Susceptibility of Community-Associated Methicillin-Resistant Staphylococcus aureus in a Rural Area of India: Is MRSA Replacing Methicillin-Susceptible Staphylococcus aureus in the Community?  

PubMed

Staphylococcus aureus (SA) is the most common cause of skin and soft tissue infections (SSTIs) and nosocomial infections. In developed countries there is a major concern about the rise of community-associated methicillin-resistant SA (CA-MRSA), but data from developing countries are scarce. In this study we describe the prevalence and antibiotic susceptibility of CA-MRSA and healthcare-associated MRSA (HA-MRSA) in a district hospital from rural India. We identified 119 CA-SA infections and 82 HA-SA infections. The majority of infections were SSTI, and the proportion of MRSA in CA-SA and HA-SA infections was 64.7% and 70.7%, respectively. The proportion of CA-MRSA in children <5 years was 73.7%. We did not observe any linezolid or vancomycin resistance. CA-SA had high levels of resistance to ciprofloxacin and low levels of resistance to chloramphenicol, doxycycline, rifampicin, and clindamycin. CA-MRSA had higher proportion of resistance to ciprofloxacin, erythromycin, gentamicin, and cotrimoxazole than CA methicillin-susceptible SA (CA-MSSA). HA-MRSA had higher proportion of resistance to clindamycin and doxycycline than CA-MRSA. The results of this study indicate that MRSA is replacing MSSA in CA-SA infections. If these findings are confirmed by other studies, the spread of CA-MRSA can be a major public health problem in India. PMID:23119178

Alvarez-Uria, Gerardo; Reddy, Raghuprakash

2012-01-01

343

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

NASA Astrophysics Data System (ADS)

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.

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

2012-11-01

344

Establishing an allergic eczema model employing recombinant house dust mite allergens Der p 1 and Der p 2 in BALB/c mice  

PubMed Central

Abstract The major house dust mite allergens Der p 1 and Der p 2 are prevalent inducers of eczema. Der p 1 is a cysteine protease disrupting epithelial barriers, whereas Der p 2 functionally mimics the LPS-binding compound MD-2 within the TLR4 complex. In this work, we tested the percutaneous sensitizing capacity of recombinant (r) Der p 1 and Der p 2 in BALB/c mice. Mice were sensitized by percutaneous application of low (10 ?g/application) and high dose (100 ?g) rDer p 1 or rDer p 2, or with rDer p 1 followed by rDer p 2. Allergen-specific and total IgE antibodies were determined by ELISA. Eczema of BALB/c was classified by the itching score and corresponded to erosions. Infiltrating immune cells were identified by haematoxylin/eosin and Giemsa staining for eosinophils or mast cells, CD3 staining for T lymphocytes. Percutaneous treatments with rDer p 1, but not rDer p 2-induced specific IgG1. However, cotreatment with rDer p 1 led to increase in anti-Der p 2 IgG titres. Both allergens elicited skin erosions because of scratching, thickening of the epidermis, and eosinophil and T-cell infiltration. Our data indicate that recombinant mite allergens in the absence of adjuvant are sufficient for inducing eczema in BALB/c mice. As the enzymatic activity of an allergen might be an important cofactor for specific sensitization via the skin, Der p 1 may act as adjuvant for other allergens too. The presented mouse model is suitable for investigating the mechanisms of allergic eczema. PMID:23163649

Szalai, Krisztina; Kopp, Tamara; Lukschal, Anna; Stremnitzer, Caroline; Wallmann, Julia; Starkl, Philipp; Vander Elst, Luc; Saint-Remy, Jean-Marie; Pali-Schöll, Isabella; Jensen-Jarolim, Erika

2012-01-01

345

Barrier repair therapy for facial atopic eczema with a non-steroidal emollient cream containing rhamnosoft, ceramides and iso-leucine. A six-case report series.  

PubMed

Atopic eczema (AE) is a skin disease very common in paediatric population and face region is commonly involved. AE of the face represents a therapeutic challenge limiting the use, especially for long periods, of corticosteroid topical products due to the high risk of atrophic skin changes. Skin barrier alterations and reduction of innate immune mechanisms (reduced levels of anti-microbial peptides) are now considered the hallmarks of AE. Therefore emollient and barrier repair therapies with topical steroid-free substances could be an alternative or an adjuvant strategy in managing AE especially for the face. A non-steroidal, anti-inflammatory moisturizing cream with barrier repair actions, containing rhamnosoft, ceramides and L-isoleucine (ILE) (Nutratopic pro-AMP) has been recently developed for the specific treatment of AE of the face. We report a series of 6 pediatric cases (2 female and 4 male, age from 6 months to 4 years) with facial eczema in children treated with pro-AMP cream for two/four weeks as single treatment, applied twice daily in the affected area with photograph documentation (baseline and after treatment). Pictures of the skin lesions at baseline and after treatment were taken in all cases using a high-definition digital camera. Pro-AMP cream use was associated with a clinical relevant improvement of all signs of eczema. The product was well tolerated. This case series document the clinical efficacy of a barrier repair therapy cream containing rhamnosoft, ceramides and iso-leucine in the treatment of atopic eczema of the face. PMID:25198568

Puviani, M; Agostinis, F; Milani, M

2014-08-01

346

Effect of different incubation atmospheres on the production of biofilm in methicillin-resistant Staphylococcus aureus (MRSA) grown in nutrient-limited medium.  

PubMed

Today, methicillin-resistant Staphylococcus aureus (MRSA) is a feared cause of nosocomial infections worldwide. These organisms can gain increased resistance to antimicrobial agents through biofilm formation, which appears to be a bacterial survival strategy. MRSA isolates obtained from patients were cultured in nutrient-limited medium supplemented with 0.2% glucose in aerobic, anaerobic, and CO(2) incubation atmospheres. Biofilm formation was quantified by the microtiter plate test. MRSA strains showed significantly lower biofilm production when grown in an aerobic atmosphere compared to that exhibited in CO(2)-rich environments. Gaseous conditions and growth in a nutritionally limited medium can profoundly influence the amount of biofilm formation in MRSA. This should be considered in any in vitro study of in vivo behavior. PMID:18704578

Ursic, Viktor; Tomic, Viktorija; Kosnik, Mitja

2008-10-01

347

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

PubMed Central

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

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

2014-01-01

348

Evaluation of the nasal microbiota in slaughter-age pigs and the impact on nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage  

PubMed Central

Background The nasal microbiota of pigs has been poorly assessed but could play a role in carriage of important microorganisms such as methicillin-resistant Staphylococcus aureus (MRSA). The objectives of this study were to describe the nasal microbiota in slaughter age pigs, to evaluate the impact of farm management on the nasal microbiota and to provide a preliminary assessment of the influence of the microbiota on MRSA carriage. Results Nasal swabs were collected from five MRSA positive and eight MRSA negative pigs on one farm that used a liquid feeding system and routine tylosin treatment, and seven MRSA negative pigs from an antibiotic-free farm that used conventional feeding. A total of 946310 sequences passed all quality control filters. The number of sequences per sample ranged from 4307 to 165656 (mean 56092, SD 40007). CatchAll analysis of richness predicted a mean of 1749 OTUs (range 213–3736, SD 996). Overall, 6291 OTUs were identified, yet 5125 (81%) were identified less than 10 times and the 12 most abundant OTUs accounted for 80.7% of sequences. Proteobacteria predominated in all but two samples. Liquid-fed/tylosin-exposed pigs had significantly lower relative abundances of Verrucomicrobia (P?=?0.004), Fibrobacteres (P?=?<0.0001) and sequences unclassified at the phylum level (P?=?0.028). When comparing only liquid-fed pigs, MRSA carriers had significantly more Bacteroidetes (P?=?0.037) than MRSA negative pigs. 124 genera were identified, with Moraxella accounting for 35.4% of sequences. In the Jaccard index tree, five of eight MRSA positive pigs clustered closely together, as did six of the seven conventionally-fed pigs. A significant difference was identified between conventional and liquid-fed pigs using parsimony test with the Jaccard (P?MRSA positive and negative pigs (P?=?0.133 and 0.175). OTUs belonging to Firmicutes were the main indicators of MRSA negative pigs, including Lactobacillus and another Lactobacillaceae and Staphylococcus. Conclusions Farm management can influence the nasal microbiota in pigs, but no impact of the microbiota on MRSA carriage was identified. Studies that further define the impact of management on the microbiota, and the impact of the microbiota on pathogen carriage are indicated. PMID:24628871

2014-01-01

349

Effect of Different Incubation Atmospheres on the Production of Biofilm in Methicillin-Resistant Staphylococcus aureus (MRSA) Grown in Nutrient-Limited Medium  

Microsoft Academic Search

Today, methicillin-resistant Staphylococcus aureus (MRSA) is a feared cause of nosocomial infections worldwide. These organisms can gain increased resistance to antimicrobial\\u000a agents through biofilm formation, which appears to be a bacterial survival strategy. MRSA isolates obtained from patients\\u000a were cultured in nutrient-limited medium supplemented with 0.2% glucose in aerobic, anaerobic, and CO2 incubation atmospheres. Biofilm formation was quantified by the

Viktor Urši?; Viktorija Tomi?; Mitja Košnik

2008-01-01

350

Healthcare-associated outbreaks and community-acquired infections due to MRSA carrying the Panton-Valentine leucocidin gene in southeastern Germany  

Microsoft Academic Search

In response to several isolations of methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leucocidin gene (PVL-MRSA), the present study was conducted to document the spread of infection in a small region of southeastern Germany. During a 9-month period, two healthcare-associated outbreaks with PVL-MRSA occurred, affecting 83 patients, personnel and contacts of personnel, and 34 additional cases were detected in the community.

H. Linde; F. Wagenlehner; B. Strommenger; I. Drubel; J. Tanzer; U. Reischl; U. Raab; C. Höller; K. G. Naber; W. Witte; F. Hanses; B. Salzberger; N. Lehn

2005-01-01

351

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

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

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

2014-01-01

352

Pumilicin 4, A Novel Bacteriocin with Anti-MRSA and Anti-VRE Activity Produced by Newly Isolated Bacteria Bacillus pumilus Strain WAPB4  

Microsoft Academic Search

A total of 34 bacterial strains with anti-methicillin-resistant Staphylococcus aureus (MRSA) activity were isolated from 69 soil and water samples collected from four areas of Thailand. One strain, WAPB4 identified\\u000a as Bacillus pumilus, showed remarkable antibacterial activity against MRSA, vancomycin-resistant Enterococcus faecalis (VRE), and several Gram-positive test bacteria. Bacteriocin produced by WAPB4 was designated as pumilicin 4. It was heat

Ratchaneewan Aunpad; Keasara Na-Bangchang

2007-01-01

353

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

PubMed Central

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

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

2015-01-01

354

A Novel Core Genome-Encoded Superantigen Contributes to Lethality of Community-Associated MRSA Necrotizing Pneumonia  

PubMed Central

Bacterial superantigens (SAg) stimulate T-cell hyper-activation resulting in immune modulation and severe systemic illnesses such as Staphylococcus aureus toxic shock syndrome. However, all known S. aureus SAgs are encoded by mobile genetic elements and are made by only a proportion of strains. Here, we report the discovery of a novel SAg staphylococcal enterotoxin-like toxin X (SElX) encoded in the core genome of 95% of phylogenetically diverse S. aureus strains from human and animal infections, including the epidemic community-associated methicillin-resistant S. aureus (CA-MRSA) USA300 clone. SElX has a unique predicted structure characterized by a truncated SAg B-domain, but exhibits the characteristic biological activities of a SAg including V?-specific T-cell mitogenicity, pyrogenicity and endotoxin enhancement. In addition, SElX is expressed by clinical isolates in vitro, and during human, bovine, and ovine infections, consistent with a broad role in S. aureus infections of multiple host species. Phylogenetic analysis suggests that the selx gene was acquired horizontally by a progenitor of the S. aureus species, followed by allelic diversification by point mutation and assortative recombination resulting in at least 17 different alleles among the major pathogenic clones. Of note, SElX variants made by human- or ruminant-specific S. aureus clones demonstrated overlapping but distinct V? activation profiles for human and bovine lymphocytes, indicating functional diversification of SElX in different host species. Importantly, SElX made by CA-MRSA USA300 contributed to lethality in a rabbit model of necrotizing pneumonia revealing a novel virulence determinant of CA-MRSA disease pathogenesis. Taken together, we report the discovery and characterization of a unique core genome-encoded superantigen, providing new insights into the evolution of pathogenic S. aureus and the molecular basis for severe infections caused by the CA-MRSA USA300 epidemic clone. PMID:22022262

Wilson, Gillian J.; Seo, Keun Seok; Cartwright, Robyn A.; Connelley, Timothy; Chuang-Smith, Olivia N.; Merriman, Joseph A.; Guinane, Caitriona M.; Park, Joo Youn; Bohach, Gregory A.; Schlievert, Patrick M.; Morrison, W. Ivan; Fitzgerald, J. Ross

2011-01-01

355

Prevalence of livestock-associated MRSA in broiler flocks and risk factors for slaughterhouse personnel in The Netherlands  

Microsoft Academic Search

To determine methicillin-resistant Staphylococcus aureus (MRSA) carriage in poultry and slaughterhouse personnel, 40 Dutch broiler flocks, in six slaughterhouses and 466 personnel were sampled. Of the employees, 26 were positive (5·6%), indicating a higher risk of exposure when compared to the general Dutch population (0·1%). This risk was significantly higher for personnel having contact with live animals (5·2%) – especially

M. N. Mulders; A. P. J. Haenen; P. L. Geenen; P. C. Vesseur; E. S. Poldervaart; T. Bosch; X. W. Huijsdens; P. D. Hengeveld; W. D. C. Dam-Deisz; E. A. M. Graat; D. J. Mevius; A. Voss; A. W. van de Giessen

2010-01-01

356

Aogacillins A and B produced by Simplicillium sp. FKI-5985: new circumventors of arbekacin resistance in MRSA.  

PubMed

Aogacillins A and B, capable of overcoming arbekacin resistance in methicillin-resistant Staphylococcus aureus (MRSA), were isolated from a culture broth of Simplicillium sp. FKI-5985. Their structures were elucidated by NMR spectroscopic studies and ECD analyses. The aogacillins possessed a novel carbon skeleton, including a ?-keto-?-methyliden-?-lactone ring connected to a 2-ethyl-6-methylcyclohexane ring by spiro conjugation. PMID:24004199

Takata, Keiko; Iwatsuki, Masato; Yamamoto, Tsuyoshi; Shirahata, Tatsuya; Nonaka, Kenichi; Masuma, Rokuro; Hayakawa, Yoichi; Hanaki, Hideaki; Kobayashi, Yoshinori; Petersson, George A; ?mura, Satoshi; Shiomi, Kazuro

2013-09-20

357

Isojacareubin from the Chinese Herb Hypericum japonicum: Potent Antibacterial and Synergistic Effects on Clinical Methicillin-Resistant Staphylococcus aureus (MRSA)  

PubMed Central

Through bioassay-guided fractionation of the extracts from the aerial parts of the Chinese herb Hypericum japonicum Thunb. Murray, Isojacareubin (ISJ) was characterized as a potent antibacterial compound against the clinical methicillin-resistant Staphylococcus aureus (MRSA). The broth microdilution assay was used to determine the minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations (MBCs) of ISJ alone. The results showed that its MICs/MBCs ranged from 4/16 to 16/64 ?g/mL, with the concentrations required to inhibit or kill 50% of the strains (MIC50/MBC50) at 8/16 ?g/mL. Synergistic evaluations of this compound with four conventional antibacterial agents representing different types were performed by the chequerboard and time-kill tests. The chequerboard method showed significant synergy effects when ISJ was combined with Ceftazidime (CAZ), Levofloxacin (LEV) and Ampicillin (AMP), with the values of 50% of the fractional inhibitory concentration indices (FICI50) at 0.25, 0.37 and 0.37, respectively. Combined bactericidal activities were also observed in the time-kill dynamic assay. The results showed the ability of ISJ to reduce MRSA viable counts by log10CFU/mL at 24 h of incubation at a concentration of 1 × MIC were 1.5 (LEV, additivity), 0.92 (CAZ, indifference) and 0.82 (AMP, indifference), respectively. These in vitro anti-MRSA activities of ISJ alone and its synergy with conventional antibacterial agents demonstrated that ISJ enhanced their efficacy, which is of potential use for single and combinatory therapy of patients infected with MRSA. PMID:22942699

Zuo, Guo-Ying; An, Jing; Han, Jun; Zhang, Yun-Ling; Wang, Gen-Chun; Hao, Xiao-Yan; Bian, Zhong-Qi

2012-01-01

358

Randomised controlled trial of short bursts of a potent topical corticosteroid versus prolonged use of a mild preparation for children with mild or moderate atopic eczema  

PubMed Central

Objective To determine whether a three day burst of a potent corticosteroid is more effective than a mild preparation used for seven days in children with mild or moderate atopic eczema. Design Randomised, double blind, parallel group study of 18 weeks' duration. Setting 13 general practices and a teaching hospital in the Nottingham area. Participants 174 children with mild or moderate atopic eczema recruited from general practices and 33 from a hospital outpatient clinic. Interventions 0.1% betamethasone valerate applied for three days followed by the base ointment for four days versus 1% hydrocortisone applied for seven days. Main outcome measures Primary outcomes were total number of scratch-free days and number of relapses. Secondary outcomes were median duration of relapses, number of undisturbed nights, disease severity (six area, six sign atopic dermatitis severity scale), scores on two quality of life measures (children's life quality index and dermatitis family impact questionnaire), and number of patients in whom treatment failed in each arm. Results No differences were found between the two groups. This was consistent for all outcomes. The median number of scratch-free days was 118.0 for the mild group and 117.5 for the potent group (difference 0.5, 95% confidence interval ?2.0 to 4.0, P=0.53). The median number of relapses for both groups was 1.0. Both groups showed clinically important improvements in disease severity and quality of life compared with baseline. Conclusion A short burst of a potent topical corticosteroid is just as effective as prolonged use of a milder preparation for controlling mild or moderate atopic eczema in children. What is already known on this topicTopical corticosteroids have been used to control atopic eczema for 40 yearsNo studies have compared short bursts of a potent preparation with prolonged use of a weak preparation for controlling mild or moderate diseaseWhat this study addsA short burst of a potent topical steroid is as effective and safe as prolonged use of a weak preparation for mild or moderate atopic eczemaThe type of preparation is immaterial provided that the dosage is adequate PMID:11923161

Thomas, K S; Armstrong, S; Avery, A; Po, A Li Wan; O'Neill, C; Young, S; Williams, H C

2002-01-01

359

Pharmacokinetics, pharmacodynamics and efficacy of novel FabI inhibitor AFN-1252 against MSSA and MRSA in the murine thigh infection model  

PubMed Central

AFN-1252, a new antimicrobial agent, specifically and potently inhibits fatty acid synthesis in Staphylococcus aureus. We characterized in vivo pharmacokinetic and pharmacodynamic profiles of AFN-1252 administered orally to neutropenic mice inoculated in thighs (?106 CFU) with methicillin-susceptible S. aureus (MSSA) ATCC 29213. Efficacy was also assessed in mice inoculated with MSSA, hospital-acquired Methicillin-resistant Staphylococcus aureus (HA-MRSA) or community-acquired (CA)-MRSA, and administered AFN-1252 or linezolid orally. Bacterial density was determined after 24 hours and efficacy defined as the change in CFU/thigh versus untreated controls at time 0. With MSSA, antibacterial reductions of ?1 log were observed at ?20 mg/kg doses, with ƒAUC/minimum inhibitory concentration (MIC) best describing the pharmacodynamic profile of AFN-1252. The 80, 50 and 5% maximum effects were observed with ƒAUC/MIC values of 22·3, 17·0, and 9·6, respectively. Similar values were obtained for CA-MRSA and HA-MRSA. AFN-1252 was 4–40 fold more effective than linezolid against CA-MRSA and HA-MRSA. These data demonstrate the excellent in vivo potency of AFN-1252 against phenotypically diverse S. aureus. PMID:23433441

Banevicius, Mary A; Kaplan, Nachum; Hafkin, Barry; Nicolau, David P

2013-01-01

360

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

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

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

2013-01-01

361

Avenaciolides: potential MurA-targeted inhibitors against peptidoglycan biosynthesis in methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

Discovery of new antibiotics for combating methicillin-resistant Staphylococcus aureus (MRSA) is of vital importance in the post-antibiotic era. Here, we report four avenaciolide derivatives (1-4) isolated from Neosartorya fischeri, three of which had significant antimicrobial activity against MRSA. The morphology of avenaciolide-treated cells was protoplast-like, which indicated that cell wall biosynthesis was interrupted. Comparing the structures and minimum inhibitory concentrations of 1-4, the ?,?-unsaturated carbonyl group seems to be an indispensable moiety for antimicrobial activity. Based on a structural similarity survey of other inhibitors with the same moiety, we revealed that MurA was the drug target. This conclusion was validated by (31)P NMR spectroscopy and MS/MS analysis. Although fosfomycin, which is the only clinically used MurA-targeted antibiotic, is ineffective for treating bacteria harboring the catalytically important Cys-to-Asp mutation, avenaciolides 1 and 2 inhibited not only wild-type but also fosfomycin-resistant MurA in an unprecedented way. Molecular simulation revealed that 2 competitively perturbs the formation of the tetrahedral intermediate in MurA. Our findings demonstrated that 2 is a potent inhibitor of MRSA and fosfomycin-resistant MurA, laying the foundation for the development of new scaffolds for MurA-targeted antibiotics. PMID:25521652

Chang, Ching-Ming; Chern, Jeffy; Chen, Ming-Yi; Huang, Kai-Fa; Chen, Chein-Hung; Yang, Yu-Liang; Wu, Shih-Hsiung

2015-01-14

362

A Data-Driven Mathematical Model of CA-MRSA Transmission among Age Groups: Evaluating the Effect of Control Interventions  

PubMed Central

Community associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a major cause of skin and soft tissue infections (SSTIs) in the US. We developed an age-structured compartmental model to study the spread of CA-MRSA at the population level and assess the effect of control intervention strategies. We used Monte-Carlo Markov Chain (MCMC) techniques to parameterize our model using monthly time series data on SSTIs incidence in children (?19 years) during January 2004 -December 2006 in Maricopa County, Arizona. Our model-based forecast for the period January 2007–December 2008 also provided a good fit to data. We also carried out an uncertainty and sensitivity analysis on the control reproduction number, which we estimated at 1.3 (95% CI [1.2,1.4]) based on the model fit to data. Using our calibrated model, we evaluated the effect of typical intervention strategies namely reducing the contact rate of infected individuals owing to awareness of infection and decolonization strategies targeting symptomatic infected individuals on both and the long-term disease dynamics. We also evaluated the impact of hypothetical decolonization strategies targeting asymptomatic colonized individuals. We found that strategies focused on infected individuals were not capable of achieving disease control when implemented alone or in combination. In contrast, our results suggest that decolonization strategies targeting the pediatric population colonized with CA-MRSA have the potential of achieving disease elimination. PMID:24277998

Wang, Xiaoxia; Panchanathan, Sarada; Chowell, Gerardo

2013-01-01

363

Evaluation of anti-methicillin-resistant Staphylococcus aureus (MRSA) activity and synergy of some bioactive plant extracts.  

PubMed

Anti-methicillin-resistant Staphylococcus aureus (MRSA) activity of ethanolic extracts of four medicinal plants namely Acorus calamus (rhizome) Hemidesmus indicus (stem), Holarrhena antidysenterica (bark), and Plumbago zeylanica (root), were detected with inhibition zone size ranged from 11 to 44 mm and minimum inhibitory concentration (MIC) varied from 0.32 to 3.25 mg/mL. Further, ethyl acetate, acetone and methanol fractions of above plants demonstrated antibacterial activity. The potency of these fractions based on zone of inhibition and MIC value was relatively higher in P. zeylanica (ethylacetate fraction), followed by acetone fractions of H. indicus, A. calamus, and H. antidysenterica. Time kill assay with most promising fractions of these plant extracts, demonstrated concentration-dependent killing of MRSA within 9-12 h of incubation. Interestingly, synergistic interaction among alcoholic extracts and some fractions of above four plants was evident against MRSA. Further, synergistic interaction of these extracts was detected with one or more antibiotics tested (tetracycline, chloramphenicol, ciprofloxacin, cefuroxime and ceftidizime). The findings also validate the traditional uses of above plants against infectious diseases. Phytochemical studies demonstrated flavonoids and phenols as major active constituents. Further investigations are needed to characterize the active principle and its interaction mechanism with antibiotics. PMID:17004300

Aqil, Farrukh; Ahmad, Iqbal; Owais, Mohd

2006-10-01

364

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

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

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

2014-01-01

365

Antimicrobial activity of isothiocyanates from cruciferous plants against methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

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

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

2014-01-01

366

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

PubMed Central

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

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

2014-01-01

367

The importance of free fatty acid chain length for the skin barrier function in atopic eczema patients.  

PubMed

An important feature of atopic eczema (AE) is a decreased skin barrier function. The stratum corneum (SC) lipids - comprised of ceramides (CERs), free fatty acids (FFAs) and cholesterol - fulfil a predominant role in the skin barrier function. In this clinical study, the carbon chain length distribution of SC lipids (FFAs and CERs) and their importance for the lipid organization and skin barrier function were examined in AE patients and compared with control subjects. A reduction in FFA chain length and an increase in unsaturated FFAs are observed in non-lesional and lesional SC of AE patients. The reduction in FFA chain length associates with a reduced CER chain length, suggesting a common synthetic pathway. The lipid chain length reduction correlates with a less dense lipid organization and a decreased skin barrier function. All changes are more pronounced in lesional SC compared with non-lesional skin. No association was observed between lipid properties and filaggrin mutations, an important predisposing factor for developing AE. The results of this study demonstrate an altered SC lipid composition and signify the importance of these changes (specifically regarding the CER and FFA chain lengths) for the impaired skin barrier function in AE. This provides insights into epidermal lipid metabolism as well as new opportunities for skin barrier repair. PMID:24299153

van Smeden, Jeroen; Janssens, Michelle; Kaye, Edward C J; Caspers, Peter J; Lavrijsen, Adriana P; Vreeken, Rob J; Bouwstra, Joke A

2014-01-01

368

A retrospective study of risk factors for poor outcomes in methicillin-resistant staphylococcus aureus (MRSA) infection in surgical patients  

PubMed Central

Background Since its isolation, Methicillin-resistant Staphlococcus aureus (MRSA) has become a major cause of hospital acquired infection (HAI), adverse patient outcome and overall resource utilisation. It is endemic in Scotland and widespread in Western hospitals. MRSA has been the subject of widespread media interest- a manifestation of concerns about sterile surgical techniques and hospital cleanliness. This study aimed to investigate patient outcome of MRSA infections over the last decade at a major orthopaedic trauma centre. The objective was to establish the association of variables, such as patient age and inpatient residence, against patient outcome, in order to quantify significant relationships; facilitating the evaluation of management strategies with an aim to improving patient outcomes and targeting high-risk procedures. Methods This is a retrospective study of the rates and outcomes of MRSA infection in orthopaedic trauma at the Royal Infirmary of Edinburgh. Data was collated using SPSS 14.0 for Windows(R). Shapiro-Wilkes testing was performed to investigate the normality of continuous data sets (e.g: age). Data was analysed using both Chi-Squared and Fisher's exact tests (in cases of expected values under 5) Results This study found significant associations between adverse patient outcome (persistent deep infection, osteomyelitis, the necessity for revision surgery, amputation and mortality) and the following patient variables: Length of inpatient stay, immuno-compromise, pre-admission residence in an institutional setting (such as a residential nursing home) and the number of antibiotics used in patient care. Despite 63% of all infections sampled resulting from proximal femoral fractures, no association between patient outcome and site of infection or diagnosis was found. Somewhat surprisingly, the relationship between age and outcome of infection was not proved to be significant, contradicting previous studies suggesting a statistical association. Antibiotic prophylaxis, previously identified as a factor in reducing overall incidence of MRSA infection, was not found to be significantly associated with outcome. Conclusions Early identification of high-risk patients as identified by this study could lead to more judicious use of therapeutic antibiotics and reductions in adverse outcome, as well as socioeconomic cost. These results could assist in more accurate risk stratification based on evidence based evaluation of the significance of the risk factors investigated. PMID:21605456

2011-01-01

369

Characterization of a Novel Arginine Catabolic Mobile Element (ACME) and Staphylococcal Chromosomal Cassette mec Composite Island with Significant Homology to Staphylococcus epidermidis ACME Type II in Methicillin-Resistant Staphylococcus aureus Genotype ST22-MRSA-IV?  

PubMed Central

The arginine catabolic mobile element (ACME) is prevalent among methicillin-resistant Staphylococcus aureus (MRSA) isolates of sequence type 8 (ST8) and staphylococcal chromosomal cassette mec (SCCmec) type IVa (USA300) (ST8-MRSA-IVa isolates), and evidence suggests that ACME enhances the ability of ST8-MRSA-IVa to grow and survive on its host. ACME has been identified in a small number of isolates belonging to other MRSA clones but is widespread among coagulase-negative staphylococci (CoNS). This study reports the first description of ACME in two distinct strains of the pandemic ST22-MRSA-IV clone. A total of 238 MRSA isolates recovered in Ireland between 1971 and 2008 were investigated for ACME using a DNA microarray. Twenty-three isolates (9.7%) were ACME positive, and all were either MRSA genotype ST8-MRSA-IVa (7/23, 30%) or MRSA genotype ST22-MRSA-IV (16/23, 70%). Whole-genome sequencing and comprehensive molecular characterization revealed the presence of a novel 46-kb ACME and staphylococcal chromosomal cassette mec (SCCmec) composite island (ACME/SCCmec-CI) in ST22-MRSA-IVh isolates (n = 15). This ACME/SCCmec-CI consists of a 12-kb DNA region previously identified in ACME type II in S. epidermidis ATCC 12228, a truncated copy of the J1 region of SCCmec type I, and a complete SCCmec type IVh element. The composite island has a novel genetic organization, with ACME located within orfX and SCCmec located downstream of ACME. One PVL locus-positive ST22-MRSA-IVa isolate carried ACME located downstream of SCCmec type IVa, as previously described in ST8-MRSA-IVa. These results suggest that ACME has been acquired by ST22-MRSA-IV on two independent occasions. At least one of these instances may have involved horizontal transfer and recombination events between MRSA and CoNS. The presence of ACME may enhance dissemination of ST22-MRSA-IV, an already successful MRSA clone. PMID:21343442

Shore, Anna C.; Rossney, Angela S.; Brennan, Orla M.; Kinnevey, Peter M.; Humphreys, Hilary; Sullivan, Derek J.; Goering, Richard V.; Ehricht, Ralf; Monecke, Stefan; Coleman, David C.

2011-01-01

370

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

PubMed Central

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

Workman, Rella

2014-01-01

371

Evaluation of a New Selective Medium, BD BBL CHROMagar MRSA II, for Detection of Methicillin-Resistant Staphylococcus aureus in Different Specimens?  

PubMed Central

The sensitivity of screening for methicillin-resistant Staphylococcus aureus (MRSA) can be improved by adding other specimen sites to nares. We describe an evaluation of a new selective medium, BBL CHROMagar MRSA II (CMRSAII), for its ability to detect MRSA from different specimen types. CMRSAII is a chromogenic medium which incorporates cefoxitin for the detection of MRSA. A study was performed at four clinical laboratories with the following specimens: 1,446 respiratory, 694 stool, 1,275 skin, and 948 wound specimens and 688 blood culture bottles containing Gram-positive cocci. The recovery of MRSA on traditional culture media was compared to results with CMRSAII. S. aureus was tested by cefoxitin disk diffusion. CMRSAII was interpreted as positive for MRSA at 24 h (range, 18 to 28 h) based solely on the visualization of mauve-colored colonies and at 48 h (range, 36 to 52 h) based on detection of mauve colonies with subsequent confirmation as S. aureus (by coagulase or latex agglutination testing). MRSA was recovered more frequently on CMRSAII (89.8% at 24 h and 95.6% at 48 h) than on traditional culture plates (83.1% at 24 h and 79.8% at 48 h) for all specimen types combined (P < 0.001). The percent sensitivities of CMRSAII at 24- and 48-h reads, respectively, were 85.5 and 92.4% for respiratory specimens, 87.9% and 98.3% for stool specimens, 88.4% and 96.1% for skin specimens, 92.1% and 94.6% for wound specimens, and 100% and 100% for positive blood cultures. The specificity was 99.8% for respiratory specimens and 100% for all others. In conclusion, CMRSAII is a reliable screening medium for multiple specimen types. PMID:20392927

Wendt, C.; Havill, N. L.; Chapin, K. C.; Boyce, J. M.; Dickenson, R.; Eigner, U.; Schütt, S.; Fahr, A. M.

2010-01-01

372

Evaluation of a new selective medium, BD BBL CHROMagar MRSA II, for detection of methicillin-resistant Staphylococcus aureus in different specimens.  

PubMed

The sensitivity of screening for methicillin-resistant Staphylococcus aureus (MRSA) can be improved by adding other specimen sites to nares. We describe an evaluation of a new selective medium, BBL CHROMagar MRSA II (CMRSAII), for its ability to detect MRSA from different specimen types. CMRSAII is a chromogenic medium which incorporates cefoxitin for the detection of MRSA. A study was performed at four clinical laboratories with the following specimens: 1,446 respiratory, 694 stool, 1,275 skin, and 948 wound specimens and 688 blood culture bottles containing Gram-positive cocci. The recovery of MRSA on traditional culture media was compared to results with CMRSAII. S. aureus was tested by cefoxitin disk diffusion. CMRSAII was interpreted as positive for MRSA at 24 h (range, 18 to 28 h) based solely on the visualization of mauve-colored colonies and at 48 h (range, 36 to 52 h) based on detection of mauve colonies with subsequent confirmation as S. aureus (by coagulase or latex agglutination testing). MRSA was recovered more frequently on CMRSAII (89.8% at 24 h and 95.6% at 48 h) than on traditional culture plates (83.1% at 24 h and 79.8% at 48 h) for all specimen types combined (P < 0.001). The percent sensitivities of CMRSAII at 24- and 48-h reads, respectively, were 85.5 and 92.4% for respiratory specimens, 87.9% and 98.3% for stool specimens, 88.4% and 96.1% for skin specimens, 92.1% and 94.6% for wound specimens, and 100% and 100% for positive blood cultures. The specificity was 99.8% for respiratory specimens and 100% for all others. In conclusion, CMRSAII is a reliable screening medium for multiple specimen types. PMID:20392927

Wendt, C; Havill, N L; Chapin, K C; Boyce, J M; Dickenson, R; Eigner, U; Schütt, S; Fahr, A M

2010-06-01

373

Differences in Epidemiological and Molecular Characteristics of Nasal Colonization with Staphylococcus aureus (MSSA-MRSA) in Children from a University Hospital and Day Care Centers  

PubMed Central

Background Clinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA). In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA) in children from a university hospital and day care centers (DCCs) of Medellin, Colombia. Methods An observational cross-sectional study was conducted in 400 children (200 in each setting), aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups. Results Frequency of S. aureus colonization was 39.8% (n?=?159) (hospital 44.5% and DCCs 35.0%) and by MRSA, 5.3% (n?=?21) (hospital 7.0% and DCCs 3.5%). Most S. aureus colonized children were older than two years (p?=?0.005), the majority of them boys (59.1%), shared a bedroom with a large number of people (p?=?0.028), with history of ?-Lactamase inhibitors usage (p?=?0.020). MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC). MRSA isolates presented 6 CC, most of them (47.6%) belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains. Conclusion Differences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of infection among the child population. PMID:24987854

Rodríguez, Erika A.; Correa, Margarita M.; Ospina, Sigifredo; Atehortúa, Santiago L.; Jiménez, J. Natalia

2014-01-01

374

Potential of sequential treatment with minocycline and S. aureus specific phage lysin in eradication of MRSA biofilms: an in vitro study.  

PubMed

Lysins are novel class of anti-infectives which are derived from bacteriophage. In the present study, the potential of previously characterised phage borne endolysin MR-10 in eradicating methicillin-resistant Staphylococcus aureus (MRSA) biofilm was evaluated. Scanning electron microscopic examination showed that both ica-positive and ica-negative MRSA formed equally potent mature biofilm. Different approaches were employed to eradicate the young as well as older biofilm formed by both types of MRSA strains. Our results showed a significant decrease (p?MRSA biofilm with minocycline (4 ?g/ml) for 3 h followed by treatment with endolysin MR-10. Since endolysin can act effectively irrespective of the metabolic status of the cells hence, they are capable of killing the rapidly growing cells (log phase cells) as well as non-dividing (stationary phase) cells. As a result they are effective in eradicating the younger and older biofilm. On staining the ica-positive MRSA biofilm with wheat germ agglutinin (WGA)-Alexa Flour 350, reduction in poly-intercellular adhesion (PIA) content was observed in comparison to control biofilm. In addition, a significant decrease (p?MRSA biofilm was also observed. Further, Live/Dead Baclight™ staining also showed presence of higher population of dead cells after treatment with minocycline and endolysin MR-10. Hence, our results showed that using minocycline sequentially with endolysin, MR-10 can effectively eradicate both young as well as older biofilm formed by ica-positive and ica-negative MRSA. PMID:25707865

Chopra, Shivani; Harjai, Kusum; Chhibber, Sanjay

2015-04-01

375

Impetigo  

MedlinePLUS

... THIS TOPIC Abscess MRSA First Aid: Skin Infections Cellulitis Skin, Hair, and Nails What Are Germs? Eczema ... First Aid: Poison Ivy/Oak/Sumac Impetigo Abscess Cellulitis Impetigo Staph Infections MRSA Abscess Cellulitis Ringworm Hand ...

376

Mediterranean diet adherence during pregnancy and risk of wheeze and eczema in the first year of life: INMA (Spain) and RHEA (Greece) mother-child cohort studies.  

PubMed

Maternal diet during pregnancy might influence the development of childhood allergic disorders. The aim of the present study was to evaluate the impact of Mediterranean diet (MD) adherence during pregnancy on wheeze and eczema in the first year of life in two population-based mother-child cohorts in Spain and Greece. We studied 1771 mother-newborn pairs from the Spanish multi-centre 'INMA' (INfancia y Medio Ambiente) study (Gipuzkoa, Sabadell and Valencia) and 745 pairs from the 'RHEA' study in Crete, Greece. The symptoms of wheeze and eczema were based on the criteria of the International Study of Asthma and Allergies in Childhood. Maternal diet during pregnancy was assessed by FFQ and MD adherence was evaluated through an a priori score. Multivariate log-binomial regression models were used to adjust for several confounders in each cohort and summary estimates were obtained by a meta-analysis. MD adherence was not associated with the risk of wheeze and eczema in any cohort, and similar results were identified in the meta-analysis approach. High meat intake (relative risk (RR) 1·22, 95 % CI 1·00, 1·49) and 'processed' meat intake (RR 1·18, 95 % CI 1·02, 1·37) during pregnancy were associated with an increased risk of wheeze in the first year of life, while a high intake of dairy products was significantly associated with a decreased risk of infantile wheeze (RR 0·83, 95 % CI 0·72, 0·96). The results of the present study show that high meat intake during pregnancy may increase the risk of wheeze in the first year of life, while a high intake of dairy products may decrease it. PMID:23680284

Chatzi, Leda; Garcia, Raquel; Roumeliotaki, Theano; Basterrechea, Mikel; Begiristain, Haizea; Iñiguez, Carmen; Vioque, Jesus; Kogevinas, Manolis; Sunyer, Jordi

2013-12-14

377

Effect of daptomycin on local interleukin-6, matrix metalloproteinase-9, and metallopeptidase inhibitor 1 in patients with MRSA-infected diabetic foot.  

PubMed

Infection is a major cause of the diabetic foot syndrome that is promoted by the increased burden of multiresistant germs like methicillin-resistant Staphylococcus aureus (MRSA). Maximizing positive outcome for serious MRSA infections requires an aggressive treatment approach and careful monitoring of the healing process. Therefore, we examined 8 patients with MRSA-infected diabetic foot syndrome of Wagner classification grade 2 or 3 (corresponding to the Texas classification stage 2 or 3) during antibiotic treatment with daptomycin. We documented the wound size and obtained samples of wound secretion for analyses of proinflammatory interleukin-6 (IL-6), protease (matrix metalloproteinase-9 [MMP-9]), and antiprotease (metallopeptidase inhibitor 1 [TIMP-1]) activity. During the course of anti-MRSA therapy, we observed a decrease in the concentration of local IL-6 within the first 3 days followed by a decrease of MMP-9 and an increase of TIMP-1. Finally, a reduction of wound size was documented. The present data show that efficient antimicrobial treatment with daptomycin has a number of beneficial effects on wound healing at the molecular level in MRSA-infected diabetic foot ulcers. PMID:24659622

Ambrosch, Andreas; Halevy, Daniel; Fwity, Boushra; Brin, Thomas; Lobmann, Ralf

2014-03-01

378

Effect of daptomycin on local interleukin-6, matrix metalloproteinase-9, and metallopeptidase inhibitor 1 in patients with MRSA-infected diabetic foot.  

PubMed

Infection is a major cause of the diabetic foot syndrome being aggravating by the increased burden of multiresistant germs like methicillin-resistant Staphylococcus aureus (MRSA). Maximizing positive outcome for serious MRSA infections requires an aggressive treatment approach and a careful monitoring of the healing process. Therefore, we examined 8 patients with MRSA-infected diabetic foot syndrome Wagner classification grades 2 or 3 (corresponding to the Texas classification stage 2 and 3) during antibiotic treatment with daptomycin. We documented the wound size and obtained samples of wound secretion for analyses of pro-inflammatory interleukin-6 (IL-6), protease (matrix metalloproteinase-9 [MMP-9]), and antiprotease activity (metallopeptidase inhibitor 1 [TIMP-1]). During the course of anti-MRSA therapy, a decrease in the concentration of local IL-6 within the first 3 days followed by a drop of MMP-9 and an increase of TIMP-1 was observed. Finally, a reduction of wound size could be documented. The present data show that efficient antimicrobial treatment with daptomycin leads to a number of beneficial processes at the molecular level of wound healing in MRSA-infected diabetic foot ulcers. PMID:23771610

Ambrosch, Andreas; Halevy, Daniel; Fwity, Boushra; Brin, Thomas; Lobmann, Ralf

2013-06-01

379

Rapamycin Augments the NMDA-Mediated TNF Suppression of MRSA-Stimulated RAW264.7 Murine Macrophages  

PubMed Central

Background. Methicillin-resistant Staphylococcus aureus (MRSA) can stimulate massive cytokine release. Ketamine suppresses tumor necrosis factor (TNF) secretion by MRSA-stimulated RAW264.7 macrophages, and the mechanism likely involves N-methyl-D-aspartic acid (NMDA) receptor antagonism. The downstream effects of NMDA-mediated TNF suppression, specifically the PI3K/Akt and mTOR modulation, have not been described. Methods. RAW264.7 cells were stimulated for 18?hrs with 105 to 107?CFU/mL inocula of either of two prototypical community-acquired- (CA-) MRSA isolates, USA300 strain LAC and USA400 strain MW2. Then we added the NMDA inhibitors ketamine or 2R-amino-5-phosphonopentanoate (AP5), NMDA substrate, LY294002, and rapamycin in various combinations. Results. NMDA inhibition suppressed TNF secretion by almost a third compared to the no-ketamine control. When NMDA substrate was added, the TNF secretion increased by 10%. Addition of LY294002 suppressed TNF production by macrophages by 20%. Rapamycin exhibited a concentration-dependent TNF induction-suppression response: induction at doses of 0.1 and 1?ng/mL and suppression at 10 and 100?ng/mL. Induction of TNF was abolished when LY294002 was added and the suppression became uniform. Ketamine-induced suppression of TNF secretion was intensified 10–15% when rapamycin was added, but not when LY294002 was added. Conclusion. These findings suggest that NMDA-induced TNF suppression can be augmented by concurrent mTOR inhibition. PMID:23094196

Spentzas, Thomas; Shappley, Rebekah K. H.; Savorgnan, Fabio; Meals, Elizabeth; English, B. Keith

2012-01-01

380

Targeting of PBP1 by ?-lactams Determines recA/SOS Response Activation in Heterogeneous MRSA Clinical Strains  

PubMed Central

The SOS response, a conserved regulatory network in bacteria that is induced in response to DNA damage, has been shown to be associated with the emergence of resistance to antibiotics. Previously, we demonstrated that heterogeneous (HeR) MRSA strains, when exposed to sub-inhibitory concentrations of oxacillin, were able to express a homogeneous high level of resistance (HoR). Moreover, we showed that oxacillin appeared to be the triggering factor of a ?-lactam-mediated SOS response through lexA/recA regulators, responsible for an increased mutation rate and selection of a HoR derivative. In this work, we demonstrated, by selectively exposing to ?-lactam and non-?-lactam cell wall inhibitors, that PBP1 plays a critical role in SOS-mediated recA activation and HeR-HoR selection. Functional analysis of PBP1 using an inducible PBP1-specific antisense construct showed that PBP1 depletion abolished both ?-lactam-induced recA expression/activation and increased mutation rates during HeR/HoR selection. Furthermore, based on the observation that HeR/HoR selection is accompanied by compensatory increases in the expression of PBP1,-2, -2a, and -4, our study provides evidence that a combination of agents simultaneously targeting PBP1 and either PBP2 or PBP2a showed both in-vitro and in-vivo efficacy, thereby representing a therapeutic option for the treatment of highly resistant HoR-MRSA strains. The information gathered from these studies contributes to our understanding of ?-lactam-mediated HeR/HoR selection and provides new insights, based on ?-lactam synergistic combinations, that mitigate drug resistance for the treatment of MRSA infections. PMID:23637786

Plata, Konrad B.; Riosa, Sarah; Singh, Christopher R.; Rosato, Roberto R.; Rosato, Adriana E.

2013-01-01

381

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

PubMed Central

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

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

382

Galloylated flavonol rhamnosides from the leaves of Calliandra tergemina with antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

Galloylated flavonol rhamnosides identified as kaempferol-3-O-(2?,3?,4?-tri-O-galloyl)-?-l-rhamnopyranoside, quercetin-3-O-(3?,4?-di-O-galloyl)-?-l-rhamnopyranoside, and quercetin-3-O-(2?,3?,4?-tri-O-galloyl)-?-l-rhamnopyranoside, together with five known galloylated and non-galloylated flavonol rhamnosides, were isolated from leaves of Calliandra tergemina (L.) Benth. Their structures were established using spectroscopic methods and their antibacterial activities against methicillin-resistant Staphylococcus aureus (MRSA) were evaluated by a microdilution method. PMID:25174555

Chan, Elaine Wan Ling; Gray, Alexander I; Igoli, John O; Lee, Sui Mae; Goh, Joo Kheng

2014-11-01

383

What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 1. Epidemiology, mechanisms of disease and methodological issues.  

PubMed

This review provides a summary of key findings from nine systematic reviews on atopic eczema (AE) published over the 2-year period from January 2012 to 31 December 2013, focusing on epidemiology, mechanisms of disease and methodological issues. There is now reasonable evidence to suggest that antibiotic exposure in early life is associated with increased incidence of AE, but delivery by caesarean section is not. The prevalence of AE is increasing in Africa, eastern Asia, western Europe and parts of northern Europe. Autoimmunity may play a part in the development and subsequent severity of AE. For researchers conducting clinical trials and other prospective studies involving patients with AE, the two best-validated scales for capturing objective clinical signs of AE are the Eczema Assessment Severity scale (EASI) and the objective SCORing Atopic Dermatitis scale (objSCORAD). For the assessment of quality of life in children aged 0-3 years, the Infant Dermatitis Quality of Life scale (IDQoL) is reasonably well validated. A standardized definition of an incident case of AE for use in prevention studies is still required. PMID:25622689

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

2015-04-01

384

Synthesis and antibacterial evaluation of a novel series of synthetic phenylthiazole compounds against methicillin-resistant Staphylococcus aureus (MRSA).  

PubMed

Methicillin-resistant Staphylococcus aureus infections are a significant global health challenge in part due to the emergence of strains exhibiting resistance to nearly all classes of antibiotics. This underscores the urgent need for the rapid development of novel antimicrobials to circumvent this burgeoning problem. Previously, whole-cell screening of a library of 2,5-disubstituted thiazole compounds revealed a lead compound exhibiting potent antimicrobial activity against MRSA. The present study, conducting a more rigorous analysis of the structure-activity relationship of this compound, reveals a nonpolar, hydrophobic functional group is favored at thiazole-C2 and an ethylidenehydrazine-1-carboximidamide moiety is necessary at C5 for the compound to possess activity against MRSA. Furthermore, the MTS assay confirmed analogs 5, 22d, and 25 exhibited an improved toxicity profile (not toxic up to 40 ?g/mL to mammalian cells) over the lead 1. Analysis with human liver microsomes revealed compound 5 was more metabolically stable compared to the lead compound (greater than eight-fold improvement in the half-life in human liver microsomes). Collectively the results presented demonstrate the novel thiazole derivatives synthesized warrant further exploration for potential use as future antimicrobial agents for the treatment of multidrug-resistant S. aureus infections. PMID:25771109

Mohammad, Haroon; Reddy, P V Narasimha; Monteleone, Dennis; Mayhoub, Abdelrahman S; Cushman, Mark; Seleem, Mohamed N

2015-04-13

385

TCA Cycle-Mediated Generation of ROS Is a Key Mediator for HeR-MRSA Survival under ?-Lactam Antibiotic Exposure  

PubMed Central

Methicillin-resistant Staphylococcus aureus (MRSA) is a major multidrug resistant pathogen responsible for several difficult-to-treat infections in humans. Clinical Hetero-resistant (HeR) MRSA strains, mostly associated with persistent infections, are composed of mixed cell populations that contain organisms with low levels of resistance (hetero-resistant HeR) and those that display high levels of drug resistance (homo-resistant HoR). However, the full understanding of ?-lactam-mediated HeR/HoR selection remains to be completed. In previous studies we demonstrated that acquisition of the HoR phenotype during exposure to ?-lactam antibiotics depended on two key elements: (1) activation of the SOS response, a conserved regulatory network in bacteria that is induced in response to DNA damage, resulting in increased mutation rates, and (2) adaptive metabolic changes redirecting HeR-MRSA metabolism to the tricarboxylic acid (TCA) cycle in order to increase the energy supply for cell-wall synthesis. In the present work, we identified that both main mechanistic components are associated through TCA cycle-mediated reactive oxygen species (ROS) production, which temporally affects DNA integrity and triggers activation of the SOS response resulting in enhanced mutagenesis. The present work brings new insights into a role of ROS generation on the development of resistance to ?-lactam antibiotics in a model of natural occurrence, emphasizing the cytoprotective role in HeR-MRSA survival mechanism. PMID:24932751

Rosato, Roberto R.; Fernandez, Regina; Paz, Liliana I.; Singh, Christopher R.; Rosato, Adriana E.

2014-01-01

386

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

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…

Khan, Yosef M.

2012-01-01

387

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

ERIC Educational Resources Information Center

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…

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

2009-01-01

388

Strategies for Clinical Management of MRSA in the Community: Summary of an Experts' Meeting Convened by the Centers for Disease Control and Prevention  

Microsoft Academic Search

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a cause of skin infections and, less commonly, invasive infections among otherwise healthy adults and children in the community. More data are needed in order to fully understand the epidemiology, microbiology, and pathophysiology of these infections and to identify optimal prevention and treatment strategies. This report summarizes strategies for the clinical management of

Rachel J. Gorwitz; Daniel B. Jernigan; John H. Powers; John A. Jernigan

2006-01-01

389

Use of antibiotics in animal agriculture & emergence of methicillin-resistant Staphylococcus aureus (MRSA) clones: Need to assess the impact on public health  

PubMed Central

Widespread use of antibiotics in human, veterinary medicine and agricultural settings has played a significant role in the emergence of resistant MRSA clones due to selection pressure. MRSA has now become established in human population as well as in various animal species. An animal associated clone, MRSA ST 398 has been reported from animal foods and also from human infections in the community as well as from the health care associated infections. Clonal relationship between strains of animal and human origins are indicators of interspecies transmission of clones. Spread of these organisms may pose a great impact on public health if animal associated strains enter into the community and health care settings. Surveillance is important to correlate the genetic changes associated with their epidemiological shift and expansion to predict its impact on public health. Strict regulations on the use of antibiotics in humans as well as in animal food production are required to control the emergence of drug resistant clones. This article reviews the information available on the role of antibiotics in emergence of MRSA strains, their epidemiological shift between humans and animals and its impact on the public health. PMID:25366200

Mehndiratta, P.L.; Bhalla, P.

2014-01-01

390

Therapy of atopic eczema  

PubMed Central

Objectives Major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Methods This health technology assessment (HTA) evaluates systemically randomized controlled studies (RCT) on the therapy of atopic dermatitis which were published between 1999 and 2004. Further it includes some important clinical studies which have been published after 2004 and other updates the English HTA report by Hoare et al. [1]. Results Topical corticosteroids and topical calcineurin-inhibitors are the principal substances which are currently used for anti-inflammatory therapy in atopic dermatitis. These substances have shown a significant therapeutic efficacy in controlled studies. In newer controlled studies no difference was observable when corticosteroids were applied once or more than once daily onto the skin. Moreover, there is now one controlled study available which points to the fact that an interval therapy with a stronger topical corticosteroid over a limited time (some weeks) may lower the risk of recurrent flares of atopic dermatitis. Both topical calcineurin-inhibitors pimecrolimus and tacrolimus have shown a significant therapeutical efficacy in a number of placebo-controlled prospective studies. The wealth of data is high for these substances. Both substances have been shown to be efficient in infants, children and adult patients with atopic dermatitis. The importance of a so-called basic therapy with emollients which have to be adapted to the current status of skin is generally accepted in clinical practice. Controlled studies show the efficacy of ”basic therapy” - although the level of evidence is quite low for this approach. The skin of patients with atopic dermatitis is colonized in the majority with Staphylococcus aureus, a gram-positive bacterium. Therefore, a therapeutical approach for the treatment of atopic dermatitis is the anti-bacterial or anti-septic treatment of the skin. Due to the lack of randomized controlled studies there is still not certain proof that antimicrobial or anti-septic treatment of non-infected eczematous skin is efficient for the treatment of atopic dermatitis. A reduction of Staphylococcus aureus is observable during an anti-inflammatory treatment of the skin with topical corticosteroids and/or the topical calcineurin-inhibitor tacrolimus. Antihistaminic drugs which are orally applied in atopic dermatitis may support the therapy of the itching skin disease. One controlled study showed a rapid reduction of itch during the use of a non-sedating antihistaminic drug. There are, however, no controlled studies which show the efficacy of antihistaminic drugs on the skin condition in atopic dermatitis. Dietetic restrictions should be applied only after a specific allergological diagnostic clarification. The “gold standard” is still a (blinded) oral provocation test which has to show an influence of a given food on the skin condition. There is sufficient evidence that there is no general dietetic approach which shows efficacy in atopic dermatitis. The treatment of patients with lactobacillae is still controversially discussed. Available studies which showed an efficacy show methodological weaknesses so that this approach can not be generally recommended for clinical practice at the time now. Approaches reducing house dust mite in the surroundings of patients with atopic dermatitis can have an effect on the skin condition so that at least in mite sensitized patients this approach appears to be reasonable. The specific immunotherapy with house dust mite showed clinical efficacy in a controlled study and in some open studies. The education of patients with atopic dermatitis or their parents is a further efficient approach in the management of this chronic skin disease. Interdisciplinary approaches in patients’ education containing also psychological elements appear to be an attractive new approach for the treatment of atopic dermatitis. Phototherapy is a further possibility of in

Werfel, Thomas; Claes, Christa; Kulp, Werner; Greiner, Wolfgang; von der Schulenburg, Johann-Matthias

2006-01-01

391

Eek! It's Eczema!  

MedlinePLUS

... skin, such as contact with scratchy fabrics (like wool) or dust mites in your bedsheets How Do ... you wear cotton or other soft, natural fibers. Wool and some synthetic cloth can make you feel ...

392

Eczema: Bleach Bath Therapy  

MedlinePLUS

... Signs, symptoms Who gets, causes Diagnosis, treatment Tips Bedbugs Signs, symptoms Who gets, causes Diagnosis, treatment Tips ... 2015 American Academy of Dermatology. All rights reserved. Reproduction or republication strictly prohibited without prior written permission.

393

Nummular Dermatitis (Discoid Eczema)  

MedlinePLUS

... Signs, symptoms Who gets, causes Diagnosis, treatment Tips Bedbugs Signs, symptoms Who gets, causes Diagnosis, treatment Tips ... 2015 American Academy of Dermatology. All rights reserved. Reproduction or republication strictly prohibited without prior written permission.

394

Types of Eczema (Dermatitis)  

MedlinePLUS

... resources My account Patient education resources Awards, grants, scholarships State society resources Become a member Meetings and ... use criteria MOC Patient safety Awards, grants and scholarships CME transcripts About AAD Recognized Credit Basic Dermatology ...