Sample records for eczema herpeticum mrsa

  1. Eczema herpeticum.

    PubMed

    Wollenberg, Andreas

    2012-01-01

    Atopic dermatitis (AD) patients tend to develop viral infections such as herpes simplex, molluscum contagiosum or verrucae vulgares more frequently than nonatopic patients. In addition, disseminated viral infections occur in the skin lesions of AD. Though these diseases are relatively rare and little is known about their specific pathogenesis, some of them are among the true medical emergencies in dermatology. This contribution covers eczema herpeticum, the disseminated viral infection of an eczematous skin disease with the herpes simplex virus, as it is the clinically most important viral complication of AD. PMID:22433376

  2. Eczema herpeticum complicating Parthenium dermatitis.

    PubMed

    Prabhakar, Ajith C; Dogra, Sunil; Handa, Sanjeev

    2005-06-01

    Parthenium dermatitis is one of the most common causes of airborne contact dermatitis in India. Eczema herpeticum has been reported in association with various eczematous conditions, including Parthenium dermatitis. We report a case of eczema herpeticum in association with Parthenium dermatitis. Because Parthenium dermatitis is a common condition in this region, one should be aware of this complication so that appropriate treatment is not delayed. PMID:16036117

  3. Treatment of Recurrent Eczema Herpeticum in Pregnancy With Acyclovir

    PubMed Central

    Baker, David A.

    1996-01-01

    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

  4. Why is eczema herpeticum unexpectedly rare?

    PubMed Central

    Leung, Donald Y.M.

    2013-01-01

    Atopic dermatitis (AD) is the most common chronic inflammatory skin disease of humans, affecting approximately 17% of children. AD patients are especially susceptible to cutaneous bacterial and viral infections, and may develop severe or fatal herpes simplex virus (HSV) infection (eczema herpeticum, EH), requiring intensive antiviral therapy. However, even though a majority of adults show serologic evidence of previous HSV exposure, EH occurs in less than 3% of AD patients. The unexpected rarity of AD patients with EH (ADEH+) suggests that multiple host factors play a role in the clinical expression of this complex phenotype. Recent studies comparing ADEH+ versus ADEH? patients reveal that patients prone to ADEH+ have more severe AD skin disease, biomarkers associated with Th2 helper cell responses (reduced interferon levels, circulating eosinophil counts, increased serum IgE and allergen sensitization) and decreased epidermal expression of filaggrin and antimicrobial peptides. ADEH+ subjects are also more likely to have a history of food allergy or asthma, early onset of AD and a history of other cutaneous infections with S. aureus or molluscum contagiosum. PMID:23439082

  5. Delayed Acyclovir and Outcomes of Children Hospitalized With Eczema Herpeticum

    PubMed Central

    Yan, Albert C.; Mittal, Manoj K.; Mohamad, Zeinab; Shah, Samir S.

    2011-01-01

    OBJECTIVE: To describe the epidemiology and outcomes of children hospitalized with eczema herpeticum and to determine the association with delayed acyclovir on outcomes. PATIENTS AND METHODS: This was a multicenter retrospective cohort study conducted between January 1, 2001, and March 31, 2010, of 1331 children aged 2 months to 17 years with eczema herpeticum from 42 tertiary care children's hospitals in the Pediatric Health Information System database. Multivariable linear regression models determined the association between delayed acyclovir therapy and the main outcome measure: hospital length of stay (LOS). RESULTS: There were no deaths during the study period. Staphylococcus aureus infection was diagnosed in 30.3% of the patients; 3.9% of the patients had a bloodstream infection. Fifty-one patients (3.8%) required ICU admission. There were 893 patients (67.1%) who received acyclovir on the first day of admission. The median LOS increased with each day delay in acyclovir initiation. In multivariable analysis, delay of acyclovir initiation by 1 day was associated with an 11% increased LOS (95% confidence interval [CI]: 3%–20%; P = .008), and LOS increased by 41% when acyclovir was started on day 3 (95% CI: 19%–67%; P < .001) and by 98% when started on day 4 to 7 (95% CI: 60%–145%; P < .001). Use of topical corticosteroids on day 1 of hospitalization was not associated with LOS. CONCLUSIONS: Delay of acyclovir initiation is associated with increased LOS in hospitalized children with eczema herpeticum. Use of topical corticosteroids on admission is not associated with increased LOS. The mortality rate of hospitalized children with eczema herpeticum is low. PMID:22084327

  6. A corneal dendritic lesion with a skin eruption: eczema herpeticum, an important differential diagnosis.

    PubMed

    Steptoe, Alex; Young-Zvandasara, Tafadzwa; Muhtaseb, Mohammed

    2015-01-01

    Eczema herpeticum is a rare and potentially life-threatening viral infection. We present the case of a 54-year-old man who presented to the emergency eye clinic with a dendritic ulcer and a facial rash. An initial diagnosis of herpes zoster ophthalmicus was suspected. On follow-up, the rash had begun to rapidly disseminate and was no longer respecting dermatome boundaries. A diagnosis of eczema herpeticum was made and appropriate treatment started. This case highlights the importance of a comprehensive history and close inspection of skin lesions in patients with herpetic eye disease. PMID:25636633

  7. ATOPIC DERMO-RESPIRATORY SYNDROME IS A CORRELATE OF ECZEMA HERPETICUM

    PubMed Central

    Hinz, T.; Zaccaro, D.; Byron, M.; Brendes, K.; Krieg, T.; Novak, N.; Bieber, T.

    2010-01-01

    Background Factors favouring the emergence of Eczema herpeticum (EH) in patients with atopic dermatitis (AD) remain elusive. The aim of this work was to identify changes in clinical and laboratory parameters in acute EH patients, before and after 6 weeks of treatment, as well as differences between AD patients with and without a history of EH. Methods A total of 235 adult subjects were included and subdivided into 6 groups: (i) AD patients with acute EH, (ii) AD patients with history of EH, (iii) AD without EH but with recurrent HSV infections, (iv) AD without EH or recurrent HSV infections and healthy non-AD controls (v) with and (vi) without recurrent HSV infections. Clinical examination of AD, assessment of atopic status and severity were done. Total IgE, allergen-specific IgE and differential blood count were analysed. Clinical diagnosis of acute EH was confirmed by PCR. Results More male AD patients are affected by EH than females. Acute episodes of EH are characterized by lower levels of lymphocytes and higher levels of monocytes. AD patients with history of EH display higher total IgE serum levels (ADEH+HSV+ vs. ADEH?HSV+, p<0.001) and higher sensitization profiles and stronger severity of AD (EASI and SCORAD; ADEH+HSV+ vs. ADEH?HSV+, p<0.001). Concomitant asthma and rhinitis were identified as correlates of EH. Conclusion From these data we conclude that AD patients with EH display a distinct clinical and biological phenotype. PMID:21255038

  8. Human Atopic Dermatitis Complicated by Eczema Herpeticum is Associated with Abnormalities in Gamma Interferon Response

    PubMed Central

    Leung, Donald YM; Gao, Pei-Song; Grigoryev, Dmitry N; Rafaels, Nicholas M; Streib, Joanne E; Howell, Michael D; Taylor, Patricia A; Boguniewicz, Mark; Canniff, Jennifer; Armstrong, Brian; Zaccaro, Daniel J; Schneider, Lynda C; Hata, Tissa R; Hanifin, Jon M; Beck, Lisa A; Weinberg, Adriana; Barnes, Kathleen C

    2011-01-01

    Background The basis for increased susceptibility of atopic dermatitis (AD) patients to develop disseminated viral skin infections such as eczema herpeticum (ADEH+) is poorly understood. Objective We sought to determine whether atopic dermatitis subjects prone to disseminated viral skin infections have defects in their interferon responses. Methods GeneChip profiling was used to identify differences in gene expression of peripheral blood mononuclear cells (PBMC) from patients with a history of ADEH+ as compared to ADEH? and non-atopic controls. Key differences in protein expression were verified by ELISPOT and/or ELISA. Clinical relevance was further demonstrated by a mouse model of disseminated viral skin infection and genetic association analysis for genetic variants in IFNG and IFNGR1 and ADEH among 435 cases and controls. Results We demonstrate by global gene expression analysis selective transcriptomic changes within the interferon (IFN) superfamily of PBMCs from ADEH+ subjects reflecting low IFN? and IFN? receptor gene expression. IFN? protein production was also significantly lower in ADEH+ (N=24) compared to ADEH? (N=20) and non-atopic (NA; N=20) controls. IFN? receptor knockout (KO) mice developed disseminated viral skin infection after epicutaneous challenge with vaccinia virus (VV). Genetic variants in IFNG and IFNGR1 SNPs were significantly associated with ADEH (112 cases, 166 controls) and IFN? production: a 2-SNP (A–G) IFNGR1 haplotype (rs10457655 and rs7749390) showed the strongest association with a reduced risk of ADEH+ ((13.2% ADEH+ vs 25.5% ADEH?, P = 0.00057). Conclusions ADEH+ patients have reduced IFN? production, and IFNG and IFNGR1 SNPs are significantly associated with ADEH+ and may contribute to an impaired immune response to herpes simplex virus (HSV). Clinical Implications Atopic dermatitis subjects prone to disseminated viral skin infections have defects in their interferon responses. Capsule summary Using genomic, immunologic and genetic approaches, these investigators demonstrated that atopic dermatitis subjects prone to disseminated viral skin infections have defects in their interferon responses. PMID:21458658

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

    PubMed

    Yoshida, Masami; Umene, Kenichi

    2003-04-01

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

  10. 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 ...

  11. Eczema

    PubMed Central

    2011-01-01

    Introduction Eczema, as defined by the World Allergy Organization (WAO) revised nomenclature in 2003, affects 15% to 20% of school children and 2% to 5% of adults worldwide. About 50% of people with eczema demonstrate atopy, with specific immunoglobulin E responses to allergens. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of topical medical treatments, and dietary interventions in adults and children with established eczema? What are the effects of breastfeeding, reducing allergens, or dietary interventions for primary prevention of eczema in predisposed infants? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 54 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: breastfeeding, controlling house dust mites, corticosteroids, dietary exclusion of eggs or cow's milk, elementary diets, emollients, essential fatty oils, few-foods diet, multivitamins, pimecrolimus, probiotics, pyridoxine, reducing maternal dietary allergens, tacrolimus, vitamin E, and zinc supplements. PMID:21609512

  12. Eczema

    PubMed Central

    Krafchik, Bernice R

    2000-01-01

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

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

    PubMed Central

    Garg, Geeta; Thami, Gurvinder P

    2012-01-01

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

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

    PubMed

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

    1996-01-01

    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

  15. Hand Eczema

    PubMed Central

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

    2014-01-01

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

  16. Eczema vaccinatum.

    PubMed

    Reed, Jennifer L; Scott, Dorothy E; Bray, Mike

    2012-03-01

    Eczema vaccinatum (EV) is a complication of smallpox vaccination that can occur in persons with eczema/atopic dermatitis (AD), in which vaccinia virus disseminates to cause an extensive rash and systemic illness. Because persons with eczema are deferred from vaccination, only a single, accidentally transmitted case of EV has been described in the medical literature since military vaccination was resumed in the United States in 2002. To enhance understanding of EV, we review its history during the era of universal vaccination and discuss its relationship to complications in persons with other diseases or injuries of the skin. We then discuss current concepts of the pathophysiology of AD, noting how defective skin barrier function, epidermal hyperplasia, and abnormal immune responses favor the spread of poxviral infection, and identify a number of unanswered questions about EV. We conclude by considering how its occurrence might be minimized in the event of a return to universal vaccination. PMID:22291103

  17. Eczema: Complications

    MedlinePLUS

    ... Diseases Asthma Food Allergy Immune System Methicillin-Resistant Staphylococcus Aureus (MRSA) National Library of Medicine, MedlinePlus ???????? Javascript ... atopic dermatitis. Bacterial Infections Scanning electron micrograph of Staphylococcus aureus bacteria. Credit: NIAID A major health risk ...

  18. Smallpox vaccination and eczema.

    PubMed

    1976-10-16

    Smallpox has disappeared from all countries except Ethiopia and the possibility of its eradication appears within reach. The need for vaccination of eczema patients against smallpox appears to be ending. Eczema vaccinatum is a rare but sometimes fatal complication of smallpox vaccination in atopic aczema and its incidence is discussed. Precautions in vaccinating atopic eczema patients include suitable treatment of the eczema, injection of vaccinial immunoglobulin and testing the competence of humoral and cellular immunity. PMID:1004311

  19. Localized psoriasis herpeticum: Case report and review of literature

    PubMed Central

    George, Mamatha; Pakran, Jaheersha; Rajan, Uma; George, Sandhya; Thomas, Sumi

    2011-01-01

    Kaposi's varicelliform eruption (KVE) is a widespread cutaneous eruption caused by viruses, especially herpes simplex virus in patients with pre-existing dermatoses. “Psoriasis herpeticum” refers to the rare occurrence of KVE in patients with psoriasis. We report a case of KVE localized to the face in a patient with exfoliative dermatitis secondary to psoriasis. This case is being reported to make the treating clinician aware of the possibility of KVE in patients with psoriatic erythroderma. PMID:23130208

  20. Stopping MRSA

    ERIC Educational Resources Information Center

    Vogel, Carl

    2008-01-01

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

  1. Eek! It's Eczema!

    MedlinePLUS

    ... makes them sneeze and have a runny nose), asthma (trouble breathing), or other allergic conditions. Some scientists think these kids may be genetically predisposed to get eczema, which means characteristics have been passed ... hay fever or asthma themselves. Eczema is not an allergy itself, but ...

  2. MRSA (treatment)

    PubMed Central

    2006-01-01

    Introduction Methicillin-resistant Staphylococcus aureus (MRSA) has a gene that makes it resistant to methicillin as well as to other beta lactam antibiotics including flucloxacillin, b-lactam/b-lactamase inhibitor combinations, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but can cause infection, especially in people with prolonged hospital admissions, with underlying disease, or after antibiotic use. About 40% of S aureus in blood cultures in the UK is resistant to methicillin. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment for MRSA infections at any body site? What are the effects of treatment for MRSA nasal or extra-nasal colonisation? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2005 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiseptic body washes, chlorhexidine-neomycin nasal cream, clindamycin, daptomycin, fusidic acid, glycopeptides (teicoplanin, vancomycin), linezolid, macrolides (azithromycin, clarithromycin, erythromycin), mupirocin nasal ointment, quinolones (ciprofloxacin, levofloxacin, moxifloxacin), quinupristin-dalfopristin, rifampicin, systemic antimicrobials, tea tree preparations, tetracyclines (doxycycline, minocycline, oxytetracycline), trimethoprim, and trimethoprim-sulfamethoxazole.

  3. [Periorbital contact eczema].

    PubMed

    Worm, M; Sterry, W

    2005-11-01

    Periorbital contact eczema is most commonly the result of an allergic contact dermatitis whereas other eczematous skin diseases like atopic eczema or seborrheic eczema occur less frequently. Also, other diseases like autoimmune disorders or rosacea need to be considered. Allergic contact dermatitis is a T-cell-mediated immunological response towards ubiquitous contact allergens. Activated T-cells migrate through the vessels into the skin and produce several inflammatory mediators. Epicutaneous patch testing is an important tool for the diagnosis of contact allergy whereby the allergens are analysed in terms of their ability to induce eczematous skin reaction. Until now the short-term use of corticosteroids are is employed for the treatment of allergic contact eczema. Modern substances with an optimal therapeutic index should rather be used. PMID:16308815

  4. Eczema Coxsackium” and Unusual Cutaneous Findings in an Enterovirus Outbreak

    PubMed Central

    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

    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

  5. Atopic eczema and allergy

    Microsoft Academic Search

    Johannes Ring; Ulf Darsow; Heidrun Behrendt

    2001-01-01

    Although the pathomechanisms of respiratory atopy are well established, the role of IgE-mediated hypersensitivity in the elicitation\\u000a and maintenance of eczematous skin lesions in atopic eczema (AE) is still controversial. There is, however, evidence for exogenous\\u000a elicitation of AE by contact with aero- or food allergens (house dust mite, cat, and so forth). Recent investigations show\\u000a that epidermal Langerhans’ cells

  6. MRSA and the Workplace

    MedlinePLUS

    ... Contact CDC-INFO Workplace Safety and Health Topics Industries & Occupations Hazards & Exposures Diseases & Injuries MRSA Safety & Prevention Chemicals Emergency Preparedness & Response NIOSH Homepage NIOSH A-Z ...

  7. 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 ...

  8. Patch testing in discoid eczema.

    PubMed

    Fleming, C; Parry, E; Forsyth, A; Kemmett, D

    1997-05-01

    We report a retrospective study of patch testing in patients with discoid eczema. 48 patients with persistent or severe discoid eczema were patch tested. The mean age of patients was 45 years and the median duration of symptoms was 6 months. 24 patients (50%) had positive patch tests, and 16 of these (33%) were considered to be clinically relevant. The most common allergens implicated were rubber chemicals, formaldehyde, neomycin, chrome, nickel (5, 2, 2, 2, 2, 2 reactions, respectively). 13 of 16 patients were followed up by telephone in 1996, and 8/13 (61%) stated they had benefited from patch testing. This study suggests allergic contact dermatitis is relatively common in persistent discoid eczema, and allergen avoidance may be of benefit. We recommend patch testing should be considered for all patients with severe or persistent discoid eczema. PMID:9197962

  9. Morphology of atopic eczema.

    PubMed

    Soter, N A

    1989-01-01

    The routine examination of skin biopsy specimens embedded in paraffin and strained with hematoxylin-eosin has failed to allow differentiation of atopic eczema from other types of eczematous dermatitis. The use of 1-micron plastic-embedded sections permits the recognition of infiltrating cell types and blood vessel alterations, thus allowing a refined method to examine cutaneous lesions and permit better definition of cutaneous structures than can be achieved in routinely-processed specimens. Acute vesicular lesions exhibited marked epidermal intercellular edema (spongiosis) and a dermal inflammatory infiltrate of lymphocytes, and activated lymphocytes with normal numbers of mast cells that exhibited various degrees of hypogranulation. Only rare eosinophils, neutrophils, and basophils were noted. Venular alterations included endothelial cell hypertrophy without necrosis. In lichenified plaques there was epidermal hyperplasia with a dermal inflammatory infiltrate that included increased numbers of fully granulated mast cells and increased numbers of lymphocytes and monocyte-macrophages. Alterations of venules included marked endothelial cell hypertrophy and basement membrane thickening. Cutaneous nerves exhibited demyelination and fibrosis. Also, increased numbers of Langerhans' cells have been noted in the epidermis of chronic lesions. Despite the absence of eosinophils, major basic protein has been demonstrated in the dermis by direct immunofluorescence techniques. Studies of lymphocyte subsets have shown increased numbers of CD4+ T lymphocytes. PMID:2683838

  10. The digital eczema centre utrecht.

    PubMed

    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

    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

  11. MRSA and Cystic Fibrosis

    MedlinePLUS

    ... MRSA can be treated with some antibiotics, nose drops and other therapies. To find out more, talk with your CF care center about ... Talk to your CF care center to find out more. back to top How ... lungs, it can be spread in tiny drops of liquid when a person coughs, sneezes or ...

  12. General Information about MRSA in the Community

    MedlinePLUS

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

  13. 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 ...

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

    Microsoft Academic Search

    Masami Yoshida; Kenichi Umene

    2003-01-01

    Herpes simplex virus type 1 (HSV-1) strains belonging to the same genotype can possibly share biological properties and clinical manifestations common to the genotype. We classified previously 66 HSV-1 strains into 35 genotypes (F1–F35) using restriction fragment length polymorphism (RFLP) and F1 and F35 genotypes were revealed to be predominant [Arch. Virol. 13 (1993) 29]. It was found later that

  15. 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 ...

  16. Genetic basis for molecular epidemiology of MRSA

    Microsoft Academic Search

    Keiichi Hiramatsu; Noriko Kondo; Teruyo Ito

    1996-01-01

    The use of genotyping in the epidemiology of methicillin-resistantStaphylococcus aureus (MRSA) is reviewed, with special emphasis on a new method that enables us to track the evolutionary path of each MRSA isolate.\\u000a The MRSA genome is made up of 2 components: one,mec DNA; and the other, the methicillinsensitiveStaphylococcus aureus (MSSA) chromosome to which themec DNA has integrated. Therefore, the MRSA

  17. NARES CULTURE FOR MRSA SCREENING I. INTRODUCTION

    E-print Network

    Kay, Mark A.

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

  18. Mouse Models of Atopic Eczema Critically Evaluated

    Microsoft Academic Search

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

    2004-01-01

    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.

  19. MRSA: treating people with infection

    PubMed Central

    2010-01-01

    Introduction Methicillin-resistant Staphylococcus aureus (MRSA) has a gene that makes it resistant to methicillin as well as to other beta-lactam antibiotics including flucloxacillin, beta-lactam/beta-lactamase inhibitor combinations, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but it can cause infection, especially in people with prolonged hospital admissions, with underlying disease, or after antibiotic use. About 20% of S aureus in blood cultures in England, Wales, and Northern Ireland is resistant to methicillin. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment for MRSA infections at any body site? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 11 systematic reviews, RCTs, or observational studies that met our inclusion criteria. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: clindamycin, daptomycin, fusidic acid, glycopeptides (teicoplanin, vancomycin), linezolid, macrolides (azithromycin, clarithromycin, erythromycin), quinolones (ciprofloxacin, levofloxacin, moxifloxacin), quinupristin–dalfopristin, pristinamycin, rifampicin, tetracyclines (doxycycline, minocycline, oxytetracycline), tigecycline, trimethoprim, and trimethoprim–sulfamethoxazole (co-trimoxazole). PMID:21418679

  20. Protective murine and human monoclonal antibodies against eczema vaccinatum

    PubMed Central

    Tomimori, Yoshiaki; Kawakami, Yuko; McCausland, Megan M.; Ando, Tomoaki; Koriazova, Lilia; Kato, Shinichiro; Kawakami, Toshi; Crotty, Shane

    2011-01-01

    Background Eczema vaccinatum is the most common severe pathology associated with smallpox vaccination (vaccinia virus), occurring at high rates among individuals with a previous history of atopic dermatitis (atopic eczema). Methods Monoclonal antibodies capable of neutralizing vaccinia virus, anti-H3 and anti-B5, have been developed as a potential therapy for treatment of human eczema vaccinatum. Results Using a small animal model of eczema vaccinatum, here we demonstrate that both murine and fully human monoclonal antibodies effectively limit eczema vaccinatum disease, foreshortening both the disease kinetics and the severity of the erosive viral skin lesions. Conclusions These neutralizing antibodies would likely be effective at reducing or eliminating clinical disease in people with eczema vaccinatum or other severe side effects of the smallpox vaccine. PMID:21311110

  1. Update on Epidemiology and Treatment of MRSA Infections in Children

    PubMed Central

    David, Michael Z.; Daum, Robert S.

    2013-01-01

    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

  2. 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...

  3. Laboratory evaluation of the BD MAX MRSA assay.

    PubMed

    Widen, Raymond; Healer, Vicki; Silbert, Suzane

    2014-07-01

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

  4. Laboratory Evaluation of the BD MAX MRSA Assay

    PubMed Central

    Healer, Vicki; Silbert, Suzane

    2014-01-01

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

  5. Associations of childhood eczema severity: A US population based study

    PubMed Central

    Silverberg, Jonathan I.; Simpson, Eric L.

    2014-01-01

    Little is known about predictors of eczema severity in the US population. We sought to determine the distribution and associations of childhood eczema severity in the US. We analyzed data from the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children (0-17yr). The prevalence of childhood eczema was 12.97% (95% confidence interval [95% CI]=12.42–13.53); 67.0% (95% CI: 64.8–69.2) had mild, 26.0% (95% CI: 23.9–28.1) moderate and 7.0% (95% CI: 5.8–8.3) severe disease. There was significant statewide-variation of the distribution of eczema severity (Rao-Scott chi square, P=0.004), with highest rates of severe disease in Northeastern and Midwestern states. In univariate models, eczema severity was increased with older age, African-American and Hispanic race/ethnicity, lower household income, oldest child in the family, home with a single mother, lower paternal/maternal education level, maternal general health, maternal/paternal emotional health, dilapidated housing and garbage on the streets. In multivariate survey logistic regression models using stepwise and backward selection, moderate–severe eczema was associated with older age, lower household income and fair or poor maternal health, but inversely associated with birthplace outside the US. These data indicate that environmental and/or lifestyle factors play an important role in eczema severity. PMID:24819283

  6. Multiple Myeloma and Atopic Eczema in an Adult

    PubMed Central

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

    2015-01-01

    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

  7. Challenges of identifying eczema in darkly pigmented skin.

    PubMed

    Myers, Joan

    2015-07-01

    There is a paucity of information about the difference in the presentation of eczema in darkly pigmented skin compared to children with fair or white skin. This article describes the possible challenges of diagnosing eczema in children with darkly pigmented skin. The physiological difference in darkly pigmented skin compared with fair or white skin is explored, and how eczema may be manifested and identified in darkly pigmented skin. The author uses the term darkly pigmented skin to describe children of black Caribbean, African or Asian descent. PMID:26156613

  8. Better environmental survival of outbreak vs. sporadic MRSA isolates

    Microsoft Academic Search

    J. H. T. Wagenvoort; W. Sluijsmans; R. J. R. Penders

    2000-01-01

    Environmental sources have been associated with prolonged epidemics of methicillin-resistantStaphylococcus aureus (MRSA). Our objective was to evaluate whether outbreak MRSA strains differ in their environmental survival from sporadic MRSA strains. The strains were detected in five adult patients unknowingly colonized by MRSA. The MRSA strains from patients No. 1 (phage pattern; III-29) and No. 2 (III-215) caused extensive outbreaks in

  9. 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 ...

  10. MRSA - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... sharing features on this page, please enable JavaScript. Arabic (???????) Bosnian (Bosanski) Chinese - Simplified (????) Chinese - Traditional ( ... Soomaali) Spanish (español) Tagalog (Tagalog) Vietnamese (Tiê?ng Viê?t) Arabic (???????) MRSA (Methicillin Resistant Staphylococcus Aureus) (Arabic) ????????? ...

  11. Distinct Pattern of Commensal Gut Microbiota in Toddlers with Eczema

    Microsoft Academic Search

    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

    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

  12. A specific molecular signature for psoriasis and eczema

    PubMed Central

    Santos-Silva, Alice

    2015-01-01

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

  13. The population impact of MRSA in a country: the national survey of MRSA in Wales, 1997

    Microsoft Academic Search

    M. Morgan; D. Evans-Williams; R. Salmon; I. Hosein; D. N. Looker; A. Howard

    2000-01-01

    Continuous data collection on all new isolates of MRSA via CoSurv has taken place in Wales since January 1996. In order to audit this data collection, and to address some of the issues that it does not include, a survey of MRSA was carried out. Questionnaires were completed by infection control teams. Rates were calculated using hospital throughput denominators. Results

  14. Sleep and neurocognitive functioning in children with eczema.

    PubMed

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

    2013-08-01

    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

  15. Therapeutic patient education in atopic eczema.

    PubMed

    Barbarot, S; Stalder, J F

    2014-07-01

    Therapeutic patient education (TPE) is a patient-centred process that entails the transfer of skills (e.g. self-management, treatment adaptation) from a trained healthcare professional to patients and/or their carers. TPE has been shown to help improve adherence, prevent complications, and improve quality of life (QoL) in chronic illnesses such as diabetes, asthma and cardiovascular disease. Recently, TPE recommendations for patients with atopic eczema have been proposed. TPE is a four-step process: understanding the patient's knowledge, beliefs and hopes; setting age-appropriate educational objectives; helping the patient (or carer) to acquire skills; and assessing the success of the programme. TPE programmes always involve a multidisciplinary team of healthcare professionals, including nurses, psychologists, doctors and dieticians who are expert in the disease area. TPE should be offered to (never forced upon) any patient who has experienced treatment failure, or to families who feel they lack social support. High-quality TPE programmes should be evidence-based, tailored to a patient's individual educational and cultural background (rather than being standardized in form and content), and have well-defined content and activities. PMID:24720486

  16. 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 ...

  17. Community-acquired MRSA and pig-farming

    Microsoft Academic Search

    Xander W Huijsdens; Beatrix J van Dijke; Emile Spalburg; Marga G van Santen-Verheuvel; Max EOC Heck; Gerlinde N Pluister; Andreas Voss; Wim JB Wannet; Albert J de Neeling

    2006-01-01

    BACKGROUND: Sporadic cases of CA-MRSA in persons without risk-factors for MRSA carriage are increasing. CASE PRESENTATION: We report a MRSA cluster among family members of a pig-farmer, his co-workers and his pigs. Initially a young mother was seen with mastitis due to MRSA. Six months later her baby daughter was admitted to the hospital with pneumococcal otitis. After staying five

  18. Developing Scottish Priorities for MRSA Research

    E-print Network

    Glasgow, University of

    to the hospital superbug MRSA has risen by nearly a quarter, statistics show. The Office for National Statistics? · 1100 bed teaching hospital · 12 month survey · 845 isolation requests · 185 (22%) not met Prospective evaluation of hospital isolation room capacity . Wigglesworth & Wilcox Journal of Hospital Infection; 63: p

  19. MRSA colonization and the risk of MRSA bacteraemia in hospitalized patients with chronic ulcers

    Microsoft Academic Search

    M.-C. Roghmann; A. Siddiqui; K. Plaisance; H. Standiford

    2001-01-01

    A cohort study of patients with chronic ulcers was performed to estimate the risk of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in a population colonized with MRSA. During a five-year period (January 1990–May 1995), 911 patients with chronic ulcers (CU), as determined by ICD9-CM code search, were admitted to an acute care hospital. Sixty percent (545\\/911) of these patients with CU

  20. Ten-year prognosis for generalized infantile eczema.

    PubMed

    Linna, O; Kokkonen, J; Lahtela, P; Tammela, O

    1992-12-01

    Forty children treated in our hospital for generalized infantile eczema were re-examined at 11-13 years of age. In 7 (18%) children the eczema had disappeared and in 26 (65%) it had become less severe. Unrelated to dermatological status or gender, allergic rhinitis was diagnosed in 31 (78%) and asthma in 21 (53%) children. Only 8 children continued without either of these two conditions. All 32 children with allergic rhinitis and/or asthma showed at least one positive skin test reaction in a test panel of 11 common inhalant and food allergens compared with only 4 of 8 children without either allergic rhinitis or asthma (p < 0.001). Our results showed an improvement of dermatological status in most children with generalized infantile eczema but there was a high risk of a concomitant respiratory allergy and development of allergic rhinitis or asthma. PMID:1290844

  1. Predicting phenotypes of asthma and eczema with machine learning

    PubMed Central

    2014-01-01

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

  2. Psychosocial adjustment in preschool children with atopic eczema.

    PubMed Central

    Daud, L R; Garralda, M E; David, T J

    1993-01-01

    Atopic eczema is a chronic skin disorder that is most common in early childhood, an important stage in the child's social and emotional development. The psychiatric adjustment and mother-child attachment in 30 preschool children with severe atopic eczema was compared with 20 matched controls. Patients with eczema had a significant increase in behaviour symptoms, 7/30 (23%) v 1/20 (5%); with significant excess of dependency/clinginess, 15/30 (50%) v 2/20 (10%); fearfulness, 12/30 (40%) v 2/20 (10%); and sleep difficulty, 19/30 (63%) v 9/20 (45%), but there was no significant difference between the two groups in the security of attachments, 25/29 (86%) v 14/20 (70%). Significantly fewer mothers of children with atopic eczema were in outside employment, 8/29 (27%) v 13/20 (65%), or felt supported socially, 10/29 (34%) v 13/20 (65%). Significantly more of them, 9/30 (30%) v 1/20 (5%), felt particularly stressed in relation to their parenting and less efficient in their disciplining of the affected child. In spite of this and at variance with earlier reports in the literature, they did not display negative attitudes towards their child. On the contrary mothers had a positive empathic attitude towards the child, 7/14 (50%) v 2/16 (12%). Child behaviour problems, 7/14 (50%) v 2/16 (12%), and maternal distress, 12/14 (85%) v 5/16 (31%), were significantly more common in the more severely affected children. Minor behaviour problems and parenting distress are important features of severe atopic eczema in early childhood but atopic eczema does not lead to insecurity of the mother-child attachment. PMID:8285781

  3. Alitretinoin for the treatment of severe chronic hand eczema

    PubMed Central

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

    2014-01-01

    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

  4. The effect of improved hand hygiene on nosocomial MRSA control.

    PubMed

    Marimuthu, Kalisvar; Pittet, Didier; Harbarth, Stephan

    2014-01-01

    The purpose of this review is to examine studies that have assessed the association between hand hygiene enhancement and methicillin-resistant Staphylococcus aureus (MRSA) rates and to explore controversies surrounding this association. Many studies have been published confirming the link between improved hand hygiene compliance and reduction in MRSA acquisition and infections, including bacteremia. These studies have also shown the cost-beneficial nature of these programmes. Despite considerable research some issues remain unanswered still, including the temporal relationship between hand hygiene enhancement strategies and decrease in MRSA rates, association between hand hygiene enhancement and MRSA-related surgical site infections, diminishing effect of hand hygiene compliance on MRSA rates after reaching a threshold and the role of instituting contact precautions in the setting of low MRSA rates and sufficient hand hygiene compliance. In conclusion, enhancement of hand hygiene compliance has been shown to reduce MRSA rates; however, some open issues warrant further investigation. PMID:25937922

  5. Attenuation of an adult T-cell leukemia skin lesion after treatment of a concomitant herpes simplex infection: a case study

    PubMed Central

    2012-01-01

    We report the development and treatment of eczema herpeticum in a 51-year-old male suffering from adult T-cell leukemia (ATL). Lesions of eczema herpeticum coexisted with the skin lesions of ATL. Treatment of eczema herpeticum resulted in a concomitant improvement in the symptoms of ATL, including a reduction in the size of the ATL plaques, for over 2 months before relapse. PMID:23021252

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. Pithomycotoxicosis (facial eczema) in ruminants in the Azores, Portugal

    Microsoft Academic Search

    C. Pinto; V. M. Santos; J. Dinis; M. C. Peleteiro; J. M. Fitzgerald; A. D. Hawkes; B. L. Smith

    2005-01-01

    Outbreaks of pithomycotoxicosis (facial eczema), a hepatogenous photosensitisation caused by the mycotoxin sporidesmin, have affected ruminants in the Azores Islands of Portugal after warm, humid periods during late summer and autumn. Twenty-two outbreaks were recorded in cattle between 1999 and 2001, affecting 11·4 per cent of the animals in the affected herds, and in 2000 there was an outbreak in

  9. Characterization of PVL-positive MRSA from Norway.

    PubMed

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

    2014-07-01

    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

  10. Comparison of culture screening protocols for methicillin-resistant Staphylococcus aureus (MRSA) using a chromogenic agar (MRSA-Select).

    PubMed

    Lee, Seungok; Park, Yeon-Joon; Yoo, Jin-Hong; Kahng, Jimin; Jeong, In-Hee; Kwon, Young-Mi; Han, Kyungja

    2008-01-01

    To compare the culture screening protocols for methicillin-resistant Staphylococcus aureus (MRSA), a total of 300 duplicate nasal swabs (233 initial cultures and 67 weekly follow-up cultures) were collected consecutively from 233 patients in the Intensive Care Unit (ICU). One swab was plated directly on MRSA-Select agar (D-MRSA-Select) and observed at 24 hr. The duplicate swab was incubated in tryptic soy broth (TSB) with 6.5% NaCl for 24 hr, and then subcultured on MRSA-Select (B-MRSA-Select), BAP (B-BAP), and mannitol salt agar with 4 mg/L oxacillin (B-MSA(OXA)), and observed at 24 hr. MRSA was detected in 13.7% (32/233) of the initial and 22.4% (15/67) of the follow-up specimens. A patient was classified as MRSA-positive if any of the media grew colonies that were tested and confirmed to be MRSA. In the initial screening samples, the sensitivities of D-MRSA-Select, B-MRSA-Select, B-BAP, and B-MSA(OXA) were 78.1%, 84.4%, 78.1%, and 65.6%, respectively, and the specificities were 100%, 98.0%, 83.1%, and 93.5%, respectively. The sensitivities of all but the B-MRSA-Select protocol were significantly lower (p <0.05). In follow-up screening, the sensitivities of D-MRSA-Select, B-MRSA-Select, B-BAP, and B-MSA(OXA) were 66.7%, 86.7%, 66.7%, and 53.3%, respectively, and the specificities were 100%, 98.1%, 90.4%, and 90.4%, respectively. D-MRSA-Select protocol was considered useful in screening for MRSA because it was fast, highly specific, and showed sensitivity comparable to B-BAP. Salt-containing enrichment broth in conjunction with MRSA-Select (B-MRSA-Select) provides a promising way to increase sensitivity in initial and follow-up screening for MRSA. PMID:18715854

  11. [MRSA clones identified in outpatient dermatology clinics].

    PubMed

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

    2014-11-01

    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

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

    PubMed Central

    Haddadin, A; Fappiano, S; Lipsett, P

    2002-01-01

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

  13. MRSA Information for Patients and Families What is Staphylococcus aureus (S. aureus)?

    E-print Network

    Kim, Duck O.

    MRSA Information for Patients and Families What is Staphylococcus aureus (S. aureus)? S. aureus) or serious (such as blood infection or pneumonia). What is MRSA? MRSA (Methicillin Resistant S. aureus. What is the difference between MRSA colonization and infection? Colonization means that MRSA is living

  14. A Holistic Approach to MRSA Eradication in Critically Ill Patients with MRSA Pneumonia

    Microsoft Academic Search

    C. Wenisch; H. Laferl; M. Szell; K. H. Smolle; A. Grisold; G. Bertha; R. Krause

    2006-01-01

    Background:  The number of Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia cases is increasing in many European countries. In this observational study in one medical and three surgical\\u000a ICUs multiple interventions for the treatment and eradication of nosocomial MRSA-pneumonia were used.\\u000a \\u000a \\u000a \\u000a Patients and Methods:  Twenty-one critically ill patients (age: 59 14 years, 15 males\\/6 females, 18 ventilator-associated, 3 nosocomial, clinical\\u000a pulmonary infection score >

  15. MRSA prevalence in european healthcare settings: a review

    PubMed Central

    2011-01-01

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

  16. Efficacy of oral hygiene products against MRSA and MSSA isolates

    Microsoft Academic Search

    A. J. Smith; D. Morrison; Douglas Robertson; Michael K. Tang; Z. Al-Doori

    2010-01-01

    Sir, Clinical experience has shown that oropharyngeal carriage of methicillin-resistant Staphylococcus aureus (MRSA) can be difficult to eradicate.1 Oral carriage of MRSA may serve as a reservoir for colonization of other body sites, or cross-infection to other patients or healthcare workers.2 Eradication of throat carriage of MRSA has been achieved using topical chlorhexidine (0.2%), in addition to normal control measures

  17. MRSA and the environment: implications for comprehensive control measures

    Microsoft Academic Search

    N. Cimolai

    2008-01-01

    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

  18. Success of MRSA Eradication in Hospital Routine: Depends on Compliance

    Microsoft Academic Search

    D. Hansen; P.-I. Patzke; U. Werfel; D. Benner; A. Brauksiepe; W. Popp

    2007-01-01

    Background:  To prevent transmission of MRSA, eradication by antiseptic washings and nasal ointment is recommended. There are few studies,\\u000a which investigated the success of eradication of MRSA carriage during everyday clinical working conditions and results are\\u000a controversial. We wanted to assess the effectiveness of MRSA eradication procedures – especially octenidine whole body washings\\u000a and mupirocin nasal ointment – under conditions of

  19. Iridoschisis and bilateral lens subluxation associated with periocular eczema.

    PubMed

    Adler, Richard A; Weinberg, Robert S

    2004-01-01

    We present a 53-year-old man with bilateral lens subluxation, unilateral iridoschisis, and a long-standing history of periocular eczema. Although a case of unilateral lens subluxation and ipsilateral iridoschisis has been described recently, the pathogenesis of this simultaneous occurrence remains unclear. Our case raises questions about the relationship among these clinical observations and suggests that these findings may exist as part of an unrecognized oculodermal syndrome. PMID:14967294

  20. Remarkable improvement of relapsing dyshidrotic eczema after treatment of coexistant hyperhidrosis with oxybutynin.

    PubMed

    Markantoni, Vasiliki; Kouris, Anargyros; Armyra, Kalliopi; Vavouli, Charitomeni; Kontochristopoulos, George

    2014-01-01

    Dyshidrotic hand eczema is a common condition, which can be resistant to various treatments. Although a number of etiologic factors are involved in the pathogenesis of dyshidrotic eczema, hyperhidrosis is assumed to play a significant role. Oxybutynin is an alternative treatment for hyperhidrosis. We present the cases of two patients suffering from hyperhidrosis and dyshidrotic eczema, who were treated with oxybutynin with impressive results. PMID:25039723

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

    PubMed

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

    2015-06-01

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

  2. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    PubMed

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. PMID:22844983

  3. MRSA patients: proven methods to treat colonization and infection

    Microsoft Academic Search

    J. M. Boyce

    2001-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infections continue to cause serious nosocomial infections in many hospitals. Measures used to control the spread of these infections include ongoing laboratory-based surveillance, placing colonized and infected patients in isolation, use of barrier precautions and handwashing and hand antisepsis. Culturing hospitalized patients at high risk of acquiring MRSA can facilitate detection and isolation of colonized patients.

  4. 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...

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

    Microsoft Academic Search

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

    2010-01-01

    Background: Methycillin resistant staphylococcus aureus (MRSA) bacteria continue to defy most available antibiotics. As a result infections with MRSA remain a growing public health concern. As a paradigm shift and a significant departure from the on-going trend to develop stronger drug-based therapies, we studied the effect of 405 nm and 470 nm wavelengths of blue light on two strains of

  6. DOES THE NOSE KNOW? AN UPDATE ON MRSA DECOLONIZATION STRATEGIES

    PubMed Central

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

    2014-01-01

    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

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

    PubMed

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

    2012-04-01

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

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

    PubMed

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

    2011-08-01

    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

  9. The antioxidant activity of Chinese herbs for eczema and of placebo herbs — I

    Microsoft Academic Search

    Andrew J. Kirby; Richard J. Schmidt

    1997-01-01

    A standardized mixture of Chinese herbs has recently been demonstrated to be an effective treatment for chronic atopic eczema in placebo controlled trials in the UK. Aqueous decoctions of this formulated mixture (PSE 222), the placebo mixture, and their component herbs were examined for antioxidant activity to determine whether antioxidant activity could account for the anti-eczema activity. Two measures of

  10. Exposure to endotoxin decreases the risk of atopic eczema in infancy: A cohort study

    Microsoft Academic Search

    Ulrike Gehring; Gabriele Bolte; Michael Borte; Wolfgang Bischof; Bärbel Fahlbusch; H.-Erich Wichmann; Joachim Heinrich

    2001-01-01

    Background: Previous studies have shown a protective effect of early exposure to cats and dogs on the development of atopic eczema, asthma, allergic rhinitis, and atopic sensitization in later life. In particular, a higher microbial exposure to endotoxin in early childhood might contribute to this effect. Objective: We examined the associations between bacterial endotoxin in house dust and atopic eczema,

  11. Baby-wipe dermatitis: Preservative-induced hand eczema in parents and persons using moist towelettes

    Microsoft Academic Search

    Jere D. Guin; Jay Kincannon; Frederick L. Church

    2001-01-01

    Background: Hand eczema can have complex causative or aggravating influences, and the pattern, history, and patch test data are helpful in identifying sources and antigen substitution. Objective: We studied our patients with hand eczema associated with exposure to baby wipes for pattern and sensitivities. Methods: Patient records over a 10-year period containing key words were reviewed for relevance of exposure,

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

    PubMed Central

    Havlickova, B; Weyandt, G H

    2014-01-01

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

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

    PubMed

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

    2014-11-01

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

  14. Evaluation of massage with essential oils on childhood atopic eczema.

    PubMed

    Anderson, C; Lis-Balchin, M; Kirk-Smith, M

    2000-09-01

    Childhood atopic eczema is an increasingly common condition in young children. As well as being irritating to the child, it causes sleepless nights for both the child and the family and leads to difficulties in parental relationships and can have severe effects on employment. A group of eight children, born to professional working mothers were studied to test the hypothesis that massage with essential oils (aromatherapy) used as a complementary therapy in conjunction with normal medical treatment, would help to alleviate the symptoms of childhood atopic eczema. The children were randomly allocated to the massage with essential oils group and both counselled and massaged with a mixture of essential oils by the therapist once a week and the mother every day over a period of 8 weeks. The preferred essential oils, chosen by the mothers for their child, from 36 commonly used aromatherapy oils, were: sweet marjoram, frankinsence, German chamomile, myrrh, thyme, benzoin, spike lavender and Litsea cubeba. A control group of children received the counselling and massage without essential oils. The treatments were evaluated by means of daily day-time irritation scores and night time disturbance scores, determined by the mother before and during the treatment, both over an 8 week period; finally general improvement scores were allocated 2 weeks after the treatment by the therapist, the general practitioner and the mother. The study employed a single case experimental design across subjects, such that there were both a within-subject control and between-subjects control, through the interventions being introduced at different times. The results showed a significant improvement in the eczema in the two groups of children following therapy, but there was no significant difference in improvement shown between the aromatherapy massage and massage only group. Thus there is evidence that tactile contact between mother and child benefits the symptoms of atopic eczema but there is no proof that adding essential oils is more beneficial than massage alone. Further studies on the essential oil massage group showed a deterioration in the eczematous condition after two further 8 week periods of therapy, following a period of rest after the initial period of contact. This may have been due to a decline in the novelty of the treatment, or, it strongly suggests possible allergic contact dermatitis provoked by the essential oils themselves. The results of this study indicate the necessity of prolonged studies with novel plant extracts as short-term beneficial results could be overturned by adverse effects after repeated usage. PMID:10960901

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-10-01

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

  17. Hand Sanitizers Carry Unproven Claims to Prevent MRSA Infections

    MedlinePLUS

    ... formulation of essential plant oils" kills the bacterium Salmonella . These claims are also unproven and, therefore, illegal. " ... claiming to prevent infection from MRSA, E. coli , Salmonella , or H1N1 flu, which a consumer can just ...

  18. An overview of livestock-associated MRSA in agriculture.

    PubMed

    Harper, Abby L; Ferguson, Dwight D; Leedom Larson, Kerry R; Hanson, Blake M; Male, Michael J; Donham, Kelley J; Smith, Tara C

    2010-04-01

    Researchers, veterinary and health care practitioners, and agricultural producers gathered in Johnston, Iowa, to attend the eighth annual Midwest Rural Agricultural Safety and Health Forum (MRASH), November 2009. Among several focus areas, four plenary talks were given on the current research being conducted examining methicillin-resistant Staphylococcus aureus (MRSA) on swine farms in the United States. These focused on prevalence of MRSA on farms, both in swine and in human workers; the presence of MRSA in air samples and in swine barn shower facilities; and the presence of methicillin-resistant and methicillin-sensitive S. aureus in retail meats. These findings begin to elucidate the overall picture of livestock-associated MRSA in the Midwestern United States. PMID:20407991

  19. Inhibition of dermal MRSA colonization by microalgal micro- and nanoparticles.

    PubMed

    Lukowski, G; Lindequist, U; Mundt, S; Kramer, A; Julich, W-D

    2008-01-01

    The aim of this study was to investigate the prevention of the dermal colonization of methicillin-resistant Staphylococcus aureus (MRSA) strains by the application of micro- and nanoparticles called Maresometrade mark. Maresometrade mark were prepared from selected microalgae by a novel emulsion technique. They contain lipids and all other components of the microalgae in an encapsulated form. It could be shown that Maresometrade mark prepared from a cyanobacterial strain of the order Nostocales (Bio33-Maresometrade mark) were able to inhibit the dermal colonization of different MRSA strains (North German Epidemic Strain, Col, N315) and even of the vancomycin-resistant strain MU50 in the models 'mouse ear' and 'cow udder teat'. Pretreatment of the skin with Maresometrade mark reduced the number of attached MRSA by 3-4 log units in comparison to the control. We assume that a prophylactic skin care with Maresometrade mark could complete the multibarrier anti-infectious strategy against MRSA. PMID:18198493

  20. Mupirocin resistance and methicillin-resistant Staphylococcus aureus (MRSA)

    Microsoft Academic Search

    I. Eltringham

    1997-01-01

    Mupirocin has become the topical agent of choice for the elimination of methicillin-resistant Staphylococcus aureus (MRSA) carriage. The increased use of this antibiotic has been followed by reports of outbreaks due to MRSA with both low- and high-level resistance. Whilst low-level resistance is becoming more widespread, it is unlikely to have a major impact upon current practice. High-level resistance is

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

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

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

  2. What is MRsa? The McGill Mature &

    E-print Network

    Kambhampati, Patanjali

    What is MRsa? The McGill Mature & Re-entry Students' A s s o c i a t i o n (MRSA) facilitates the integration of mature and re-entry students into the traditional spectrum of academic life and gives its Office mcgillmrsa@gmail.com MatuRe & Re-entRy students Fall 2012 Winter 2013 FiRst­yeaR OFFice The First

  3. What is MRsa? The McGill Mature &

    E-print Network

    Volesky, Bohumil

    What is MRsa? The McGill Mature & Re-entry Students' A s s o c i a t i o n (MRSA) facilitates the integration of mature and re-entry students into the traditional spectrum of academic life and gives its Office mcgillmrsa@gmail.com MatuRe & Re-entRy students Fall 2010 Winter 2011 FiRst­yeaR OFFice The First

  4. In vitro anti-MRSA activity of carvone with gentamicin.

    PubMed

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

    2014-04-01

    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

  5. In vitro anti-MRSA activity of carvone with gentamicin

    PubMed Central

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

    2014-01-01

    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

  6. Quantitative assessment of human MRSA risks from swine.

    PubMed

    Cox, Louis Anthony Tony; Popken, Douglas A

    2014-09-01

    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

  7. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA

    Microsoft Academic Search

    R. Coello; J. R. Glynn; C. Gaspar; J. J. Picazo; J. Fereres

    1997-01-01

    In hospital outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) many patients are initially colonized without infection. The reasons why some progress to infection while others do not are not known. A cohort of 479 hospital patients, initially only colonized with MRSA, was followed prospectively for the development of MRSA infection. Risk factors for progression to infection were assessed using Cox proportional

  8. Is methicillin-resistant Staphylococcus aureus (MRSA) contamination of ward-based computer terminals a surrogate marker for nococomial MRSA transmission and handwashing compliance?

    Microsoft Academic Search

    J. Devine; R. P. D. Cooke; E. P. Wright

    2001-01-01

    A survey of two acute district general hospitals (A and B) was undertaken to investigate the extent of methicillin-resistant Staphylococcus aureus (MRSA) contamination of ward-based computer terminals. Of 25 terminals examined, MRSA was identified in six (24%). Environmental contamination was of a low level. Five of the MRSA positive terminals were from hospital A which had a significantly higher rate

  9. Epidemiology of Emerging Methicillin-Resistant Staphylococcus aureus (MRSA) in Denmark: a Nationwide Study in a Country with Low Prevalence of MRSA Infection

    Microsoft Academic Search

    Nuno A. Faria; Duarte C. Oliveira; Henrik Westh; Dominique L. Monnet; Anders R. Larsen; Robert Skov; Hermõ ´ nia de Lencastre

    2005-01-01

    Strict infection control measures introduced during the 1970s have kept the incidence of methicillin- resistant Staphylococcus aureus (MRSA) infections extremely low in Denmark. Nevertheless, similarly to other countries, MRSA infections began to appear in the community in the late 1990s. A nationwide surveillance program has collected and stored all MRSA isolates since 1988 and, since 1999, clinical information has been

  10. Molecular and Epidemiological Evaluation of Strain Replacement in Patients Previously Harboring Gentamicin-Resistant MRSA ? †

    PubMed Central

    De Angelis, Giulia; Francois, Patrice; Lee, Andie; Schrenzel, Jacques; Renzi, Gesuele; Girard, Myriam; Pittet, Didier; Harbarth, Stephan

    2011-01-01

    Gentamicin-susceptible methicillin-resistant Staphylococcus aureus (GS-MRSA) clones have gradually replaced gentamicin-resistant MRSA (GR-MRSA) clones in many European countries. We studied molecular and epidemiological aspects of MRSA strain replacement in individual patients. All patients from whom at least 2 MRSA strains showing different gentamicin susceptibility patterns were isolated between 1996 and 2008 were retrospectively identified. Staphylococcal cassette chromosome mec (SCCmec) type and clonality between isolates were determined using molecular methods. Risk factors for individual GR-MRSA SCCmec I (prevalent clone) strain replacement with GS-MRSA non-SCCmec I types were studied in a nested case-crossover study (n = 55 patients). MRSA strain replacement was observed in 127 patients, 85 (67%) of whom were initially colonized with GR-MRSA replaced subsequently by GS-MRSA. Most GS-MRSA replacement strains (50; 59%) possessed SCCmec IV. All MRSA isolate pairs from the same patient that consisted of different gentamicin susceptibility and SCCmec types were also genotypically different. Exposure to domiciliary nursing assistance (odds ratio [OR], 8.1; 95% confidence interval [CI], 1.2 to 53.7) and high Charlson scores (OR, 7.1; 95% CI, 1.1 to 46.8) were associated with individual strain replacement. In individual patients, exogenous acquisition of a different MRSA strain was responsible for strain replacement in most cases. Domiciliary nursing assistance could be a target for specific control measures to prevent transmission of GS-MRSA in our setting. PMID:21918027

  11. Tea and Coffee Consumption and MRSA Nasal Carriage

    PubMed Central

    Matheson, Eric M.; Mainous, Arch G.; Everett, Charles J.; King, Dana E.

    2011-01-01

    PURPOSE Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). METHODS We performed a secondary analysis of data from the 2003–2004 National Health and Nutrition Examination Survey to investigate the relationship between the consumption of coffee, hot tea, cold tea, and soft drinks, and MRSA nasal carriage among the noninstitutionalized population of the United States. RESULTS An estimated 2.5 million persons (1.4% of the population) were MRSA nasal carriers. In an adjusted logistic regression analysis controlling for age, race, sex, poverty-income ratio, current health status, hospitalization in the past 12 months, and use of antibiotics in the past month, individuals who reported consuming hot tea were one-half as likely to have MRSA nasal carriage relative to individuals who drank no hot tea (odds ratio = 0.47; 95% confidence interval, 0.31–0.71). Similarly, individuals who reported consuming coffee had about a one-half reduction in the risk of MRSA nasal carriage relative to individuals who drank no coffee (odds ratio = 0.47; 95% confidence interval, 0.24–0.93). CONCLUSIONS Consumption of hot tea or coffee is associated with a lower likelihood of MRSA nasal carriage. Our findings raise the possibility of a promising new method to decrease MRSA nasal carriage that is safe, inexpensive, and easily accessible. PMID:21747100

  12. Recent advances in epidemiology and prevention of atopic eczema.

    PubMed

    Cipriani, Francesca; Dondi, Arianna; Ricci, Giampaolo

    2014-11-01

    Atopic dermatitis (AD), named also atopic eczema, is a chronic relapsing inflammatory skin disease with a considerable social and economic burden. The primum movens of AD is in most cases a genetic and/or immune-supported defect of the skin barrier, facilitating penetration and sensitization to food or airborne allergens, as well as infections by Staphylococcus aureus, herpes simplex virus, or other microbes. New pathogenetic concepts have generated new approaches to prevention and therapy of AD. In particular, the daily use of emollients in newborns at high risk of AD has shown interesting results, with a reduction in the cumulative incidence of AD ranging from 32% to 50% of the treated infants. On the other hand, the AD preventive efficacy of food and/or inhalant allergen avoidance has been questioned, and supplementation strategies (vitamin D, probiotics, or other compounds) need to be further investigated. PMID:25406640

  13. Mapping randomized controlled trials of treatments for eczema - The GREAT database (The Global Resource of Eczema Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010)

    Microsoft Academic Search

    Helen Nankervis; Alan Maplethorpe; Hywel C Williams

    2011-01-01

    Background  Massive duplication of effort occurs when researchers all over the world undertake extensive searches for randomized controlled\\u000a trials when preparing systematic reviews, when developing evidence-based guidelines and when applying for research funding\\u000a for eczema treatments. Such duplication wastes valuable resources.\\u000a \\u000a \\u000a Searching for randomized controlled trials of eczema is a laborious task involving scrutiny of thousands of individual references\\u000a from diverse

  14. Eczema in early life: Genetics, the skin barrier, and lessons learned from birth cohort studies

    PubMed Central

    Biagini Myers, Jocelyn M.; Khurana Hershey, Gurjit K.

    2010-01-01

    Eczema is a chronic inflammatory disorder of the skin that affects up to 30% of children. It often afflicts infants in the first few months of life and can be the first indicator of the atopic march. Recent results from birth cohort studies have uncovered novel information regarding genetic and environmental factors that promote the development of eczema. Birth cohort studies provide an optimal study design to elucidate these associations and prospectively track longitudinal data including exposure assessment and health outcomes from birth into early life and childhood. This is especially relevant for eczema given the age specific emergence of this disease. In this review, we will provide a general overview of pediatric eczema and discuss the important findings in the literature with respect to genetics and environmental exposures, highlighting those derived from birth cohort studies. Additionally, we will review how these relate to the atopic march, the hygiene hypothesis and the integrity of the skin barrier. PMID:20739029

  15. Immunization with modified vaccinia virus Ankara prevents eczema vaccinatum in a murine model of atopic dermatitis

    PubMed Central

    Oyoshi, Michiko K.; Wang, James YT; Geha, Raif S.

    2011-01-01

    Summary Immunization with modified vaccinia virus Ankara (MVA) protects mice with allergic skin inflammation from developing eczema vaccinatum (EV), suggesting that immunization with MVA would be effective in preventing EV in patients with atopic dermatitis. PMID:21820712

  16. Bovine-associated MRSA ST398 in The Netherlands

    PubMed Central

    2012-01-01

    During routinely screening (50.000 milk samples on an annual basis) 14 MRSA ST398 strains were identified in the period of January 2008 to September 2008 in 14 different dairy herds located in the provinces Overijssel and Gelderland, The Netherlands. Molecular analysis was performed by Cfr9I PFGE, ST398-specific diagnostic PCR, spa typing, SCCmec typing and Panton-Valentine Leukocidin (PVL) gene PCR. The molecular analyses of 14 MRSA (one MRSA strain per herd) strains revealed that all strains belong to ST398 with 3 closely related spa types (t011, t108 and t889, all commonly found in pigs) and carry 2 different SCCmec types, IVa and V. All MRSA strains were resistant to two or more classes of antibiotics and also PVL negative. The majority of farms (n?=?9, 64%) harboured combined livestock with both cows and pigs present. Our study contributes to the growing evidence that MRSA ST398 is transmitted among various animal species and can be considered as an etiological agent of mastitis in dairy cows. PMID:22549050

  17. Bovine-associated MRSA ST398 in the Netherlands.

    PubMed

    Tavakol, Mehri; Riekerink, Richard G M Olde; Sampimon, Otlis C; van Wamel, Willem J B; van Belkum, Alex; Lam, Theo J G M

    2012-01-01

    During routinely screening (50.000 milk samples on an annual basis) 14 MRSA ST398 strains were identified in the period of January 2008 to September 2008 in 14 different dairy herds located in the provinces Overijssel and Gelderland, The Netherlands. Molecular analysis was performed by Cfr9I PFGE, ST398-specific diagnostic PCR, spa typing, SCCmec typing and Panton-Valentine Leukocidin (PVL) gene PCR. The molecular analyses of 14 MRSA (one MRSA strain per herd) strains revealed that all strains belong to ST398 with 3 closely related spa types (t011, t108 and t889, all commonly found in pigs) and carry 2 different SCCmec types, IVa and V. All MRSA strains were resistant to two or more classes of antibiotics and also PVL negative. The majority of farms (n = 9, 64%) harboured combined livestock with both cows and pigs present. Our study contributes to the growing evidence that MRSA ST398 is transmitted among various animal species and can be considered as an etiological agent of mastitis in dairy cows. PMID:22549050

  18. Occupational exposure to laboratory animals causing a severe exacerbation of atopic eczema.

    PubMed

    Bhabha, Friyana K; Nixon, Rosemary

    2012-05-01

    A 24-year-old man with a long history of severe atopic eczema presented with a marked exacerbation requiring hospital admission. It emerged that his occupation as an animal house technician required him to work closely with laboratory animals, particularly mice and rats. Radioallergosorbent tests to mice allergens were markedly elevated. Avoidance of animal work, in conjunction with medical treatment, resulted in a marked improvement of his eczema. PMID:22571570

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

    PubMed Central

    Silverberg, Jonathan I.; Simpson, Eric L.

    2015-01-01

    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

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

    PubMed Central

    Thompson, Deryn Lee; Thompson, Murray John

    2014-01-01

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

  1. Fifteen-Year Follow-Up of Hand Eczema: Predictive Factors

    Microsoft Academic Search

    Birgitta Meding; Karin Wrangsjö; Bengt Järvholm

    2005-01-01

    The aim of this study was to identify factors of importance for the long-term prognosis of hand eczema in the general population. In a 15-y follow-up, 868 (78%) individuals with hand eczema, diagnosed and clinically examined in a previous population-based study, answered a postal questionnaire with questions concerning persistence of the disease. In a logistic regression model, the extent of

  2. Randomized controlled observer-blinded treatment of chronic foot eczema with iontophoresis and bath-PUVA.

    PubMed

    Tupker, Ron A; Coenraads, Pieter J; Zanen, Pieter; Schuttelaar, Marie Louise A

    2013-07-01

    The aim of this study was to investigate the effect of iontophoresis combined with local psoralen plus ultraviolet A (PUVA) therapy in chronic foot eczema. A randomized, observer-blinded, multi-centre study was conducted in 48 patients with chronic moderate-to-severe foot eczema randomized to one of 3 groups: In the iontophoresis group local bath-PUVA was preceded by iontophoresis. In the PUVA group only local PUVA was given. The corticosteroid group was treated with fluticasone. All treatments were given for 8 weeks, with an 8-week follow-up period. The primary efficacy parameter was eczema score described by Rosén et al. Secondary efficacy parameters were a global impression by the patient, and the Dermatology Life Quality Index (DLQI). The eczema score and the DLQI decreased significantly over time. There were no significant differences in the decrease in eczema score (p=0.053) and DLQI values (p=0.563) between the 3 treatments. The DLQI values in our chronic foot eczema patients were high. There was no obvious advantage of local bath-PUVA with or with-out iontophoresis over local steroid therapy. PMID:23420314

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

    PubMed

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

    2015-03-01

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

  4. [Effect of methylrosanilinium chloride to MRSA nasal carriers].

    PubMed

    Ogino, J; Murakami, Y; Yamada, T

    1992-03-01

    Since the end of 1987, we have noticed an increasing incidence of Methicillin resistant Staphylococcus aureus (MRSA) among the inpatients of Yamanashi Medical College Hospital. MRSA strains were identified in 70-80 percent of the specimens obtained from patients with Staphylococcus aureus. From 1988 we performed yearly bacteriological examinations of the nares of medical personnel at Yamanashi Medical College Hospital. We treated nasal carriers with OFLX drop lotion or Povidone-iodine applied to the nares. In 1991 we treated eight nasal carriers, who had been unsuccessfully treated with Povidone-iodine, with 0.01% Methylrosanilinium Chloride ointment which was applied to the nares once a day for two weeks. A post-bacteriological examination again revealed that MRSA vanished from the nares of six nasal carriers. The minimum inhibitory concentration (MIC) of Methylrosanilinium Chloride was determined by the agar plate dilution method. The 100% MICs of MSSA were 1.0 microgram/ml and of MRSA were 1.0 microgram/ml by Methylrosanilinium Chloride. Moreover we examined the MICs of Methylrosanilinium Chloride against MRSA under the existing 5% Albumin, and consequently the 100% MICs were 4.0 micrograms/ml. Therefore a 0.01% Methylrosanilinium Chloride has sufficient efficacy against MRSA. The reaction of the skin and nasal mucosa to Methylrosanilinium Chloride was examined by using three groups of guinea pigs. 0.1% and 0.01% Methylrosanilinium Chloride ointment and hydrophylic poloid were applied to the nares and skin once a day for two weeks. Post-observation with an opticmicroscope revealed no significant findings. Methylrosanilinium Chloride shows good anti-Staphylococcus aureus ability. Further investigation is needed to determine if Methylrosanilinium Chloride has additional clinical application. PMID:1624827

  5. Aphonia and epiglottitis in neonate with concomitant MRSA skin infection.

    PubMed

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

    2014-09-01

    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

  6. Potent Small Molecule Suppression of Oxacillin Resistance in MRSA

    PubMed Central

    Harris, Tyler L.; Worthington, Roberta J.; Melander, Christian

    2013-01-01

    The use of adjuvant molecules that have the ability to restore the susceptibility of multi-drug resistant bacteria, such as MRSA, to clinically available antibiotics is a promising alternative to the development of novel antimicrobials. We report an extremely potent small molecule that, at sub-MIC levels, lowers the MIC of oxacillin against a number of MRSA strains by up to 512-fold. Preliminary mechanistic investigations indicate that the VraSR two-component system plays a role in the activity of this compound. PMID:23047322

  7. Aphonia and epiglottitis in neonate with concomitant MRSA skin infection

    PubMed Central

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

    2014-01-01

    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

  8. Genome and virulence determinants of high virulence community-acquired MRSA

    Microsoft Academic Search

    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

    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

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

    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

    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

  11. Low prevalence of methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission in the Netherlands: the value of search and destroy and restrictive antibiotic use

    Microsoft Academic Search

    H. F. L Wertheim; M. C Vos; H. A. M Boelens; A. Voss; C. M. J. E. Vandenbroucke-Grauls; M. H. M Meester; J. A. J. W. Kluytmans; P. H. J van Keulen; H. A. Verbrugh

    2004-01-01

    In the Netherlands, less than 1% of clinical isolates of Staphylococcus aureus are methicillin-resistant (MRSA). A national search and destroy policy prevents MRSA from becoming endemic. Some MRSA outbreaks cannot be related to patients at risk for MRSA carriage. This study was designed to measure the prevalence of MRSA among patients without risk factors for MRSA carriage at the time

  12. Glomerulonephritis associated with MRSA infection: A possible role of bacterial superantigen

    Microsoft Academic Search

    Akio Koyama; Masaki Kobayashi; Naoto Yamaguchi; Kunihiro Yamagata; Katsuhisa Takano; Masami Nakajima; Fujiko Irie; Michihiro Goto; Masaya Igarashi; Tadashi Iitsuka; Yasuko Aoki; Hideko Sakurai; Noriko Sakurayama; Katashi Fukao

    1995-01-01

    Glomerulonephritis associated with MRSA infection: A possible role of bacterial superantigen. We report 10 cases of glomerulonephritis following methicillin-resistant Staphylococcus aureus (MRSA) infection. The clinical features of this syndrome were an abrupt or insidious onset of rapidly progressive glomerulonephritis (RPGN) with nephrotic syndrome and occasionally purpura, following MRSA infection. The renal histologic findings showed a variety of types of proliferative

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

    PubMed Central

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

    2013-01-01

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

  14. A clinical trial for evaluation of leech application in the management of Vicarcik? (Eczema)

    PubMed Central

    Shankar, K.M. Pratap; Rao, S. Dattatreya; Umar, Shaik Nafeez; Gopalakrishnaiah, V.

    2014-01-01

    Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcik? (Eczema) with standard clinical parameters viz. Eczema Area and Severity Index (EASI) score, SCORing of Atopic Dermatitis (SCORAD) Index and Dermatology Life Quality Index (DLQI). Materials and Methods: An open labeled clinical trial study without control group was conducted with 27 patients having the classical symptoms of vicarcik? (Eczema), selected as per the inclusion and exclusion criteria from outpatient department and inpatient department sections of Shalya Department, S.V. Ayurvedic Hospital, Tirupati. Minimum four sittings of leech application were carried out with 7 days interval. Pre- and post-treatment evaluation of the patient was done with Eczema Area and Severity Index (EASI) score, SCORing of Atopic Dermatitis (SCORAD) Index and Dermatology Life Quality Index (DLQI). Statistical Analysis: Analysis of the data was done with Student's paired t-test. Results: The total EASI score showed considerable reduction up to 54.45% (P < 0.01) and the SCORAD Index significantly reduced by 55% (P < 0.01). The life quality of the patient calculated by DLQI improved significantly by 62.36% (P < 0.01). Conclusion: Leech application gives significant relief for the symptoms of eczema. The life quality of the patient also improved significantly after leech therapy. No adverse reactions were reported during the entire course of study. PMID:25593404

  15. Trying to control MRSA causes more problems than it solves

    Microsoft Academic Search

    S. P. Barrett; R. V. Mummery; B. Chattopadhyay

    1998-01-01

    Despite occasional reports of local success, the steadily increasing prevalence of strains of Staphylococcus aureus resistant to methicillin (MRSA) shows that attempts to limit their spread do not work. In this commentary we suggest that efforts to control the spread of methicillinresistance are counterproductive, and that energies should instead be directed towards the control of outbreaks of disease and preventing

  16. Transferable vancomycin resistance in a community-associated MRSA lineage.

    PubMed

    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

    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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  18. Microbiota in healthy skin and in atopic eczema.

    PubMed

    Baviera, Giuseppe; Leoni, Maria Chiara; Capra, Lucetta; Cipriani, Francesca; Longo, Giorgio; Maiello, Nunzia; Ricci, Giampaolo; Galli, Elena

    2014-01-01

    The Italian interest group (IG) on atopic eczema and urticaria is member of the Italian Society of Allergology and Immunology. The aim of our IG is to provide a platform for scientists, clinicians, and experts. In this review we discuss the role of skin microbiota not only in healthy skin but also in skin suffering from atopic dermatitis (AD). A Medline and Embase search was conducted for studies evaluating the role of skin microbiota. We examine microbiota composition and its development within days after birth; we describe the role of specific groups of microorganisms that colonize distinct anatomical niches and the biology and clinical relevance of antimicrobial peptides expressed in the skin. Specific AD disease states are characterized by concurrent and anticorrelated shifts in microbial diversity and proportion of Staphylococcus. These organisms may protect the host, defining them not as simple symbiotic microbes but rather as mutualistic microbes. These findings reveal links between microbial communities and inflammatory diseases such as AD and provide novel insights into global shifts of bacteria relevant to disease progression and treatment. This review also highlights recent observations on the importance of innate immune systems and the relationship with normal skin microflora for the maintenance of healthy skin. PMID:25126558

  19. Guidelines for diagnosis, prevention and treatment of hand eczema.

    PubMed

    Diepgen, Thomas L; Andersen, Klaus E; Chosidow, Oliver; Coenraads, Peter Jan; Elsner, Peter; English, John; Fartasch, Manigé; Gimenez-Arnau, Ana; Nixon, Rosemary; Sasseville, Denis; Agner, Tove

    2015-01-01

    The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful me-dical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wis-senschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medi-cal Societies in Germany).No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest. PMID:25763418

  20. Long Term Treatment Concepts and Proactive Therapy for Atopic Eczema

    PubMed Central

    Ehmann, Laura Maximiliane

    2012-01-01

    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

  1. Immunomodulatory effects of recombinant lactoferrin during MRSA infection

    PubMed Central

    Hwang, Shen-An; Kruzel, Marian L.; Actor, Jeffrey K.

    2014-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infection remains a serious hazard to global health despite increases in public education and development of innovative treatment strategies. Use of immune modulatory therapy to combat infection is gaining interest as a novel treatment alternative. Lactoferrin (LF), an iron binding protein with multiple immune modulating properties, has the potential to modify the course of systemic MRSA infection. Specifically, LF is capable of limiting deleterious inflammatory responses while promoting development of antigen specific T-cell activity. The efficacy of a novel recombinant mouse LF (rmLF) to protect against MRSA infection was examined in a mouse peritonitis model. BALB/c mice were infected with a lethal dose of MRSA and treated at 2 hours post-infection with rmLF. The effects of rmLF on MRSA-infected primary monocytes and granulocytes were analyzed for inflammatory mediator production. The rmLF treated mice demonstrated only modest increase in survival by more than 24hrs, albeit with reduced bacteremia. Serum cytokines, IL-17 and IL-6, were significantly reduced post challenge in the rmLF treated mice. Treatment with rmLF led to a minor decrease in IL-1?, and a slight increase in TNF-? production. Preliminary investigation towards human clinical relevance was accomplished using human blood derived monocytes and granulocytes infected with MRSA and treated with a homologous recombinant human LF (rhLF). Treatment with (rhLF) led to increased production of IFN-? and IL-2. The human cell studies also showed a concurrent decrease in TNF-?, IL-6, IL-1?, IL-12p40, and IL-10. The study reports the first investigation into the efficacy of a novel recombinant mouse lactoferrin (LF) therapy in a mouse model of MRSA peritonitis. Overall, these results indicate the rmLF and rhLF have a high degree of overlap to modify inflammatory responses, although differences in activities were observed indicating existence of mechanisms between the two heterologous recombinant molecules. PMID:24613206

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

    PubMed

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

    2014-08-01

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

  3. Reduced vancomycin susceptibility in porcine ST9 MRSA isolates

    PubMed Central

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

    2013-01-01

    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

  4. Epidemiology of MRSA and current strategies in Europe and Japan

    PubMed Central

    Kramer, Axel; Wagenvoort, Hans; Åhrén, Christina; Daniels-Haardt, Inka; Hartemann, Philippe; Kobayashi, Hiro; Kurcz, Andrea; Picazo, Juan; Privitera, Gaetano; Assadian, Ojan

    2010-01-01

    The prevalence of health-care associated infections caused by multi-drug resistant organisms has significantly increased over the past decade. Among these organisms, Methicillin-resistant Staphylococcus aureus (MRSA) plays a prominent and increasing role. Because of consequences for patients and the economic burden in course of prolonged treatment following MRSA infections and additional indirect costs for e.g. isolation or antiseptic treatment, this trend will further damage European health-care systems. In 2006, a workshop was initiated at the 8th International Congress of the German Society of Hospital Hygiene held in Berlin. The aim of this workshop was to give an overview of the current situation of MRSA in selected European countries and to elaborate on potential strategies to prevent MRSA-infections and dissemination. A questionnaire encompassing 20 questions addressed topics such as epidemiology, current measures and future prospects was distributed to representatives from various European countries and Japan. A variety of widely different answers was obtained. It was shown that in all countries prevalence of MRSA is on a rising tide. This trend is observable in all European countries, albeit less strong in The Netherlands, Slovenia, France, Austria and Scandinavian countries. It was conclude that prevention strategies in a united and expanding European Community will become of utmost importance and that rapid screening strategies, e.g. PCR, might be of assistance in such an approach. A potential strategy to improve infection control measures could be the requirement of health-insurance providers to sign contracts only with hospitals able to proof having an infection control management in place. PMID:20204100

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

    PubMed

    Lewis-Jones, S

    2006-08-01

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

  6. Rapid Detection of Methicillin-Resistant Staphylococcus aureus (MRSA) in Diverse Clinical Specimens by the BD GeneOhm MRSA Assay and Comparison with Culture?

    PubMed Central

    Lucke, Katja; Hombach, Michael; Hug, Melanie; Pfyffer, Gaby E.

    2010-01-01

    The efficacy of the BD GeneOhm methicillin-resistant Staphylococcus aureus (MRSA) assay was assessed by analyzing nasal swabs and swabs from other body sites for the presence of MRSA in a low-prevalence area. From 681 patients with a high risk for MRSA carriage, 1,601 specimens were collected and transported in Amies agar. After discordant analysis, the sensitivity, specificity, positive predictive value, and negative predictive value of the BD GeneOhm MRSA assay were 84.3%, 99.2%, 88.4%, and 98.9%, respectively, compared to culture. PMID:20071545

  7. The role of gowns in preventing nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA): gown use in MRSA control.

    PubMed

    Grant, J; Ramman-Haddad, L; Dendukuri, N; Libman, M D

    2006-02-01

    During a 2-year period, a standard isolation protocol for control of methicillin-resistant Staphylococcus aureus was compared with a similar protocol in which gowns were not used but the availability of alcohol-based hand disinfectant was increased. Intervention wards had 0.10 fewer new MRSA transmissions per ward per month, compared with control wards (P was not significant). PMID:16465638

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

    PubMed

    Kaur, Mandip; Chandola, H M

    2010-01-01

    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

  9. Antibacterial activity of Lactobacillus acidophilus and Lactobacillus casei against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Karska-Wysocki, Barbara; Bazo, Mari; Smoragiewicz, Wanda

    2010-10-20

    Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug-resistant microorganism and the principal nosocomial pathogen worldwide. The antibacterial activity of lactic acid bacteria against MRSA from ten human clinical isolates as well as MRSA standard strain ATCC 43300 was tested in vitro. The Lactobacillus (Lb.) strains (Lb. acidophilus CL1285(®) and Lb. casei LBC80R) as pure cultures, which came from commercial food products were employed. The growth inhibitory effect produced by the antimicrobial activity of the lactic acid bacteria on the MRSA strains was tested on solid medium using agar diffusion methods as well as a using a liquid medium procedure that contained a mixture of MRSA and lactic acid bacteria cultures. In the latter instance, we were able to demonstrate that the direct interaction of lactic acid bacteria and MRSA in such a mixture led to the elimination of 99% of the MRSA cells after 24 h of their incubation at 37°C. PMID:20116228

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

    PubMed Central

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

    2013-01-01

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

  11. Effects of Prenatal and Perinatal Exposure to Fine Air Pollutants and Maternal Fish Consumption on the Occurrence of Infantile Eczema

    Microsoft Academic Search

    Wieslaw Jedrychowski; Frederica Perera; Umberto Maugeri; Dorota Mrozek-Budzyn; Rachel L. Miller; Elzbieta Flak; Elzbieta Mroz; Ryszard Jacek; John D. Spengler

    2011-01-01

    Background: As there is a scarcity of evidence on potential hazards and preventive factors for infantile eczema operating in the prenatal period, the main goal of this study was to assess the role of prenatal exposure to fine particulate matter and environmental tobacco smoke (ETS) in the occurrence of infant eczema jointly with the possible modulating effect of maternal fish

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

    Microsoft Academic Search

    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

    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

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

    Microsoft Academic Search

    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

    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

  14. [Alitretinoin in chronic hand eczema: summary of clinical trials].

    PubMed

    Richard, M-A

    2010-11-01

    After an open preliminary study, two double-blind placebo-controlled randomized studies have confirmed the value of per os alitretinoin in the management of severe chronic hand eczema (CHE). The first showed dose-dependent efficacy and a response defined as "clear" or "almost clear" by 53% of the patients receiving 10-40 mg of alitretinoin per day for 12 weeks. In the second multicenter study (the Bach study), comparing the efficacy of a 12-week alitretinoin treatment (10 mg, 30 mg) to placebo for CHE, a "clear or almost clear" result was observed in 17% (placebo group), 28% (group alitretinoin 10 mg), and 48% (group alitretinoin 30 mg). The onset of action was also significantly shorter in the group treated with 30 mg of alitretinoin compared to the group treated with 10 mg. In a study of randomized retreatment versus placebo, 80% of the patients who were initially responders to alitretinoin and whose CHE had relapsed found "clear" or "almost clear" with alitretinoin 30 mg administered for 12-24 weeks compared to 48% with alitretinoin 10 mg. In all the studies, clinical tolerance was comparable and satisfactory, with the most frequent negative side effects being headache, flushing, and mucocutaneous signs identical to those compared with other retinoids. An increase in cholesterol and/or triglycerides was the most frequent biological side effect. Central hypothyroidism, with no clinical expression, was observed more rarely. These studies confirm that alitretinoin treatment can be envisaged as second-line therapy in adults with CHE that does not respond to well-observed treatment with class potent or very potent dermocorticoids. PMID:21185982

  15. The Role of Acetaminophen and Geohelminth Infection on the Incidence of Wheeze and Eczema

    PubMed Central

    Amberbir, Alemayehu; Medhin, Girmay; Alem, Atalay; Britton, John; Davey, Gail; Venn, Andrea

    2011-01-01

    Rationale: Acetaminophen has been hypothesized to increase the risk of asthma and allergic disease, and geohelminth infection to reduce the risk, but evidence from longitudinal cohort studies is lacking. Objectives: To investigate the independent effects of these exposures on the incidence of wheeze and eczema in a birth cohort. Methods: In 2005–2006 a population-based cohort of 1,065 pregnant women from Butajira, Ethiopia, was established, to whom 1,006 live singleton babies were born. At ages 1 and 3, questionnaire data were collected on wheeze, eczema, child's use of acetaminophen, and various potential confounders, along with a stool sample for geohelminth analysis. Those without wheeze (n = 756) or eczema (n = 780) at age 1 were analyzed to determine the independent effects of geohelminth infection and acetaminophen use in the first year of life on the incidence of wheeze and eczema by age 3. Measurements and Main Results: Wheeze and eczema incidence between the ages of 1 and 3 were reported in 7.7% (58 of 756) and 7.3% (57 of 780) of children, respectively. Acetaminophen use was significantly associated with a dose-dependent increased risk of incident wheeze (adjusted odds ratio = 1.88 and 95% confidence interval 1.03–3.44 for one to three tablets and 7.25 and 2.02–25.95 for ?4 tablets in the past month at age 1 vs. never), but not eczema. Geohelminth infection was insufficiently prevalent (<4%) to compute estimates of effect. Conclusions: These findings suggest frequent acetaminophen use early in life increases the risk of new-onset wheeze, whereas the role of geohelminth infection on allergic disease incidence remains to be seen as the cohort matures. PMID:20935107

  16. Comparative analysis of fecal microbiota in infants with and without eczema.

    PubMed

    Hong, Pei-Ying; Lee, Bee Wah; Aw, Marion; Shek, Lynette Pei Chi; Yap, Gaik Chin; Chua, Kaw Yan; Liu, Wen-Tso

    2010-01-01

    Eczema is a chronic form of childhood disorder that is gaining in prevalence in affluent societies. Previous studies hypothesized that the development of eczema is correlated with changes in microbial profile and composition of early life endemic microbiota, but contradictory conclusions were obtained, possibly due to the lack of minimization of apparent non-health related confounders (e.g., age, antibiotic consumption, diet and mode of delivery). In this study, we recruited seven caesarean-delivered and total formula-fed infants, and comparatively examined the early-life endemic microbiota in these infants with and without eczema. Using 16S pyrosequencing, infants' fecal microbiota were observed to comprise Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes as the four main phyla, and the presence and absence of specific populations within these four phyla are primarily mediated by ageing. Quantitative analysis of bacterial targets on a larger sample size (n = 36 at 1, 3, and 12 months of age) revealed that the abundances of Bifidobacterium and Enterobacteriaceae were different among caesarean-delivered infants with and without eczema, and the bacterial targets may be potential biomarkers that can correlate to the health status of these infants. Our overall findings suggest that the minimization of possible confounders is essential prior to comparative evaluation and correlation of fecal microbiota to health status, and that stool samples collected from caesarean-delivered infants at less than 1 year of age may represent a good cohort to study for potential biomarkers that can distinguish infants with eczema from those without. These findings would greatly facilitate future efforts in understanding the possible pathogenesis behind certain bacterial targets, and may lead to a timely intervention that reduces the occurrence of early life eczema and possibly allergic disorders in later life. PMID:20376357

  17. [Allergic contact eczema to a long-used cosmetic : Methylisothiazolinon, a type IV-allergen].

    PubMed

    Gäbelein-Wissing, N; Lehmann, P; Hofmann, S C

    2015-06-01

    Methylisothiazolinone was permitted in 2004 as preservative in rinse-off and leave-on products by the European cosmetics directive. This led to a dramatic increase in contact eczemas induced by MI in the past few years. Here, we report a patient who developed a spreading contact eczema of the face, neck and proximal arms mimicking a photodermatosis. The reaction was caused by use of a facial ointment that only recently started to contain MI. Type IV-sensitization to MI was verified by patch testing. PMID:25601721

  18. Effect of contact precautions for MRSA on patient satisfaction scores.

    PubMed

    Livorsi, D J; Kundu, M G; Batteiger, B; Kressel, A B

    2015-07-01

    Contact precautions may have an adverse effect on a patient's hospital experience and the delivery of care. This case-control study compared patient satisfaction scores between 70 patients isolated for MRSA and 139 non-isolated patients. Based on an adjusted analysis, there was no difference in patient satisfaction between the two groups. Age and educational status were found to affect patient satisfaction. PMID:25799481

  19. Surveillance and epidemiology of MRSA bacteraemia in the UK

    Microsoft Academic Search

    Alan P. Johnson; Andrew Pearson; Georgia Duckworth

    2005-01-01

    Surveillance of bacteraemia caused by methicillin-resistant Staphylococcus aureus (MRSA) in the UK has involved collection of data from hospital microbiology laboratories via several mechanisms, including a voluntary reporting scheme that has been operational in England and Wales since 1989 and mandatory reportingschemesthathavebeenrunningindependentlyinEngland,Wales,ScotlandandNorthernIreland since 2001. In addition, surveillance schemes involving panels of participating sentinel laboratories that submit isolates for centralized susceptibility

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

    PubMed Central

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

    2013-01-01

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

  1. Community-based intervention to manage an outbreak of MRSA skin infections in a county jail.

    PubMed

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

    2010-07-01

    This article describes a community-based intervention to manage an outbreak of community-associated 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

  2. Goeckerman therapy for the treatment of eczema: a practical guide and review of efficacy.

    PubMed

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

    2013-02-01

    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 ultraviolet B 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

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

    PubMed Central

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

    2015-01-01

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

  4. RE: Japanese Combination Formula for Treatment of Eczema: A Clinical Study

    Microsoft Academic Search

    Shari Henson; Brenda Milot; ELS John Neustadt; Heather S Oliff; Marissa Oppel; Cathleen Rapp; Steven Foster; Roberta Lee; Kathleen Coyne

    Atopic dermatitis (eczema) is an immune-mediated dermatological condition characterized by severe and prolonged itching and rough, red patches of skin. Rash typically occurs on the face, neck, upper trunk, wrists, hands, knees, and elbows. It may form weeping, crusting lesions, which can become infected. Patients with atopic dermatitis may have difficulty sleeping due to the discomfort caused by the rash

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

    PubMed

    Fatima, Saba; Rafiq, Ali; Majid, Zain

    2015-04-01

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

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

    PubMed

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

    2013-05-01

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

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

    E-print Network

    Yener, Aylin

    with a washcloth, as this removes the natural oil coating that protects our skin · Avoid long and hot showers of 1 Eczema, or atopic dermatitis, is a common allergic skin reaction often affecting the face, elbows intense. The rash that develops may appear very dry, with flaking skin, or can have small bubble like

  8. Eczema prevalence in the United States: data from the 2003 National Survey of Children's Health.

    PubMed

    Shaw, Tatyana E; Currie, Gabriel P; Koudelka, Caroline W; Simpson, Eric L

    2011-01-01

    Using the 2003 National Survey of Children's Health sponsored by the federal Maternal and Child Health Bureau, we calculated prevalence estimates of eczema nationally and for each state among a nationally representative sample of 102,353 children 17 years of age and under. Our objective was to determine the national prevalence of eczema/atopic dermatitis in the US pediatric population and to further examine geographic and demographic associations previously reported in other countries. Overall, 10.7% of children were reported to have a diagnosis of eczema in the past 12 months. Prevalence ranged from 8.7 to 18.1% between states and districts, with the highest prevalence reported in many of the East Coast states, as well as in Nevada, Utah, and Idaho. After adjusting for confounders, metropolitan living was found to be a significant factor in predicting a higher disease prevalence with an odds ratio of 1.67 (95% confidence interval of 1.19-2.35, P=0.008). Black race (odds ratio 1.70, P=0.005) and education level in the household greater than high school (odds ratio 1.61, P=0.004) were also significantly associated with a higher prevalence of eczema. The wide range of prevalence suggests that social or environmental factors may influence disease expression. PMID:20739951

  9. Eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition. Family history is usually positive for

    E-print Network

    Virginia Tech

    be used on the face and genital area, but the strength isn't high enough to treat eczema on the rest at the extremes of temperature: winter with low humidity and overly-heated buildings and summer with increased bathing because the water on your skin helps to absorb the lotion and then the moisturizers help to seal

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

    Microsoft Academic Search

    William Cookson

    2004-01-01

    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

  11. Association Between TSLP Polymorphisms and Eczema in Japanese Women: the Kyushu Okinawa Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Hitsumoto, Shinichi; Tanaka, Keiko; Arakawa, Masashi

    2015-08-01

    We examined the association between thymic stromal lymphopoietin (TSLP) single nucleotide polymorphisms (SNPs) and eczema in young adult Japanese women. Cases were 188 women who met the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC) for eczema. Controls were 565 women without eczema according to the ISAAC criteria, who had not been diagnosed with asthma, atopic eczema, and/or allergic rhinitis by a doctor and who had no asthma as defined by the European Community Respiratory Health Survey criteria and no rhinoconjunctivitis according to the ISAAC criteria. Compared with women with the TT genotype of SNP rs1837253, those with the TC or CC genotype had a significantly increased risk of eczema after adjustment for age and smoking, although this association was not significant in crude analysis. There were no relationships between SNP rs3806933 or rs2289276 and eczema. The TC and CC genotypes combined of SNP rs1837253 may be significantly positively associated with eczema. PMID:25700684

  12. Survival of methicillin-resistant Staphylococcus aureus (MRSA) on naturally contaminated dry mops

    Microsoft Academic Search

    S. Oie; A. Kamiya

    1996-01-01

    The floors of single rooms being used by inpatients colonized by methicillin-resistant Staphylococcus aureus (MRSA) were cleaned using disposable dust-attracting dry mops. Each mop was divided into 12 sections and MRSA quantified serially. This experiment was repeated a total of 21 times for four patients. The MRSA survival rate on the dry mops compared with a control was 59·0–125% after

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

    PubMed Central

    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

    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

  14. Synthetic analogues of the marine bisindole deoxytopsentin: potent selective inhibitors of MRSA pyruvate kinase.

    PubMed

    Veale, Clinton G L; Zoraghi, Roya; Young, Ryan M; Morrison, James P; Pretheeban, Manoja; Lobb, Kevin A; Reiner, Neil E; Andersen, Raymond J; Davies-Coleman, Michael T

    2015-03-27

    As part of an ongoing study to elucidate the SAR of bisindole alkaloid inhibitors against the evolutionary conserved MRSA pyruvate kinase (PK), we present here the synthesis and biological activity of six dihalogenated analogues of the naturally occurring sponge metabolite deoxytopsentin, including the naturally occurring dibromodeoxytopsentin. The most active compounds displayed potent low nanomolar inhibitory activity against MRSA PK with concomitant significant selectivity for MRSA PK over human PK orthologues. Computational studies suggest that these potent MRSA PK inhibitors occupy a region of the small interface of the enzyme tetramer where amino acid sequence divergence from common human PK orthologues may contribute to the observed selectivity. PMID:25372480

  15. Zeroing in on methicillin-resistant Staphylococcus aureus: US Department of Veterans Affairs' MRSA Prevention Initiative.

    PubMed

    Kralovic, Stephen M; Evans, Martin E; Simbartl, Loretta A; Ambrose, Meredith; Jain, Rajiv; Roselle, Gary A

    2013-05-01

    Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) Prevention Initiative within US Department of Veterans Affairs medical facilities was associated with a significant reduction in MRSA health care-associated infection (HAI) rates nationwide. The first 36 months of data from the Initiative were analyzed to determine how many facilities reported zero MRSA HAIs each month. From October 2007 through September 2010, there was a 37.6% increase nationwide in the number of facilities achieving zero MRSA HAIs each month. PMID:23102985

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

    PubMed Central

    Kurosu, Michio; Siricilla, Shajila; Mitachi, Katsuhiko

    2013-01-01

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

  17. MRSA in pork production shower facilities: an intervention to reduce occupational exposure.

    PubMed

    Leedom Larson, K R; Wagstrom, E A; Donham, K J; Harper, A L; Hanson, B M; Male, M J; Smith, T C

    2012-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization has been documented in swine and swine workers. MRSA has also been found in the shower facilities of conventional swine farms. We previously conducted a review of the literature to identify measures used to reduce MRSA prevalence in athletic facilities. In this study, we evaluated those measures for adaptability to the pork production environment. A best practices protocol was developed to reduce MRSA levels in pork production shower facilities and implemented in two conventional swine production systems. PMID:22458012

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

    PubMed

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

    2013-06-01

    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

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

    PubMed Central

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

    2013-01-01

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

  20. Comparison of the BD Max methicillin-resistant Staphylococcus aureus (MRSA) assay and the BD GeneOhm MRSA achromopeptidase assay with direct- and enriched-culture techniques using clinical specimens for detection of MRSA.

    PubMed

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

    2012-10-01

    We evaluated the new, fully automated molecular BD Max methicillin-resistant Staphylococcus aureus (MRSA) assay for detection of methicillin-resistant S. aureus in a low-prevalence (4.1%) setting. Sensitivity, specificity, and positive and negative predictive values were 93.9%, 99.2%, 83.8%, and 99.7%, respectively. The assay reported fewer unresolved results than the BD GeneOhm MRSA ACP assay. PMID:22814471

  1. Comparison of the BD Max Methicillin-Resistant Staphylococcus aureus (MRSA) Assay and the BD GeneOhm MRSA Achromopeptidase Assay with Direct- and Enriched-Culture Techniques Using Clinical Specimens for Detection of MRSA

    PubMed Central

    Hofko, Marjeta; Zimmermann, Stefan

    2012-01-01

    We evaluated the new, fully automated molecular BD Max methicillin-resistant Staphylococcus aureus (MRSA) assay for detection of methicillin-resistant S. aureus in a low-prevalence (4.1%) setting. Sensitivity, specificity, and positive and negative predictive values were 93.9%, 99.2%, 83.8%, and 99.7%, respectively. The assay reported fewer unresolved results than the BD GeneOhm MRSA ACP assay. PMID:22814471

  2. A comparison of linezolid with glycopeptides in severe MRSA pneumonia.

    PubMed

    Abunasser, Jafar; Metersky, Mark L

    2009-10-01

    Evaluation of: Luna CM, Bruno DA, García-Morato J et al. Effect of linezolid compared with glycopeptides in methicillin-resistant Staphylococcus aureus severe pneumonia in piglets. Chest 135(6), 1564-1571 (2009). Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major pathogen in nosocomial infections and accounts for a large proportion of nosocomial pneumonia. However, there are limited antibiotics available for the treatment of this serious and potentially lethal infection. Until recently, the only effective antibiotic was vancomycin, but the oxazolidinones, such as linezolid, have been shown to be a valuable addition to the arsenal of antimicrobial agents that can be used for MRSA pneumonia. Clinical trials have been conducted to compare vancomycin and linezolid head-to-head in pneumonia and, in post hoc subgroup analyses, showed that linezolid use was associated with improved survival. The ensuing debate over these results was dominated by two opinions; there were those who speculated on the mechanism by which linezolid achieved this benefit, namely attributing it to pharmacodynamics and pharmacokinetics, and others who criticized the methodology of the studies and questioned the validity of the results altogether. This study by Luna and colleagues was designed with several goals in mind. The first was to attempt to generate an animal model of MRSA pneumonia in piglets by duplicating techniques used in animal models of Gram-negative pneumonia. Then they studied the effect of three antibiotics (vancomycin, linezolid and teicoplanin) on outcomes in the same model, while simultaneously measuring antibiotic levels in the serum, bronchoalveolar lavage fluid and lung tissue, in an attempt to attribute differences in survival to pharmacological properties of the drugs used. Their results showed a survival benefit only for linezolid, despite the fact that all three antibiotics had levels above MIC in all the compartments sampled, leading them to speculate that linezolid may have improved outcomes by mechanisms not directly related to its antimicrobial actions. PMID:19803704

  3. Immune response to Varicella vaccine in children with atopic dermatitis compared to non-atopic controls

    PubMed Central

    Schneider, Lynda; Weinberg, Adriana; Boguniewicz, Mark; Taylor, Patricia; Oettgen, Hans; Heughan, Lisa; Zaccaro, Daniel; Armstrong, Brian; Holliday, Aaron; Leung, Donald Y M

    2010-01-01

    Atopic dermatitis subjects and controls had similar cellular immune responses to Varicella vaccine. Atopic dermatitis subjects with a history of eczema herpeticum made high levels of Varicella specific IgE. PMID:20889193

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

    PubMed Central

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

    2012-01-01

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

  5. Syntheses and anti-MRSA activities of the C3 analogs of mansonone F, a potent anti-bacterial sesquiterpenoid: insights into its structural requirements for anti-MRSA activity

    Microsoft Academic Search

    Dong-Yun Shin; Sun Nam Kim; Jung-Hyun Chae; Soon-Sil Hyun; Seung-Yong Seo; Yong-Sil Lee; Kwang-Ok Lee; Seok-Ho Kim; Yun-Sang Lee; Jae Min Jeong; Nam-Song Choi; Young-Ger Suh

    2004-01-01

    Syntheses and excellent anti-MRSA activities of the mansonone F analogs are reported. In addition, the minimal structural requirements for its anti-MRSA activities as well as its structure–activity relationship including the C3 substituents effects on anti-MRSA activity are also described. In particular, this study revealed that both ortho-quinone and tricyclic systems of mansonone F are essential for anti-MRSA activities.

  6. [Loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling in a 28-year-old man].

    PubMed

    Wahl, U; Stranzenbach, R; Tischoff, I; Tannapfel, A; Stadler, R; Ernst, F

    2014-03-01

    A 28-year-old man presented with loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling. The tentative diagnosis of malignant lymphoma was made. To confirm the diagnosis, extirpation of a lymph node and a skin biopsy were performed. Systemic treatment with methylprednisolone resulted in an improvement of eczema and lymph node swelling. Because of the histological findings and clinical course, we diagnosed dermatopathic lymphadenopathy, also known as Pautrier-Woringer syndrome. PMID:24522559

  7. Limited effectiveness of chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA)

    Microsoft Academic Search

    G. Kampf; R. Jarosch; H. Rüden

    1998-01-01

    Hand disinfectants containing chlorhexidine are thought to be less bactericidal against methicillin-resistant Staphylococcus aureus (MRSA) than methicilhn-susceptible Staphylococcus aureus (MSSA). We report an in vitro comparison between three distinct MRSA strains and three MSSA strains. The bactericidal efficacy of chlorhexidine digluconate, ‘Hibiscrub’ and ‘Hibisol’ against Staphylococcus aureus was determined in a quantitative suspension test. Logarithmic reduction factors (RF) were calculated

  8. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA)

    Microsoft Academic Search

    Derek F. J. Brown; David I. Edwards; Peter M. Hawkey; Donald Morrison

    2005-01-01

    These evidence-based guidelines have been produced after a literature review of the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). We have considered the detection of MRSA in screening samples and the detection of reduced susceptibility to glycopeptides in S. aureus. Recommendations are given for the identification of S. aureus and for suitable methods of susceptibility testing and

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

    E-print Network

    de Lijser, Peter

    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

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

    PubMed Central

    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

    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

  11. Prevalence and risk factor analysis of livestock associated MRSA-positive pig herds in The Netherlands.

    PubMed

    Broens, E M; Graat, E A M; Van der Wolf, P J; Van de Giessen, A W; De Jong, M C M

    2011-10-01

    In 2005, methicillin-resistant Staphylococcus aureus was found in pig herds and in humans in contact with pigs. To determine the prevalence of, this now-called livestock-associated (LA) MRSA among pig herds in The Netherlands and to identify and quantify risk factors, an observational study of 202 pig herds was performed between 2007 and 2008. Five environmental wipes and 60 nasal swabs from each herd were collected, and microbiological analysis was performed on single environmental samples and pooled nasal samples. A herd was considered MRSA-positive if ?1 sample tested positive. The prevalence of MRSA-positive herds was 67% in breeding herds and 71% in finishing herds. Multivariable logistic regression analysis was then performed on data from 171 breeding herds. The number of MRSA-positive herds increased from ?30% at the start to ?75% at the end of the study, most likely due to transmission between herds. The prevalence of MRSA increased with herd size, as ?40% of smaller herds (<250 sows) were MRSA-positive compared to >80% of larger herds (>500 sows). Other risk factors (e.g. antimicrobial use, purchase of gilts and hygiene measures) were not significantly associated with MRSA, though associated with herd size. Herd size appeared to be a compilation of several factors, which made larger herds more often MRSA positive. PMID:21733585

  12. Evolution of Sporadic Isolates of Methicillin-Resistant Staphylococcus aureus (MRSA) in Hospitals and Their Similarities to Isolates of Community-Acquired MRSA

    Microsoft Academic Search

    M. Aires de Sousa; H. de Lencastre

    2003-01-01

    Forty-one methicillin-resistant Staphylococcus aureus (MRSA) hospital isolates that clearly differed from the six major pandemic clones of MRSA in pulsed-field gel electrophoresis type, mecA and Tn554 polymorphism, and epidemic behavior were selected from an international strain collection for more detailed characterization. SpaA typing, multilocus sequence typing, and SCCmec (staphylococcal cassette chromosome mec) typing dem- onstrated extensive diversity among these sporadic

  13. Evaluation of the BD GeneOhm Methicillin-Resistant Staphylococcus aureus (MRSA) Assay as a Method for Detection of MRSA Isolates, Using a Large Collection of European and North African Isolates

    PubMed Central

    Bes, Michele; Meugnier, Helene; Tigaud, Sylvestre; Etienne, Jérôme; Vandenesch, François; Laurent, Frédéric

    2014-01-01

    Using a large collection of European and North African methicillin-resistant Staphylococcus aureus (MRSA) isolates with a variety of genetic backgrounds and staphylococcal cassette chromosome mec (SCCmec) types, we evaluated the reliability of the BD GeneOhm MRSA assay. Results revealed high performance of this test for detecting MRSA strains provided from Europe and North Africa (98.3%). PMID:25274997

  14. Effects of tetracycline and zinc on selection of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 398 in pigs.

    PubMed

    Moodley, Arshnee; Nielsen, Søren Saxmose; Guardabassi, Luca

    2011-09-28

    An in vivo experiment was conducted to evaluate the effects of tetracycline and zinc on pig colonization and transmission of methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST) 398. Eight piglets naturally colonized with MRSA ST398 and 8 MRSA-negative piglets of the same age and breed were assigned to three groups treated with tetracycline and zinc (Group 1), zinc (Group 2) or tetracycline alone (Group 3) and one non-treated group (Group 4), each containing two MRSA-positive and two MRSA-negative animals. Two additional non-treated control groups composed of only MRSA-positive (Group 5) and MRSA-negative (Group 6) animals were used to check for stability of MRSA carriage status. Nasal swabs and environmental wipes were collected on Days 0, 7, 14, and 21, and the occurrence of MRSA in each sample was quantified by bacteriological counts on Brilliance™ MRSA agar. Significantly higher nasal MRSA counts were observed in the zinc-treated (p=0.015) and tetracycline-treated (p=0.008) animals compared to the non-treated animals. Environmental MRSA counts appeared to increase over time in Groups 1 and 2 but such an increase was not statistically significant. MRSA-negative animals housed with MRSA-positive animals became positive in all groups, whereas the carriage status of the animals in Groups 5 and 6 did not change. This study demonstrates that feed supplemented with tetracycline or zinc increases the numbers of MRSA ST398 in the nasal cavity of pigs. Transmission of MRSA from positive to negative animals housed within the same pen was not influenced by exposure to these agents. PMID:21664077

  15. Occupational eczema and asthma in a hairdresser caused by hair-bleaching products.

    PubMed

    Hougaard, Majken G; Menné, Torkil; Søsted, Heidi

    2012-01-01

    Occupational allergic contact eczema and asthma caused by bleaching agents is seen in hairdressers. Bleaching agents contain persulfate salts, which are known to induce immediate reactions such as rhinitis, asthma, contact urticaria, and anaphylaxis. The immunologic mechanism is not, however, fully understood. The specific inhalation challenge test is considered to be the gold standard for diagnosing occupational asthma and rhinitis. However, this test is not always accessible. Therefore, the diagnosis of occupational allergic asthma caused by persulfate salts is made by combining a clinical history, a diagnosis of asthma, and a positive skin prick test (SPT). Standardized methods for performing SPT with persulfate salts are warranted. A case of a young hairdresser with occupational asthma and hand eczema caused by persulfate salts is presented, and the procedure for performing the SPT with ammonium persulfate and potassium persulfate is described in detail. PMID:23169211

  16. Survival of environmental and clinical strains of methicillin-resistant Staphylococcus aureus [MRSA] in marine and fresh waters

    Microsoft Academic Search

    Emily Levin-Edens; Natasha Bonilla; J. Scott Meschke; Marilyn C. Roberts

    2011-01-01

    Recent studies have found variable levels of methicillin-resistant Staphylococcus aureus [MRSA] in marine water from temperate and warmer climates suggesting that temperature may play a role in survival of MRSA in the environment. The aim of the study was to compare the survival of clinical and environmental MRSA and MSSA strains in fresh and marine water incubated at 13 °C and

  17. Risk factors associated with nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection including previous use of antimicrobials

    Microsoft Academic Search

    Eileen M. Graffunder; Richard A. Venezia

    2002-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen world- wide. To investigate an association between antimicrobial use and MRSA, a case control study of 121 patients infected with MRSA compared with 123 patients infected with methicillin- susceptible S. aureus (MSSA) was carried out. Antimicrobial use was analysed by three different logistic regression models: all ? ? ? ?-lactam antibiotics,

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

    PubMed Central

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

    2010-01-01

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

  19. Drinking deep-sea water restores mineral imbalance in atopic eczema\\/dermatitis syndrome

    Microsoft Academic Search

    Y Hataguchi; H Tai; H Nakajima; H Kimata

    2005-01-01

    Objective:The effect of drinking deep-sea water on hair minerals was studied in patients with atopic eczema\\/dermatitis syndrome (AEDS). Study of hair minerals revealed an imbalance of essential minerals and an increase in toxic minerals in AEDS patients.Design:After drinking deep-sea water (Amami no Mizu) for 6 months in AEDS patients, hair minerals (essential minerals and toxic minerals), clinical evaluation of the

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

    PubMed Central

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

    2014-01-01

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

  1. Silver-Coated Textiles Reduce Staphylococcus aureus Colonization in Patients with Atopic Eczema

    Microsoft Academic Search

    Anke Gauger; Martin Mempel; Annika Schekatz; Torsten Schäfer; Johannes Ring; Dietrich Abeck

    2003-01-01

    Background: In atopic eczema (AE), skin colonization with Staphylococcus aureus is known to play a major triggering and possibly pathophysiological role. Methods: In this open-labeled controlled side-to-side comparative trial, affected sites (flexures of both elbows) in 15 patients diagnosed as having generalized or localized AE were evaluated regarding S. aureus colonization and clinical severity of AE over a 2-week period.

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

    PubMed Central

    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

    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

  3. Rifampicin and sodium fusidate reduces the frequency of methicillin-resistant Staphylococcus aureus (MRSA) isolation in adults with cystic fibrosis and chronic MRSA infection.

    PubMed

    Garske, L A; Kidd, T J; Gan, R; Bunting, J P; Franks, C A; Coulter, C; Masel, P J; Bell, S C

    2004-03-01

    Nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) to patients with cystic fibrosis (CF) frequently results in chronic respiratory tract carriage. This is an increasing problem, adds to the burden of glycopeptide antibiotic use in hospitals, and represents a relative contraindication to lung transplantation. The aim of this study was to determine whether it is possible to eradicate MRSA with prolonged oral combination antibiotics, and whether this treatment is associated with improved clinical status. Adult CF patients (six male, one female) with chronic MRSA infection were treated for six months with rifampicin and sodium fusidate. Outcome data were examined for six months before treatment, on treatment and after treatment. The patients had a mean age of 29.3 (standard deviation=6.3) years and FEV(1) of 36.1% (standard deviation=12.7) predicted. The mean duration of MRSA isolation was 31 months. MRSA isolates identified in these patients was of the same lineage as the known endemic strain at the hospital when assessed by pulsed-field gel electrophoresis. Five of the seven had no evidence of MRSA during and for at least six months after rifampicin and sodium fusidate. The proportion of sputum samples positive for MRSA was lower during the six months of treatment (0.13) and after treatment (0.19) compared with before treatment (0.85) (P<0.0001). There was a reduction in the number of days of intravenous antibiotics per six months with 20.3+/-17.6 on treatment compared with 50.7 before treatment and 33.0 after treatment (P=0.02). There was no change in lung function. Gastrointestinal side effects occurred in three, but led to therapy cessation in only one patient. Despite the use of antibiotics with anti-staphylococcal activity for treatment of respiratory exacerbation, MRSA infection persists. MRSA can be eradicated from the sputum of patients with CF and chronic MRSA carriage by using rifampicin and sodium fusidate for six months. This finding was associated with a significant reduction in the duration of intravenous antibiotic treatment during therapy. PMID:15003669

  4. Effects of Prenatal and Perinatal Exposure to Fine Air Pollutants and Maternal Fish Consumption on the Occurrence of Infantile Eczema

    PubMed Central

    Jedrychowski, Wieslaw; Perera, Frederica; Maugeri, Umberto; Mrozek-Budzyn, Dorota; Miller, Rachel L.; Flak, Elzbieta; Mroz, Elzbieta; Jacek, Ryszard; Spengler, John D.

    2011-01-01

    Background As there is a scarcity of evidence on potential hazards and preventive factors for infantile eczema operating in the prenatal period, the main goal of this study was to assess the role of prenatal exposure to fine particulate matter and environmental tobacco smoke (ETS) in the occurrence of infant eczema jointly with the possible modulating effect of maternal fish consumption. Methods The study sample consisted of 469 women enrolled during pregnancy, who gave birth to term babies (>36 weeks of gestation). Among all pregnant women recruited, personal measurements of fine particulate matter (PM2.5) were performed over 48 h in the second trimester of pregnancy. After delivery, every 3 months in the first year of the newborn's life, a detailed, standardized, face-to-face interview was administered to each mother, in the process of which a trained interviewer recorded any history of infantile eczema and data on potential environmental hazards. The estimated risk of eczema related to higher prenatal exposure to fine particulate matter (PM2.5 >53.0 ?g/m3) and postnatal ETS as well as the protective effect of maternal fish intake were adjusted for potential confounders in a multivariable logistic regression model. Results While the separate effects of higher prenatal PM2.5 and postnatal ETS exposure were not statistically significant, their joint effect appeared to have a significant influence on the occurrence of infantile eczema [odds ratio 2.39, 95% confidence interval (CI) 1.10–5.18]. With maternal fish intake of more than 205 g/week, the risk of eczema decreased by 43% (odds ratio 0.57, 95% CI 0.35–0.93). The incidence rate ratio (IRR) for eczema symptoms, estimated from the Poisson regression model, was increased with both higher exposure to prenatal PM2.5 and postnatal ETS (IRR 1.55, 95% CI 0.99–2.44) and in children of atopic mothers (IRR 1.35, 95% CI 1.04–1.75) but was lower in girls (IRR 0.78, 95% CI 0.61–1.00). The observed preventive effect of fish consumption on the frequency of eczema symptoms was consistent with the results of the logistic analysis (IRR 0.72, 95% CI 0.52–0.99). Conclusions The findings indicate that higher prenatal exposure to fine particulate matter combined with postnatal exposure to ETS may increase the risk of infant eczema, while maternal fish intake during pregnancy may reduce the risk of infantile eczema. PMID:21293147

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

    PubMed

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

    2015-10-01

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

  6. Clinical and Laboratory Issues in Community-acquired MRSA

    PubMed Central

    Beavers-May, Toni; Jacobs, Richard F.

    2004-01-01

    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

  7. Control of endemic MRSA-what is the evidence? A personal view.

    PubMed

    Marshall, C; Wesselingh, S; McDonald, M; Spelman, D

    2004-04-01

    Although there is extensive literature on the control of MRSA, when that concerning epidemics is excluded, only a limited amount remains regarding the control of endemic MRSA. Several guidelines have been recently published recommending stringent control measures, which are often suggested based on their success in controlling MRSA outbreaks in hospitals with few MRSA or in containing MRSA cases introduced into a hospital with no MRSA. In these settings, multiple measures are usually introduced with apparently successful results. However, results may not be generalizable to other settings and we do not know the minimum effective measures required for MRSA containment. This paper aims critically to review the literature to determine whether evidence exists for the value of the infection control measures that are widely recommended in the endemic setting. Much of this literature is based on observational studies, with few randomized, controlled trials having been conducted. More well-designed studies are required before many of the principles on which we build infection control programmes can be regarded as evidence based. PMID:15066735

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

    PubMed Central

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

    2015-01-01

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

  9. A Randomised Controlled Trial of Ion-Exchange Water Softeners for the Treatment of Eczema in Children

    PubMed Central

    Thomas, Kim S.; Dean, Tara; O'Leary, Caroline; Sach, Tracey H.; Koller, Karin; Frost, Anthony; Williams, Hywel C.

    2011-01-01

    Background Epidemiological studies and anecdotal reports suggest a possible link between household use of hard water and atopic eczema. We sought to test whether installation of an ion-exchange water softener in the home can improve eczema in children. Methods and Findings This was an observer-blind randomised trial involving 336 children (aged 6 months to 16 years) with moderate/severe atopic eczema. All lived in hard water areas (?200 mg/l calcium carbonate). Participants were randomised to either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone. The primary outcome was change in eczema severity (Six Area Six Sign Atopic Dermatitis Score, SASSAD) at 12 weeks, measured by research nurses who were blinded to treatment allocation. Analysis was based on the intent-to-treat population. Eczema severity improved for both groups during the trial. The mean change in SASSAD at 12 weeks was ?5.0 (20% improvement) for the water softener group and ?5.7 (22% improvement) for the usual care group (mean difference 0.66, 95% confidence interval ?1.37 to 2.69, p?=?0.53). No between-group differences were noted in the use of topical corticosteroids or calcineurin inhibitors. Conclusions Water softeners provided no additional benefit to usual care in this study population. Small but statistically significant differences were found in some secondary outcomes as reported by parents, but it is likely that such improvements were the result of response bias, since participants were aware of their treatment allocation. A detailed report for this trial is also available at http://www.hta.ac.uk. Trial registration Current Controlled Trials ISRCTN71423189 Please see later in the article for the Editors' Summary PMID:21358807

  10. Risk factors for MRSA in fattening pig herds - a meta-analysis using pooled data.

    PubMed

    Fromm, Sabine; Beißwanger, Elena; Käsbohrer, Annemarie; Tenhagen, Bernd-Alois

    2014-11-01

    The importance of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) as an infectious agent for humans has increased in recent years in Germany. Although it is well known that the prevalence of MRSA in pig farms is high, risk factors for the presence of MRSA in herds of fattening pigs are still poorly understood. The aim of this study was to evaluate available data from previous studies on MRSA in fattening pigs in a meta-analysis to answer the question: What are the factors associated with the occurrence of MRSA in fattening pig herds? The studies on MRSA in pigs that were identified by literature research were heterogeneous with respect to the risk factors investigated and the type of herds focused on. Therefore we decided to carry out a pooling analysis on herd level rather than a typical meta-analysis. Eligible herd data were identified based on the published literature and communication with the authors. The final data set covered 400 fattening pig herds from 10 different studies and 12 risk factors. The prevalence of MRSA in the 400 fattening pig herds was 53.5%. Data were analyzed using generalized estimating equations (GEE). The resulting multivariate model confirmed previously identified risk factors for MRSA in pig herds (herd size and herd type). It also identified further risk factors: group treatment of fattening pigs with antimicrobial drugs (OR=1.79) and housing fattening pig herds on at least partially slatted floors (OR=2.39) compared to plain floor. In contrast, according to the model, fattening pig herds on farms keeping other livestock along with pigs were less likely to harbor MRSA (OR=0.54). The results underline the benefits from a pooling analysis and cooperative re-evaluation of published data. PMID:25241618

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

    PubMed Central

    2013-01-01

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

  12. Longitudinal study on transmission of MRSA CC398 within pig herds

    PubMed Central

    2012-01-01

    Background Since the detection of MRSA CC398 in pigs in 2004, it has emerged in livestock worldwide. MRSA CC398 has been found in people in contact with livestock and thus has become a public health issue. Data from a large-scale longitudinal study in two Danish and four Dutch pig herds were used to quantify MRSA CC398 transmission rates within pig herds and to identify factors affecting transmission between pigs. Results Sows and their offspring were sampled at varying intervals during a production cycle. Overall MRSA prevalence of sows increased from 33% before farrowing to 77% before weaning. Overall MRSA prevalence of piglets was?>?60% during the entire study period. The recurrent finding of MRSA in the majority of individuals indicates true colonization or might be the result of contamination. Transmission rates were estimated using a Susceptible-Infectious-Susceptible (SIS-)model, which resulted in values of the reproduction ratio (R0) varying from 0.24 to 8.08. Transmission rates were higher in pigs treated with tetracyclins and ?-lactams compared to untreated pigs implying a selective advantage of MRSA CC398 when these antimicrobials are used. Furthermore, transmission rates were higher in pre-weaning pigs compared to post-weaning pigs which might be explained by an age-related susceptibility or the presence of the sow as a primary source of MRSA CC398. Finally, transmission rates increased with the relative increase of the infection pressure within the pen compared to the total infection pressure, implying that within-pen transmission is a more important route compared to between-pen transmission and transmission through environmental exposure. Conclusion Our results indicate that MRSA CC398 is able to spread and persist in pig herds, resulting in an endemic situation. Transmission rates are affected by the use of selective antimicrobials and by the age of pigs. PMID:22607475

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

    PubMed

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

    2015-07-01

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

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

    PubMed Central

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

    2011-01-01

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

  15. Linezolid eradicates MRSA better than vancomycin from surgical-site infections

    Microsoft Academic Search

    John Weigelt; Haytham M. A. Kaafarani; Kamal M. F. Itani; Robert N. Swanson

    2004-01-01

    BackgroundThe purpose of this analysis was to compare the efficacy of linezolid versus vancomycin in patients with suspected or proven gram-positive methicillin-resistant Staphylococcus aureus (MRSA) surgical-site infections.

  16. The enduring menace of MRSA: incidence, treatment, and prevention in a county jail.

    PubMed

    Deger, Grant E; Quick, David W

    2009-07-01

    Nationwide, methicillin-resistant Staphylococcus aureus (MRSA) presents an increasing hazard to inmates. This article reviews our 1-year (2005) experience with skin and soft tissue infections (SSTIs) in a medium-sized county jail. As part of a quality assurance process, the authors cultured every SSTI presenting to our institution. The authors found that a full 68% of SSTIs (50 of 74) were MRSA species, and new MRSA cases presented regularly throughout the year. Inmates usually have poor understanding of infectious processes and need constant support and education. Correctional health care providers must approach their antibiotic treatment for today's SSTIs with the knowledge that MRSA is very common. This article reviews treatment options, preventive measures, and institutional hygiene. PMID:19477805

  17. The Nottingham Staphylococcus aureus population study: prevalence of MRSA among the elderly in a university hospital

    Microsoft Academic Search

    S. Hori; R. Sunley; A. Tami; H. Grundmann

    2002-01-01

    A prevalence survey of methicillin-resistant Staphylococcus aureus (MRSA) in elderly patients (65 years and older) three weeks after admission to a university hospital was performed. Risk factors associated with hospital MRSA carriage were determined. The design was a cross-sectional patient-based study and all adult wards at the University Hospital Nottingham (1600 beds) were included. Three hundred and forty-two elderly individuals

  18. The effect of increased bed numbers on MRSA transmission in acute medical wards

    Microsoft Academic Search

    C. C. Kibbler; A. Quick; A.-M. O'Neill

    1998-01-01

    An 18-month prospective survey was performed to examine the effect of adding a fifth bed to four-bedded bays in three acute medical wards on colonization by methicillin-resistant Staphylococcus aureus (MRSA). Screening procedures were in accordance with the UK national guidelines. All patients newly colonized with MRSA were visited, and their bed location determined. Data from the five-bedded bays were compared

  19. Emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection in Queensland, Australia

    Microsoft Academic Search

    Wendy J. Munckhof; Jacqueline Schooneveldt; Geoffrey W. Coombs; Jane Hoare; Graeme R. Nimmo

    2003-01-01

    Objectives: To investigate the incidence and epidemiology of non-multiresistant methicillin-resistant Staphylococcus aureus (nmMRSA) infection in south-east Queensland, Australia.Study design: A retrospective survey was done of hospital records of all patients who had non-multiresistant MRSA isolated at Ipswich Hospital (a 250-bed general hospital, 40 km south-west of Brisbane, Queensland, Australia) between March 2000 and June 2001. Laboratory typing of these isolates

  20. Prenylated flavonoids from Desmodium caudatum and evaluation of their anti-MRSA activity.

    PubMed

    Sasaki, Hisako; Kashiwada, Yoshiki; Shibata, Hirofumi; Takaishi, Yoshihisa

    2012-10-01

    Seven prenylated flavonoids and a prenylated chromanochroman derivative, together with eight known flavonoids, were isolated from roots of Desmodium caudatum. The 15 structures were elucidated by extensive spectroscopic analyses. The antibacterial activity of many of other compounds was evaluated against methicillin-resistant Staphylococcus aureus (MRSA: COL and 5) by a disc diffusion method, and the minimum inhibitory concentrations (MICs) to MRSA were determined. PMID:22800912

  1. Percutaneous treatment of chronic MRSA osteomyelitis with a novel plant-derived antiseptic

    Microsoft Academic Search

    Eugene Sherry; Harry Boeck; Patrick H Warnke

    2001-01-01

    BACKGROUND: Antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE, are an increasing problem world-wide, causing intractable wound infections. Complex phytochemical extracts such as tea tree oil and eucalypt-derived formulations have been shown to have strong bactericidal activity against MRSA in vitro. Polytoxinol (PT) antimicrobial, is the trade name of a range of antimicrobial preparations in solution,

  2. A staff questionnaire study of MRSA infection on ENT and general surgical wards

    Microsoft Academic Search

    P. S. Phillips; A. K. Golagani; A. Malik; F. B. Payne

    2010-01-01

    Methicillin-resistant Staphyloccocus aureus (MRSA) infection has received much attention in both the medical and non-medical press. However, it is not widely encountered\\u000a on ENT wards, given the profile of short-stay, relatively well patients, although its impact seems to be increasing. We wished\\u000a to explore the knowledge and attitudes towards MRSA on general surgical and ENT wards, and see if there

  3. Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry?

    Microsoft Academic Search

    Melanie Zimmerli; Andreas F. Widmer; Marc Dangel; Andreas Filippi; Reno Frei; Jürg Meyer

    2009-01-01

    We assessed the frequency of carriers of methicillin-resistant Staphylococcus aureus (MRSA) among 500 dental patients of a university clinic. From each participant, two specimens were taken from the anterior\\u000a nares and the pharynx and analysed by culture. The participants completed a questionnaire on possible risk factors of MRSA\\u000a infection. Two hundred ten individuals carried S. aureus, 90 in the nares

  4. Selective killing of vaccinia virus by LL-37: implications for eczema vaccinatum.

    PubMed

    Howell, Michael D; Jones, James F; Kisich, Kevin O; Streib, Joanne E; Gallo, Richard L; Leung, Donald Y M

    2004-02-01

    Possible bioterrorism with smallpox has led to the resumption of smallpox (vaccinia virus) immunization. One complication, eczema vaccinatum, occurs primarily in patients with atopic dermatitis (AD). Skin lesions of patients with AD, but not psoriasis, is deficient in the cathelicidin antimicrobial peptide (LL-37) and human beta-defensin-2 (HBD-2). We hypothesized that this defect may explain the susceptibility of patients with AD to eczema vaccinatum. The Wyeth vaccine strain of vaccinia virus was incubated with varying concentrations of human (LL-37) and murine (CRAMP) cathelicidins, human alpha-defensin (HBD-1, HBD-2), and a control peptide. Outcomes included quantification of viral PFU, vaccinia viral gene expression by quantitative real-time RT-PCR, and changes in virion structure by transmission electron microscopy. CRAMP knockout mice and control animals were inoculated by skin pricks with 2 x 10(5) PFU of vaccinia and examined daily for pox development. Physiologic amounts of human and murine cathelicidins (10-50 micro M), but not human defensins, which had antibacterial activity, resulted in the in vitro reduction of vaccinia viral plaque formation (p < 0.0001), vaccinia mRNA expression (p < 0.001), and alteration of vaccinia virion structure. In vivo vaccinia pox formation occurred in four of six CRAMP knockout animals and in only one of 15 control mice (p < 0.01). These data support a role for cathelicidins in the inhibition of orthopox virus (vaccinia) replication both in vitro and in vivo. Susceptibility of patients with AD to eczema vaccinatum may be due to a deficiency of cathelicidin. PMID:14734759

  5. Polymerase chain reaction-based active surveillance of MRSA in emergency department patients

    PubMed Central

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

    2015-01-01

    Conventional culture methods to detect methicillin-resistant Staphylococcus aureus (MRSA) take a few days, and their sensitivity and usefulness also need to be improved. In this study, active screening was performed using the polymerase chain reaction (PCR) for colonization with MRSA on admission and follow-up surveillance after admission to an emergency department between June 2012 and August 2012, and the backgrounds of PCR and/or culture-method-positive patients were compared. Among 95 patients, 15 (15.8%) patients were positive for MRSA on PCR and/or culture; 6.3% (6/95) of patients were positive on admission, and 9.5% (9/95) became positive during the stay after admission. The major primary diagnoses in MRSA-positive patients were trauma and cerebrovascular diseases. Nine (60%) of 15 patients were MRSA-positive on both PCR and culture, compared with three (20%) of 15 who were PCR-positive but culture-negative. The other three (20%) of 15 patients were PCR-negative but culture-positive. Furthermore, there was a tendency for younger age and shorter stay to be associated with PCR-positive but culture-negative results. These findings suggest that active surveillance with PCR may be highly sensitive and useful for the early diagnosis of MRSA colonization to prevent nosocomial transmission from the emergency department to the regular inpatient wards of the hospital. PMID:25999747

  6. Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities.

    PubMed

    Coia, J E; Duckworth, G J; Edwards, D I; Farrington, M; Fry, C; Humphreys, H; Mallaghan, C; Tucker, D R

    2006-05-01

    Meticillin-resistant Staphylococcus aureus (MRSA) remains endemic in many UK hospitals. Specific guidelines for control and prevention are justified because MRSA causes serious illness and results in significant additional healthcare costs. Guidelines were drafted by a multi-disciplinary group and these have been finalised following extensive consultation. The recommendations have been graded according to the strength of evidence. Surveillance of MRSA should be undertaken in a systematic way and should be fed back routinely to healthcare staff. The inappropriate or unnecessary use of antibiotics should be avoided, and this will also reduce the likelihood of the emergence and spread of strains with reduced susceptibility to glycopeptides, i.e. vancomycin-intermediate S. aureus/glycopeptide-intermediate S. aureus (VISA/GISA) and vancomycin-resistant S. aureus (VRSA). Screening for MRSA carriage in selected patients and clinical areas should be performed according to locally agreed criteria based upon assessment of the risks and consequences of transmission and infection. Nasal and skin decolonization should be considered in certain categories of patients. The general principles of infection control should be adopted for patients with MRSA, including patient isolation and the appropriate cleaning and decontamination of clinical areas. Inadequate staffing, especially amongst nurses, contributes to the increased prevalence of MRSA. Laboratories should notify the relevant national authorities if VISA/GISA or VRSA isolates are identified. PMID:16581155

  7. Asthma, eczema, and reports on pollen and cat allergy among pupils in Shanxi province, China

    Microsoft Academic Search

    D. Norbäck; Z.-H. Zhao; Z.-H. Wang; G. Wieslander; Y.-H. Mi; Z. Zhang

    2007-01-01

    Objectives  To study self-reported asthma, eczema, and pollen and furry pet allergy among pupils (9–20 years) in Shanxi province, China,\\u000a in relation to dietary and environmental factors.\\u000a \\u000a \\u000a \\u000a Methods  A standardised questionnaire was distributed to pupils in two primary and two secondary schools, one in Taiyuan city (3.0\\u000a milj. inhabitants), the others in Qingxu county, a rural area 30 km outside Taiyuan. Totally, 2,116 pupils

  8. Evaluation of Three Techniques for Detection of Low-Level Methicillin-Resistant Staphylococcus aureus (MRSA): a Disk Diffusion Method with Cefoxitin and Moxalactam, the Vitek 2 System, and the MRSA-Screen Latex Agglutination Test

    Microsoft Academic Search

    Annie Felten; Bernadette Grandry; Philippe Henri Lagrange; Isabelle Casin

    2002-01-01

    Very-low-level methicillin-resistant Staphylococcus aureus (MRSA), or class 1 MRSA, is often misdiagnosed as methicillin-susceptible S. aureus (MSSA). We evaluated the performances of three methods for detection of low-level methicillin resistance: the disk diffusion method using the cephamycin antibiotics cefoxitin and moxalactam, the Vitek 2 system (bioMerieux), and the MRSA-screen test (Denka). Detection of the mecA gene by PCR was considered

  9. Prevalence of self-reported eczema in relation to living environment, socio-economic status and respiratory symptoms assessed in a questionnaire study

    PubMed Central

    Montnemery, Peter; Nihlén, Ulf; Göran Löfdahl, Claes; Nyberg, Per; Svensson, Åke

    2003-01-01

    Background Potential links between eczema and obstructive pulmonary diseases have been postulated. Previously we have reported the prevalence of upper and lower respiratory diseases and the relation to environmental and socio-economic factors in a randomly selected adult population in southern Sweden using a postal questionnaire. In the present study we wanted to analyse the prevalence of eczema and its relation to socio-economic status, heredity factors and environmental factors in an adult population. Methods Self-reported eczema, upper and lower respiratory symptoms, asthma and Chronic Bronchitis Emphysema (CBE) were examined in 12,071 adults, aged 20–59 years, living in southern Sweden by using a postal questionnaire. There were comparable numbers of males and females in all age groups. Multiple logistic regression analysis (forward conditional) was applied to estimate the association between the proposed risk factors (heredity, self-reported asthma and CBE, nasal symptoms, socio-economic group, environmental factors, age, gender and smoking habits) and self-reported eczema. Results The response rate was 70.1%. In all, 1240 subjects (14.6%) stated that they had eczema. In all age cohorts self-reported eczema was more frequently reported by women than by men (p < 0.05). The prevalence of self-reported eczema among the economically active population varied from 17.1% to 8.2% with the highest rates among assistant non-manual employees. However, when controlling for age, gender and risk occupation there was no association between low social position and eczema. Living close to heavy traffic (OR = 1.45, 95% CI 1.25–1.67) and living seaside (OR = 1.17, 95% CI 1.01–1.35) but not urban/suburban living was associated with eczema. Heredity of eczema (OR = 5.77, 95% CI 5.02–6.64), self reported allergic rhinitis (OR = 2.31, 95% CI 2.00–2.68), self reported asthma (OR = 1.98, 95% CI 1.56–2.51) and self reported CBE (OR = 1.42, 95% CI 1.08–1.87) were all associated with eczema. Conclusions In this epidemiological study we see that self-reported eczema is a common disease in an adult population especially among women. Eczema seems to be linked to environment factors, obstructive pulmonary diseases and rhinitis. PMID:12859793

  10. Prevalence and acquisition of MRSA amongst patients admitted to a tertiary-care hospital in brazil

    PubMed Central

    2010-01-01

    Background There are few studies in Brazil that address baseline prevalence of MRSA colonization and associated risk factors at hospital admission, or the incidence of nosocomial colonization. We report a prospective study in a tertiary-care, university-affiliated hospital to implement a new MRSA control policy at the institution. Methods A cohort of randomly selected patients admitted to emergency and clinical wards at our hospital was followed until discharge. Nasal swabs were taken for identification of MRSA-colonized patients and detection of SCCmecA in positive cultures, at admission and weekly thereafter. Multivariate analysis using a log-binomial analysis was used to identify risk factors for colonization. Results After screening 297 adult patients and 176 pediatric patients, the prevalence of MRSA at admission was 6.1% (95%CI, 3.6% to 9.4%), in the adult population and 2.3% (95%CI, 0.6% to 5.7%), for children. From multivariate analysis, the risk factors associated with colonization in adults were: age above 60 years (P = 0.019) and hospitalization in the previous year (P = 0.022). Incidence analysis was performed in 276 MRSA-negative patients (175 adults and 101 children). Acquisition rate was 5.5/1,000 patient-days for adults (95%CI, 3.4 to 8.5/1,000 patients-days), and 1.1/1,000 patient-days for children (95%CI, 0.1 to 4.0/1,000 patients-days). Conclusions The identification of MRSA carriers is a step towards establishing a control policy for MRSA, and helps to identify measures needed to reduce colonization pressure and to decrease the high acquisition rate in hospitalized patients. PMID:21073755

  11. Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections.

    PubMed

    Wilcox, M H; Hall, J; Pike, H; Templeton, P A; Fawley, W N; Parnell, P; Verity, P

    2003-07-01

    We have examined whether topical perioperative prophylaxis can reduce the incidence of methicillin-resistant Staphylococcus aureus (MRSA) surgical site infections (SSIs). Using a controlled before and after approach on patients from four orthopaedic wards, undergoing orthopaedic surgery involving insertion of metal prostheses and/or fixation, received perioperative prophylaxis with nasal mupirocin for five days, and a shower or bath with 2% (v/v) triclosan before surgery (PPNMT). After introduction of PPNMT there was a marked decrease in incidence of MRSA SSIs (per 1000 operations) from 23 in the six months beforehand (period A) to 3.3 (P<0.001) and 4 (P<0.001) in subsequent consecutive six-month periods (B and C, respectively). Of 11 MRSA SSI cases that occurred during periods B and C, only one had actually received PPNMT, and 10 occurred after acute, as opposed to elective, surgery (P<0.001). Point prevalence nasal MRSA carriage decreased from 38% before PPNMT to 23% immediately after, and 20%, 7%, 10% and 8% (P<0.001) at six-monthly intervals post-intervention. Conversely, the prevalence of nasal MRSA carriage in a control elderly medicine ward did not change significantly. Vancomycin usage, in terms of defined daily doses, declined by 23%. Low-level mupirocin resistance was found in 2.3% of S. aureus isolates from orthopaedic patients before PPNMT, and in 3.9%, 6.1%, 10% and 0% in subsequent six month periods. No S. aureus isolates with high-level mupirocin resistance were found. PPNMT can reduce the incidence of MRSA SSls after orthopaedic surgery, probably by reducing nasal MRSA carriage in the endemic setting, without selecting for mupirocin resistance. PMID:12855234

  12. Emodin is identified as the active component of ether extracts from Rhizoma Polygoni Cuspidati, for anti-MRSA activity.

    PubMed

    Cao, Feng; Peng, Wei; Li, Xiaoli; Liu, Ming; Li, Bin; Qin, Rongxin; Jiang, Weiwei; Cen, Yanyan; Pan, Xichun; Yan, Zifei; Xiao, Kangkang; Zhou, Hong

    2015-06-01

    This study investigated the anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) activity and chemical compositions of ether extracts from Rhizoma Polygoni Cuspidati (ET-RPC). Significant anti-MRSA activities of ET-RPC against MRSA252 and MRSA clinical strains were tested in in vitro antibacterial experiments, such as inhibition zone diameter test, minimal inhibitory concentration test, and dynamic bacterial growth assay. Subsequently, 7 major compounds of ET-RPC were purified and identified as polydatin, resveratrol-4-O-d-(6'-galloyl)-glucopyranoside, resveratrol, torachryson-8-O-glucoside, emodin-8-O-glucoside, 6-hydroxy-emodin, and emodin using liquid chromatography - electrospray ionization - tandem mass spectrometry. After investigation of anti-MRSA activities of the 7 major compounds, only emodin had significant anti-MRSA activity. Further, transmission electron microscopy was used to observe morphological changes in the cell wall of MRSA252, and the result revealed that emodin could damage the integrity of cell wall, leading to loss of intracellular components. In summary, our results showed ET-RPC could significantly inhibit bacterial growth of MRSA strains. Emodin was identified as the major compound with anti-MRSA activity; this activity was related to destruction of the integrity of the cell wall and cell membrane. PMID:25966789

  13. Acid-coated Textiles (pH 5.5-6.5) - a New Therapeutic Strategy for Atopic Eczema?

    PubMed

    Jaeger, Teresa; Rothmaier, Markus; Zander, Holger; Ring, Johannes; Gutermuth, Jan; Anliker, Mark D

    2015-06-24

    Increased transepidermal water loss (TEWL) and decreased skin capacitance are characteristic features of the disturbed epidermal barrier in atopic eczema (AE). The "acid mantle", which is a slightly acidic film on the surface of the skin has led to the development of acidic emollients for skin care. In this context, the effect of citric acid-coated textiles on atopic skin has not been examined to date. A textile carrier composed of cellulose fibres was coated with a citric acid surface layer by esterification, ensuring a constant pH of 5.5-6.5. Twenty patients with AE or atopic diathesis were enrolled in the study. In a double-blind, half-side experiment, patients had to wear these textiles for 12 h a day for 14 days. On day 0 (baseline), 7 and 14, tolerability (erythema, pruritus, eczema, wearing comfort) and efficacy on skin barrier were assessed by TEWL skin hydration (corneometry/capacitance), pH and clinical scoring of eczema (SCORAD). Citric acid-coated textiles were well tolerated and improved eczema and objective parameters of skin physiology, including barrier function and a reduced skin surface pH, with potential lower pathogenic microbial colonisation. PMID:24953993

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

    Microsoft Academic Search

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

    1989-01-01

    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

  15. Effect of feeding metal amino acid complexed trace minerals to dairy cattle for the prevention of facial eczema

    Microsoft Academic Search

    J. M. DeFrain; M. T. Socha; D. J. Tomlinson; A. R. Hittmann; B. J. McKay

    2010-01-01

    Two hundred eighty-two cows were assigned to a 40-week experiment to determine the efficacy of zinc amino acid complex (CZ), with or without cobalt glucoheptonate and amino acid complexes of manganese and copper, in preventing facial eczema (FE). Apart from 25 control cows, which received no supplemental zinc, manganese, copper, and cobalt throughout treatment periods, remaining 257 cows were randomly

  16. Combination Therapy of Sophoraflavanone B against MRSA: In Vitro Synergy Testing

    PubMed Central

    Mun, Su-Hyun; Kang, Ok-Hwa; Joung, Dae-Ki; Kim, Sung-Bae; Seo, Yun-Soo; Choi, Jang-Gi; Lee, Young-Seob; Cha, Seon-Woo; Ahn, Young-Sup; Han, Sin-Hee; Kwon, Dong-Yeul

    2013-01-01

    Sophoraflavanone B (SPF-B), a known prenylated flavonoid, was isolated from the roots of Desmodium caudatum. The aim of this study was to determine the antimicrobial synergism of SPF-B combined with antibiotics against methicillin-resistant Staphylococcus aureus (MRSA). MRSA, a multidrug-resistant pathogen, causes both hospital- and community-acquired infections worldwide. The antimicrobial activity of SPF-B was assessed by the broth microdilution method, checkerboard dilution test, and time-kill curve assay. The MIC of SPF-B for 7 strains of S. aureus ranges from 15.6 to 31.25??g/mL determined. In the checkerboard method, the combinations of SPF-B with antibiotics had a synergistic effect; SPF-B markedly reduced the MICs of the ?-lactam antibiotics: ampicillin (AMP) and oxacillin (OXI); aminoglycosides gentamicin (GET); quinolones ciprofloxacin (CIP) and norfloxacin (NOR) against MRSA. The time-kill curves assay showed that a combined SPF-B and selected antibiotics treatment reduced the bacterial counts below the lowest detectable limit after 24?h. These data suggest that the antibacterial activity of SPF-B against MRSA can be effectively increased through its combination with three groups of antibiotics (?-lactams, aminoglycosides, and quinolones). Our research can be a valuable and significant source for the development of a new antibacterial drug with low MRSA resistance. PMID:24319486

  17. Combination Therapy of Sophoraflavanone B against MRSA: In Vitro Synergy Testing.

    PubMed

    Mun, Su-Hyun; Kang, Ok-Hwa; Joung, Dae-Ki; Kim, Sung-Bae; Seo, Yun-Soo; Choi, Jang-Gi; Lee, Young-Seob; Cha, Seon-Woo; Ahn, Young-Sup; Han, Sin-Hee; Kwon, Dong-Yeul

    2013-01-01

    Sophoraflavanone B (SPF-B), a known prenylated flavonoid, was isolated from the roots of Desmodium caudatum. The aim of this study was to determine the antimicrobial synergism of SPF-B combined with antibiotics against methicillin-resistant Staphylococcus aureus (MRSA). MRSA, a multidrug-resistant pathogen, causes both hospital- and community-acquired infections worldwide. The antimicrobial activity of SPF-B was assessed by the broth microdilution method, checkerboard dilution test, and time-kill curve assay. The MIC of SPF-B for 7 strains of S. aureus ranges from 15.6 to 31.25? ? g/mL determined. In the checkerboard method, the combinations of SPF-B with antibiotics had a synergistic effect; SPF-B markedly reduced the MICs of the ? -lactam antibiotics: ampicillin (AMP) and oxacillin (OXI); aminoglycosides gentamicin (GET); quinolones ciprofloxacin (CIP) and norfloxacin (NOR) against MRSA. The time-kill curves assay showed that a combined SPF-B and selected antibiotics treatment reduced the bacterial counts below the lowest detectable limit after 24?h. These data suggest that the antibacterial activity of SPF-B against MRSA can be effectively increased through its combination with three groups of antibiotics ( ? -lactams, aminoglycosides, and quinolones). Our research can be a valuable and significant source for the development of a new antibacterial drug with low MRSA resistance. PMID:24319486

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    2014-01-01

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

  20. Dyshidrotic Eczema

    MedlinePLUS

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  1. Eczema: Cause

    MedlinePLUS

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  2. Dyshidrotic eczema

    MedlinePLUS

    ... often in water or moist You work with cement or do other work that exposes your hands ... moist (called lubricating or moisturizing the skin). Use ointments (such as petroleum jelly), creams, or lotions. Moisturizers: ...

  3. Potential for pet animals to harbour methicillin-resistant Staphylococcus aureus when residing with human MRSA patients.

    PubMed

    Morris, D O; Lautenbach, E; Zaoutis, T; Leckerman, K; Edelstein, P H; Rankin, S C

    2012-06-01

    Colonization by methicillin-resistant Staphylococcus aureus (MRSA) may be persistent in people and is horizontally transmissible. The scientific literature suggests that domestic pets may also participate in cross-transmission of MRSA within households. The objectives of this study were to evaluate the prevalence of and risk factors for MRSA carriage by pets residing in households with an MRSA-infected person. From 66 households in which an MRSA-infected patient resided, we screened 47 dogs and 52 cats using a swab protocol. Isolates from pets and humans were genotyped using two techniques and compared for concordance. Human participants completed a 22-question survey of demographic and epidemiologic data relevant to staphylococcal transmission. Eleven of 99 pets (11.5%) representing 9 (13.6%) of households were MRSA-positive, but in only six of these households were the human and animal-source strains genetically concordant. Human infection by strain USA 100 was significantly associated with pet carriage [OR = 11.4 (95% CI 1.7, 76.9); P = 0.013]. Yet, for each day of delay in sampling the pet after the person's MRSA diagnosis, the odds of isolating any type of MRSA from the pet decreased by 13.9% [(95% CI 2.6, 23.8); P = 0.017)]. It may be concluded that pets can harbour pandemic strains of MRSA while residing in a household with an infected person. However, the source of MRSA to the pet cannot always be attributed to the human patient. Moreover, the rapid attrition of the odds of obtaining a positive culture from pets over time suggests that MRSA carriage may be fleeting. PMID:22233337

  4. Kaposi's varicelliform eruption: a case report and review of the literature.

    PubMed

    Kramer, Sasha C; Thomas, Chadwick J; Tyler, William B; Elston, Dirk M

    2004-02-01

    Disseminated herpes or vaccinia in the setting of underlying skin diseases is known as Kaposi's varicelliform eruption (KVE). Patients typically present with disseminated vesicopustules in the areas of the most severe involvement of their underlying skin disease. We report a case of eczema herpeticum in a woman with a long-standing history of atopic dermatitis (AD). This report also reviews the literature on eczema herpeticum and eczema vaccinatum (EV), summarizes clinical and histopathologic characteristics and treatment, and discusses the recommendations of the Centers for Disease Control and Prevention for smallpox vaccination. PMID:15027517

  5. 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

    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

    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

  6. Percutaneous treatment of chronic MRSA osteomyelitis with a novel plant-derived antiseptic

    PubMed Central

    Sherry, Eugene; Boeck, Harry; Warnke, Patrick H

    2001-01-01

    Background Antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE, are an increasing problem world-wide, causing intractable wound infections. Complex phytochemical extracts such as tea tree oil and eucalypt-derived formulations have been shown to have strong bactericidal activity against MRSA in vitro. Polytoxinol (PT) antimicrobial, is the trade name of a range of antimicrobial preparations in solution, ointment and cream form. Methods We report the first use of this drug, administered percutaneously, via calcium sulphate pellets (Osteoset,TM), into bone, to treat an intractable MRSA infection of the lower tibia in an adult male. Results and Discussion Over a three month period his symptoms resolved with a healing response on x-ray and with a reduced CRP. PMID:11368798

  7. Prevalence of childhood asthma, rhinitis and eczema in Scandinavia and Eastern Europe.

    PubMed

    Björkstén, B; Dumitrascu, D; Foucard, T; Khetsuriani, N; Khaitov, R; Leja, M; Lis, G; Pekkanen, J; Priftanji, A; Riikjärv, M A

    1998-08-01

    There is evidence that the prevalence of allergies and asthma differs between populations in western and eastern Europe. This study investigated the prevalence of wheezing, rhinitis and eczema among schoolchildren in urban and rural areas of Scandinavia and the formerly socialist countries of Eastern Europe. A total of 79,000 children from two age groups (13-14 yrs and 6-7 yrs) in 18 study centres responded to a questionnaire within the International Study of Asthma and Allergy in Children (ISAAC). The 12 month period prevalence of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema was calculated. The prevalence of wheezing among the 13-14 yr old children was 11.2-19.7% in Finland and Sweden, 7.6-8.5% in Estonia, Latvia and Poland and 2.6-5.9% in Albania, Romania, Russia, Georgia and Uzbekistan (except Samarkand). The prevalence of itching eyes and flexural dermatitis varied in a similar manner between the three regions. The regional differences were less pronounced among the 6-7 yr old children in the seven participating centres. The highest prevalence of rhinitis was recorded in April-July in Scandinavia and during the winter months in the other countries. The prevalence of atopy-related disorders was higher in Scandinavia than in Estonia, Latvia and Poland, which in turn had a higher prevalence than five other countries of eastern Europe with a culture less similar to western Europe. This supports the hypothesis that "Western life style" is associated with a high prevalence of childhood allergy. PMID:9727797

  8. Prevalence of asthma, allergic rhinitis and eczema among university students in Bangkok.

    PubMed

    Vichyanond, P; Sunthornchart, S; Singhirannusorn, V; Ruangrat, S; Kaewsomboon, S; Visitsunthorn, N

    2002-01-01

    Prevalence of childhood asthma is increasing worldwide including in developing countries such as Thailand. Despite a wide availability of epidemiological data on childhood asthma in Thailand, prevalence of asthma in adults has not been well studied within this community. Objectives of this study were to study prevalence of asthma, allergic rhinitis and eczema in a random group of university students in Bangkok using the standardized written and video questionnaires from the ISAAC phase I protocol. The ISAAC phase I, written and video (International version, AVQ 3.0) questionnaires were administered to 3631 randomly selected university students from six universities in Bangkok. The age range of subjects were between 16-31 years (mean +/- SD= 19.1 +/- 1.7 years). There were 1197 males and 2434 females (ratio = 1:2.03). Data were entered into and analysed by the EpiInfo 4 program. Prevalence of wheeze within the past 12 months and of diagnosed asthma for this group of subjects was 10.1% and 8.8%. Prevalence of allergic rhinitis (nasal with eye symptoms within the past 12 months) was 26.3% and of eczema (rash at typical sites of atopic dermatitis, within the past 12 months) was 9.4%. Presence of rhinoconjunctivitis, gender and age were significant risk factors for asthma with male, younger subjects and those with rhinoconjunctivitis reported more frequent asthma-related symptoms (P < 0.01). As in previous studies which found an increase in asthma among Thai children, this survey indicates that the prevalence of asthma among Thai university students has increased to the same level as in several European countries. A large number of adults residing in Bangkok are suffering from rhinitis-related symptoms, the majority of which probably represents allergic rhinitis. PMID:11863208

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

    PubMed Central

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

    2013-01-01

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

  10. 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...

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

    Microsoft Academic Search

    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

    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

  12. Antimicrobial resistance profile of Staphylococcus aureus isolated from raw meat: A research for methicillin resistant Staphylococcus aureus (MRSA)

    Microsoft Academic Search

    G. Pesavento; B. Ducci; N. Comodo; A. Lo Nostro

    2007-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a risk factor for patients in general population and particularly in immunocompromised patients. As a matter of fact, it can produce serious infections that may then evolve in septicaemia. However, transmission of MRSA from food to people can represent a serious problem only for immunocompromised people. Vancomycin is the elective antimicrobial commonly used

  13. susceptibility profile of 16 Methicillin resistant StaphylococcuS aureuS (Mrsa) clinical isolates against Major antibiotics

    Microsoft Academic Search

    M. Mastura; Selangor Darul Ehsan

    Increased prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) has become a major threat to healthcare world wide. This study was therefore designed to assess susceptibility profile of 16 MRSA isolates acquired from two local hospitals with three reference isolates (acquired from American Type Culture Collection (ATCC)) as comparison. Amikacin, erythromycin, norfloxacin, oxacillin and vancomycin representing five major classes of antibiotics

  14. Auxiliary factors: a chink in the armor of MRSA resistance to ?-lactam antibiotics.

    PubMed

    Roemer, Terry; Schneider, Tanja; Pinho, Mariana G

    2013-10-01

    Combination agents provide an important orthogonal approach to treat infectious diseases, particularly those caused by drug resistant pathogens. Indeed, applying a biologically 'rational' and systems-level paradigm to discover potent, selective, and synergistic agents would augment current (and arguably overly relied upon) empirical and serendipitous approaches to such discovery efforts. Here, we review the cellular mechanisms of ?-lactam drug resistance and tolerance achieved amongst methicillin-resistant Staphylococcus aureus (MRSA) as well as their molecular targets and strategies to identify cognate inhibitors as potential combination agents to restore ?-lactam efficacy against MRSA. PMID:23895826

  15. Evaluation of the IDI-MRSA Assay for Detection of Methicillin-Resistant Staphylococcus aureus from Nasal and Rectal Specimens Pooled in a Selective Broth

    Microsoft Academic Search

    M. Desjardins; Christiane Guibord; B. Lalonde; B. Toye; K. Ramotar

    2006-01-01

    Rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) by PCR can be performed directly from nasal specimens with the IDI-MRSA assay. To improve the efficiency of screening, we evaluated the performance of the IDI-MRSA assay for the detection of MRSA from pooled and unpooled specimens cultured in a selective broth. Of the 287 specimens evaluated, 71 were culture and PCR positive,

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

    PubMed Central

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

    2014-01-01

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

  17. Evaluation of Two New Chromogenic Media, CHROMagar MRSA and S. aureus ID, for Identifying Staphylococcus aureus and Screening Methicillin-Resistant S. aureus

    Microsoft Academic Search

    Goran Hedin; Hong Fang

    Methicillin-resistant Staphylococcus aureus (MRSA) has, during the last 3 decades, evolved as one of the most important causes of hospital infections worldwide. In Sweden, the prev- alence of MRSA is still low in comparison with the prevalences in other European countries (14). Since 2000, however, an increasing number of patients carrying MRSA have been iden- tified in Stockholm. To cope

  18. Prevalence of Atopic Eczema and Related Symptoms in Brazilian Schoolchildren: Results From the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3

    Microsoft Academic Search

    D Solé; Charles K Naspitz

    Background: International comparisons of the prevalence of atopic eczema and related symptoms are scarce. The standardized protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) facilitates investigation of prevalence all over the world. Objective: To apply the ISAAC written questionnaire to evaluate the prevalence of atopic eczema and related symptoms among 6-7 year-old children and 13-14 year-old

  19. MRSA colonisation (eradicating colonisation in people without active/invasive infection)

    PubMed Central

    2011-01-01

    Introduction Methicillin-resistant Staphylococcus aureus (MRSA) has a gene that makes it resistant to methicillin as well as to other beta-lactam antibiotics, including flucloxacillin, beta-lactam/beta-lactamase inhibitor combinations, cephalosporins, and carbapenems. MRSA can be part of the normal body flora (colonisation), especially in the nose, but it can cause infection. Until recently, MRSA has primarily been a problem associated with exposure to the healthcare system, especially in people with prolonged hospital admissions, with underlying disease, or after antibiotic use. In many countries worldwide, a preponderance of S aureus bloodstream isolates are resistant to methicillin. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatment for MRSA nasal or extra-nasal colonisation? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 9 systematic reviews, RCTs, or observational studies that met our inclusion criteria. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiseptic body washes, chlorhexidine–neomycin nasal cream, mupirocin nasal ointment, systemic antimicrobials, tea tree oil preparations, and other topical antimicrobials. PMID:21477403

  20. Antibacterial effect of essential oils from two medicinal plants against Methicillin-resistant Staphylococcus aureus (MRSA)

    Microsoft Academic Search

    A. Tohidpour; M. Sattari; R. Omidbaigi; A. Yadegar; J. Nazemi

    2010-01-01

    Antimicrobial properties of plants essential oils (EOs) have been investigated through several observations and clinical studies which purpose them as potential tools to overcome the microbial drug resistance problem. The aim of this research is to study the antibacterial effect of two traditional plants essential oils, Thymus vulgaris and Eucalyptus globulus against clinical isolates of Methicillin resistant Staphylococcus aureus (MRSA)

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

    PubMed Central

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

    2015-01-01

    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

  2. Linezolid Has Unique Immunomodulatory Effects in Post-Influenza Community Acquired MRSA Pneumonia

    PubMed Central

    Bhan, Urvashi; Podsiad, Amy B.; Kovach, Melissa A.; Ballinger, Megan N.; Keshamouni, Venkateshwar; Standiford, Theodore J.

    2015-01-01

    Introduction Post influenza pneumonia is a leading cause of mortality and morbidity, with mortality rates approaching 60% when bacterial infections are secondary to multi-drug resistant (MDR) pathogens. Staphylococcus aureus, in particular community acquired MRSA (cMRSA), has emerged as a leading cause of post influenza pneumonia. Hypothesis Linezolid (LZD) prevents acute lung injury in murine model of post influenza bacterial pneumonia Methods Mice were infected with HINI strain of influenza and then challenged with cMRSA at day 7, treated with antibiotics (LZD or Vanco) or vehicle 6 hours post bacterial challenge and lungs and bronchoalveolar lavage fluid (BAL) harvested at 24 hours for bacterial clearance, inflammatory cell influx, cytokine/chemokine analysis and assessment of lung injury. Results Mice treated with LZD or Vanco had lower bacterial burden in the lung and no systemic dissemination, as compared to the control (no antibiotic) group at 24 hours post bacterial challenge. As compared to animals receiving Vanco, LZD group had significantly lower numbers of neutrophils in the BAL (9×103 vs. 2.3×104, p < 0.01), which was associated with reduced levels of chemotactic chemokines and inflammatory cytokines KC, MIP-2, IFN-?, TNF-? and IL-1? in the BAL. Interestingly, LZD treatment also protected mice from lung injury, as assessed by albumin concentration in the BAL post treatment with H1N1 and cMRSA when compared to vanco treatment. Moreover, treatment with LZD was associated with significantly lower levels of PVL toxin in lungs. Conclusion Linezolid has unique immunomodulatory effects on host inflammatory response and lung injury in a murine model of post-viral cMRSA pneumonia. PMID:25635685

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  6. Livestock-associated MRSA in household members of pig farmers: transmission and dynamics of carriage, a prospective cohort study.

    PubMed

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

    2015-01-01

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

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

    PubMed Central

    2013-01-01

    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

  8. Antibacterials as adjuncts to incision and drainage for adults with purulent methicillin-resistant Staphylococcus aureus (MRSA) skin infections.

    PubMed

    Forcade, Nicolas A; Wiederhold, Nathan P; Ryan, Laurajo; Talbert, Robert L; Frei, Christopher R

    2012-02-12

    The annual incidence of skin and soft tissue infections (SSTIs) has nearly tripled in the US since the early 1990s. Many purulent SSTIs in the community setting are caused by methicillin-resistant Staphylococcus aureus (MRSA). Incision and drainage (I&D) are indicated for most purulent MRSA infections; however, the use of adjunctive antibacterials is controversial. The objective of this study was to systematically evaluate studies that have investigated whether or not antibacterials provide added benefit to I&D alone for purulent MRSA SSTIs. We included articles from MEDLINE and The Cochrane Library that fulfilled the following criteria: (i) original research; (ii) English language; (iii) compared I&D alone versus I&D plus antibacterials for purulent MRSA SSTIs; and (iv) compared patient outcomes. We also reviewed the references of these articles to identify other relevant studies. Studies that solely examined paediatric patients were excluded. To facilitate cross-study comparison, we systematically evaluated the following study characteristics: (i) study design; (ii) patient population; (iii) comparator groups; (iv) sample size; (v) outcome measures; (vi) outcome definitions; (vii) duration of follow-up; and (viii) measurement and adjustment of potential confounding variables. Eleven studies, spanning more than 30 years, met inclusion criteria. Two of these were conducted prior to the emergence of MRSA in the community; another evaluated cephalexin versus placebo for MRSA. None of these found added benefit of adjunctive antibacterials. Four studies compared health outcomes between patients who received 'active' or 'appropriate' therapy and those who received 'inactive' or 'inappropriate' therapy after I&D for purulent MRSA SSTIs. Two of these studies found 'active' or 'appropriate' therapy to be beneficial, while two others did not. Four studies compared health outcomes between patients who received anti-MRSA antibacterials plus I&D with those who received alternative antibacterials plus I&D for purulent MRSA SSTIs. Three of these reported improved outcomes with anti-MRSA antibacterials, while another reported mixed findings. Presently, the bulk of the available evidence suggests anti-MRSA antibacterials provide added benefit to I&D alone for purulent MRSA SSTIs; however, the current evidence is limited to small, case-control, observational studies. PMID:22316350

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

    PubMed

    Magen, Eli; Mishal, Joseph; Schlesinger, Menachem

    2006-12-01

    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

  10. Widespread eczema vaccinatum acquired by contacts. A report of an autopsy case.

    PubMed

    Shirasawa, K; Akai, K; Kawaguchi, Y; Maeda, S; Nagahara, S; Toyoda, H; Kurata, T

    1979-05-01

    A 4-month-old male infant predisposed to allergic dermatitis acquired wide-spread eczema vaccinatum by contacts with a recently vaccinated sibling. He died of acute purulent peritonitis following a perforation of multiple duodenal ulcers. Fluorescence immunocytochemical and electron microscopic studies on the skin lesions revealed the presence of viral antigens and numerous virus particles compatible morphologically with those of the mature form from the same batch of smallpox vaccine given to the sibling. A large number of virus particles in the developmental form were also predominantly scattered in the cytoplasm of cells at the stratum malpighii of the epidermis as well as in neutrophils and macrophages in the skin lesions. The virus isolation from the skin lesions was done by using the HeLa cells and the human embryonic lung fibroblasts. No abnormal laboratory data were noted in immunoglobulins. On the basis of atrophy of the thymus and other lymphatic tissues and an appearance of large pyroninophilic cells in association with blastoid transformation, the authors discussed a possible participation of the disturbance of cellular immunity secondary to the virus infection in the development of the disease. PMID:377910

  11. Evaluation of the Xpert MRSA assay for rapid detection of methicillin-resistant Staphylococcus aureus from nares swabs of geriatric hospitalized patients and failure to detect a specific SCC mec type IV variant

    Microsoft Academic Search

    C. Laurent; P. Bogaerts; D. Schoevaerdts; O. Denis; A. Deplano; C. Swine; M. J. Struelens; Y. Glupczynski

    2010-01-01

    Rapid and reliable detection of methicillin-resistant Staphylococcus aureus (MRSA) carriers is crucial for control of MRSA nosocomial transmission. We aimed to evaluate the performance of the GeneXpert\\u000a real-time PCR system using the Xpert MRSA assay on a collection of 40 representative Belgian MRSA strains and for MRSA screening\\u000a of geriatric inpatients. Double nasal swabs were used: the first swab for

  12. Comparison of Xpert MRSA/SA Nasal and MRSA/SA ELITe MGB assays for detection of the mecA gene with susceptibility testing methods for determination of methicillin resistance in Staphylococcus aureus isolates.

    PubMed

    Belmekki, Mohamed; Mammeri, Hedi; Hamdad, Farida; Rousseau, Florence; Canarelli, Brigitte; Biendo, Maurice

    2013-10-01

    In a series of 82 Staphylococcus strains isolated from culture, 100% were identified as Staphylococcus aureus by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS); 99.9% (77/82) of them were resistant to benzylpenicillin, oxacillin, and cefoxitin, and 6.1% (5/82) were susceptible to methicillin. Xpert MRSA/SA assay results were concordant with the phenotypic results in 76.8% (63/82) of cases and discordant in 23.2% (19/82) of cases. The MRSA/SA ELITe MGB kit results were concordant with phenotypic results in 100% of the cases. When comparing the Xpert MRSA/SA assay results with the MRSA/SA ELITe MGB kit results, 78% (64/82) of the cases were concordant, while 22% (18/82) of the cases were discordant. No statistically significant differences were observed between the two techniques. The PCR protocol that was used to validate the results of these two methods gave the following results: 49 were conventional methicillin-resistant S. aureus (MRSA) isolates (mecA positive and mecALGA251 negative), and 25 were phenotypic MRSA isolates (mecA negative and mecALGA251 positive). PMID:23863569

  13. Nosocomial methicillin-resistant Staphylococcus aureus (MRSA) and epidermidis (MRSE) infections in orthopaedic surgery. Importance, prophylaxis and therapy

    Microsoft Academic Search

    D. P. König; O. Randerath; M. H. Hackenbroch

    1999-01-01

    Summary  \\u000a MRSA\\/MRSE infections are a major problem in hospitals and although in orthopaedic units the incidence is low awareness of\\u000a this problem is necessary. Once a MRSA strain has been isolated the strict use of the hygiene precautions has to be applied\\u000a to avoid epidemic spread of the strain. The patient has to be isolated. The staff has to use

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

    PubMed Central

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

    2015-01-01

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

  15. Investigation of gaseous ozone for MRSA decontamination of hospital side-rooms.

    PubMed

    Berrington, A W; Pedler, S J

    1998-09-01

    A domestic, gaseous ozone generator was investigated for use in the decontamination of hospital side-rooms that have housed patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Three models of bacterial contamination were used. These were exposed to ozone generation in a standard hospital side-room for 4 and 7 h. A methicillin-sensitive and a methicillin-resistant strain of S. aureus were compared. Ozone concentrations of 0.14 ppm were reached, levels which are sufficient to cause mild pulmonary toxicity. Bacterial counts were reduced in the vicinity of the gas generator in most instances, but the effect elsewhere in the room was, at best, limited. MRSA appeared more resistant to the effects of ozone than methicillin-sensitive S. aureus. We conclude that the device tested would be inadequate for the decontamination of such hospital side-rooms. PMID:9777523

  16. Asphodosides A-E, anti-MRSA metabolites from Asphodelus microcarpus.

    PubMed

    Ghoneim, Mohammed M; Elokely, Khaled M; El-Hela, Atef A; Mohammad, Abd-Elsalam I; Jacob, Melissa; Radwan, Mohamed M; Doerksen, Robert J; Cutler, Stephen J; Ross, Samir A

    2014-09-01

    Bioassay guided fractionation of the ethanolic extract of Asphodelus microcarpus Salzm. et Viv. (Xanthorrhoeaceae or Asphodelaceae) resulted in isolation of five compounds identified as asphodosides A-E (1-5). Compounds 2-4 showed activity against methicillin resistant Staphylococcus aureus (MRSA) with IC50 values of 1.62, 7.0 and 9.0?g/mL, respectively. They also exhibited activity against Staphylococcus aureus (non-MRSA) with IC50 values of 1.0, 3.4 and 2.2?g/mL, respectively. The structure elucidation of isolated metabolites was carried out using spectroscopic data (1D and 2D NMR), optical rotation and both experimental and calculated electronic circular dichroism (ECD). PMID:25034614

  17. High-throughput identification of antibacterials against methicillin-resistant Staphylococcus aureus (MRSA) and the transglycosylase.

    PubMed

    Cheng, Ting-Jen Rachel; Wu, Ying-Ta; Yang, Shih-Ting; Lo, Kien-Hock; Chen, Shao-Kang; Chen, Yin-Hsuan; Huang, Wen-I; Yuan, Chih-Hung; Guo, Chih-Wei; Huang, Lin-Ya; Chen, Kuo-Ting; Shih, Hao-Wei; Cheng, Yih-Shyun E; Cheng, Wei-Chieh; Wong, Chi-Huey

    2010-12-15

    To identify new transglycosylase inhibitors with potent anti-methicillin-resistant Staphylococcus aureus (MRSA) activities, a high-throughput screening against Staphylococcus aureus was conducted to look for antibacterial cores in our 2M compound library that consists of natural products, proprietary collection, and synthetic molecules. About 3600 hits were identified from the primary screening and the subsequent confirmation resulted in a total of 252 compounds in 84 clusters which showed anti-MRSA activities with MIC values as low as 0.1 ?g/ml. Subsequent screening targeting bacterial transglycosylase identified a salicylanilide-based core that inhibited the lipid II polymerization and the moenomycin-binding activities of transglycosylase. Among the collected analogues, potent inhibitors with the IC(50) values below 10 ?M against transglycosylase were identified. The non-carbonhydrate scaffold reported in this study suggests a new direction for development of bacterial transglycosylase inhibitors. PMID:21075637

  18. Controlling methicillin-resistant Staphylococcus aureus (MRSA) in a hospital and the role of hydrogen peroxide decontamination: an interrupted time series analysis

    PubMed Central

    Mitchell, Brett G; Digney, Wilhelmine; Locket, Phil; Dancer, Stephanie J

    2014-01-01

    Objectives The impact of surface disinfection versus detergent cleaning on healthcare associated infection rates remains unresolved. We aimed to evaluate the efficacy of hydrogen peroxide (HP) decontamination against methicillin-resistant Staphylococcus aureus (MRSA). Design Single centred retrospective before and after study design. Setting Launceston General Hospital, Tasmania, Australia. Participants Patients with MRSA infection or colonisation. Interventions Rooms occupied by patients with MRSA infection or colonisation were cleaned following discharge with either detergent or HP. Main outcome measures MRSA room contamination following cleaning; new MRSA acquisition in patients. Results Over 3600 discharge cleans were completed, with more than 32?600 environmental swabs processed. MRSA was isolated from 24.7% rooms following detergent cleaning and from 18.8% of rooms after HP (p<0.001). The incidence of MRSA acquisition reduced from 9.0 to 5.3 per 10?000 patient days in detergent and disinfectant arms, respectively (p<0.001). Conclusions Use of HP disinfection led to a decrease in residual MRSA contamination in patient rooms compared with detergent. It may also have encouraged the reduction in patient MRSA acquisition despite several confounders including staff feedback on terminal cleaning, additional MRSA screening and quicker laboratory methods. Infection control is best served by concurrent interventions targeting both the patient and healthcare environment. PMID:24747791

  19. Methicillin-resistant staphylococcus aureus (MRSA) carriage in a dermatology unit

    PubMed Central

    Pacheco, Renata L.; Lobo, Renata D.; Oliveira, Maura S.; Farina, Elthon F.; Santos, Cleide R.; Costa, Silvia F.; Padoveze, Maria Clara; Garcia, Cilmara P.; Trindade, Priscila A.; Quitério, Ligia M.; Rivitti, Evandro A.; Mamizuka, Elsa M.; Levin, Anna S.

    2011-01-01

    OBJECTIVE: The aim of this study was to characterize Staphylococcus aureus (MRSA) carriage in a dermatology unit. METHODS: This was a prospective and descriptive study. Over the course of 26 weeks, surveillance cultures were collected weekly from the anterior nares and skin of all patients hospitalized in a 20-bed dermatology unit of a tertiary-care hospital. Samples from healthcare workers (HCWS) were cultured at the beginning and end of the study. Colonized patients were put under contact precautions, and basic infection control measures were enforced. Staphylococcus aureus colonization pressure was determined monthly. Colonized and non-colonized patients were compared, and isolates were evaluated for antimicrobial susceptibility, SCCmec type, virulence factors, and type. RESULTS: Of the 142 patients evaluated, 64 (45%) were colonized by MRSA (39% hospital acquired; 25% community acquired; 36% indeterminate). Despite isolation precautions, hospital-acquired Staphylococcus aureus occurred in addition to the continuous entry of Staphylococcus aureus from the community. Colonization pressure increased from 13% to 59%, and pemphigus and other bullous diseases were associated with MRSA colonization. Eleven out of 71 HCWs (15%) were Staphylococcus aureus carriers, although only one worker carried a persistent clone. Of the hospital-acquired MRSA cases, 14/28 (50%) were SCCmec type IV (3 PFGE types), 13 were SCCmec type III (46%), and one had an indeterminate type. These types were also present among the community-acquired Staphylococcus aureus isolates. SSCmec type IV isolates were shown to be more susceptible than type III isolates. There were two cases of bloodstream infection, and the pvl and tst virulence genes were absent from all isolates. CONCLUSIONS: Dermatology patients were colonized by community- and hospital-acquired Staphylococcus aureus. Half of the nosocomial Staphylococcus aureus isolates were SCCmec type IV. Despite the identification of colonized patients and the subsequent contact precautions and room placement, Staphylococcus aureus colonization continued to occur, and colonization pressure increased. Pemphigus and other bullous diseases were associated with Staphylococcus aureus. PMID:22189732

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

    PubMed

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

    2015-04-01

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

  1. Investigation of gaseous ozone for MRSA decontamination of hospital side-rooms

    Microsoft Academic Search

    A. W. Berrington; S. J. Pedler

    1998-01-01

    A domestic, gaseous ozone generator was investigated for use in the decontamination of hospital side-rooms that have housed patients colonized with methicillin-resistant Staphylococcus aureus (MRSA). Three models of bacterial contamination were used. These were exposed to ozone generation in a standard hospital side-room for 4 and 7 h. A methicillin-sensitive and a methicillinresistant strain of S. aureus were compared. Ozone

  2. An MRSA screening policy for a small New South Wales hospital

    Microsoft Academic Search

    Eve Goldbeug

    Most nosocomial infections are caused by opportunistic bacteria, which are part of the normal microbiota of the human body. Particularly troublesome to the compromised host are the antibiotic-resistant strains of Gram-positive Staphylococcus aums and Gram-negative bacteria such as Escherichia coli and Pseudomonas acruginosa. Methirillin- mistant 5. aums (MRSA) in particular has been the subject of many policies and protocols devised

  3. Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections

    Microsoft Academic Search

    M. H Wilcox; J Hall; H Pike; P. A Templeton; W. N Fawley; P Parnell; P Verity

    2003-01-01

    We have examined whether topical perioperative prophylaxis can reduce the incidence of methicillin-resistant Staphylococcus aureus (MRSA) surgical site infections (SSIs). Using a controlled before and after approach on patients from four orthopaedic wards, undergoing orthopaedic surgery involving insertion of metal prostheses and\\/or fixation, received perioperative prophylaxis with nasal mupirocin for five days, and a shower or bath with 2% (v\\/v)

  4. [Methicillin resistance detection in Staphylococcus aureus: comparison between conventional methods and MRSA-Screen latex agglutination technique].

    PubMed

    Soloaga, R; Corso, A; Gagetti, P; Faccone, D; Galas, M

    2004-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen that has emerged over the last four decades, causing both nosocomial and community-acquired infections. Rapid and accurate detection of methicillin resistance in S. aureus is important for the use of appropriate antimicrobial therapy and for the control of nosocomial spread of MRSA strains. We evaluated the efficiency of conventional methods for detection of methicillin resistance such as the disk diffusion, agar dilution, oxacillin agar screen test, and the latex agglutination test MRSA-Screen latex, in 100 isolates of S. aureus, 79 mecA positive and 21 mecA negative. The MRSA-Screen latex (Denka Seiken, Niigata, Japón), is a latex agglutination method that detects the presence of PLP-2a, product of mecA gene in S. aureus. The PCR of the mecA gene was used as the "gold standard" for the evaluation of the different methods tested. The percentages of sensitivity and specificity were as follows: disk difusión 97 and 100%, agar dilution 97 and 95%, oxacillin agar screen test 100 and 100%, and MRSA-Screen latex, 100 and 100 %. All methods presented high sensitivity and specificity, but MRSA-Screen latex had the advantage of giving a reliable result, equivalent to PCR, in only 15 minutes. PMID:15174748

  5. Effectiveness of Hospital-Wide Methicillin-Resistant Staphylococcus aureus (MRSA) Infection Control Policies Differs by Ward Specialty

    PubMed Central

    Sadsad, Rosemarie; Sintchenko, Vitali; McDonnell, Geoff D.; Gilbert, Gwendolyn L.

    2013-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies. PMID:24340085

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2012-01-01

    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

  8. Comparison of protocols for surveillance of methicillin-resistant Staphylococcus aureus (MRSA): medical staff vs ICU patients.

    PubMed

    Lee, Seungok; Park, Yeon-Joon; Oh, Eun-Jee; Kahng, Jimin; Yoo, Jin Hong; Jeong, In-Hee; Kwon, Young-Mi; Han, Kyungja

    2007-01-01

    To compare the sensitivity of various protocols for methicillin-resistant Staphylococcus aureus (MRSA) surveillance, active surveillance for detecting MRSA nasal colonization was performed on 97 members of the medical staff and 218 patients in the Intensive Care Unit (ICU) of a university hospital. Duplicate nasal swabs were collected from each participant. One was plated directly on a blood agar plate (D-BAP) and observed at 24 and 48 hr. Another was incubated overnight in tryptic soy broth (TSB) with 6.5% NaCl, and subcultured on both BAP (B-BAP) and mannitol salt agar with 4 mg/L of oxacillin (B-MSAOXA). The MRSA colonization rate was similar in the medical staff and patient samples (16.5% vs 11.9%, p = 0.285). Among the medical staff members, the sensitivity of MRSA detection was the same (93.8%) in D-BAP and B-BAP. In the ICU patients, which are a high-risk group, the sensitivity of MRSA detection was improved by adding a pre-enrichment step (73.1% on D-BAP vs 96.2% on B-BAP). The simple direct plating protocol was sufficiently sensitive for the medical staff members, but pre-enrichment was an essential step to increase detection of MRSA in the ICU patients. PMID:17709688

  9. Inhibitory and resistance-modifying potential of plant-based alkaloids against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Mohtar, Mastura; Johari, Saiful Azmi; Li, Abdul Rashid; Isa, Mazurah Mohamed; Mustafa, Shuhaimi; Ali, Abdul Manaf; Basri, Dayang Fredalina

    2009-08-01

    Increased prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has become a major threat to the health sector worldwide due to their virulence, limited therapeutic options and their distribution in both hospital and community settings. Discovery and development of new anti-MRSA agents as alternatives to the very few antibiotics left in the armamentarium are, thus, urgently required. Recently, an efflux mechanism in MRSA has been identified as one of the main contributors of resistance towards various structurally unrelated antibiotics. The potential of reserpine (a phytoalkaloid) as efflux pump inhibitor (EPI) against various microbes remains limited as the concentration needed for inhibition is toxic to humans. This study therefore aimed to evaluate 13 alkaloid compounds as potential inhibitory agents and/or potential EPIs against a panel of three MRSA isolates which not only differ in their susceptibility to vancomycin (amongst the last drugs available to treat serious MRSA infection), but also exhibited active efflux activity. Results indicated berberine's moderate inhibitiory activity against two MRSA isolates scoring a minimum inhibitory concentration (MIC) value of 125 microg/ml. Notable efflux inhibitory activity (ranging from two- to eightfold Ethidium Bromide MIC reduction) meanwhile was detected from quinine, piperine and harmaline using reserpine as the positive control. Findings from this study support the opinion that a vast number of potential phytocompounds with pharmacological potential await discovery. Therapeutic application of these compounds, however, warrants further investigation to ascertain their pharmacodynamics and safety aspects. PMID:19475447

  10. High Resolution Typing by Whole Genome Mapping Enables Discrimination of LA-MRSA (CC398) Strains and Identification of Transmission Events.

    PubMed

    Bosch, Thijs; Verkade, Erwin; van Luit, Martijn; Pot, Bruno; Vauterin, Paul; Burggrave, Ronald; Savelkoul, Paul; Kluytmans, Jan; Schouls, Leo

    2013-01-01

    After its emergence in 2003, a livestock-associated (LA-)MRSA clade (CC398) has caused an impressive increase in the number of isolates submitted for the Dutch national MRSA surveillance and now comprises 40% of all isolates. The currently used molecular typing techniques have limited discriminatory power for this MRSA clade, which hampers studies on the origin and transmission routes. Recently, a new molecular analysis technique named whole genome mapping was introduced. This method creates high-resolution, ordered whole genome restriction maps that may have potential for strain typing. In this study, we assessed and validated the capability of whole genome mapping to differentiate LA-MRSA isolates. Multiple validation experiments showed that whole genome mapping produced highly reproducible results. Assessment of the technique on two well-documented MRSA outbreaks showed that whole genome mapping was able to confirm one outbreak, but revealed major differences between the maps of a second, indicating that not all isolates belonged to this outbreak. Whole genome mapping of LA-MRSA isolates that were epidemiologically unlinked provided a much higher discriminatory power than spa-typing or MLVA. In contrast, maps created from LA-MRSA isolates obtained during a proven LA-MRSA outbreak were nearly indistinguishable showing that transmission of LA-MRSA can be detected by whole genome mapping. Finally, whole genome maps of LA-MRSA isolates originating from two unrelated veterinarians and their household members showed that veterinarians may carry and transmit different LA-MRSA strains at the same time. No such conclusions could be drawn based spa-typing and MLVA. Although PFGE seems to be suitable for molecular typing of LA-MRSA, WGM provides a much higher discriminatory power. Furthermore, whole genome mapping can provide a comparison with other maps within 2 days after the bacterial culture is received, making it suitable to investigate transmission events and outbreaks caused by LA-MRSA. PMID:23805225

  11. High Resolution Typing by Whole Genome Mapping Enables Discrimination of LA-MRSA (CC398) Strains and Identification of Transmission Events

    PubMed Central

    Bosch, Thijs; Verkade, Erwin; van Luit, Martijn; Pot, Bruno; Vauterin, Paul; Burggrave, Ronald; Savelkoul, Paul; Kluytmans, Jan; Schouls, Leo

    2013-01-01

    After its emergence in 2003, a livestock-associated (LA-)MRSA clade (CC398) has caused an impressive increase in the number of isolates submitted for the Dutch national MRSA surveillance and now comprises 40% of all isolates. The currently used molecular typing techniques have limited discriminatory power for this MRSA clade, which hampers studies on the origin and transmission routes. Recently, a new molecular analysis technique named whole genome mapping was introduced. This method creates high-resolution, ordered whole genome restriction maps that may have potential for strain typing. In this study, we assessed and validated the capability of whole genome mapping to differentiate LA-MRSA isolates. Multiple validation experiments showed that whole genome mapping produced highly reproducible results. Assessment of the technique on two well-documented MRSA outbreaks showed that whole genome mapping was able to confirm one outbreak, but revealed major differences between the maps of a second, indicating that not all isolates belonged to this outbreak. Whole genome mapping of LA-MRSA isolates that were epidemiologically unlinked provided a much higher discriminatory power than spa-typing or MLVA. In contrast, maps created from LA-MRSA isolates obtained during a proven LA-MRSA outbreak were nearly indistinguishable showing that transmission of LA-MRSA can be detected by whole genome mapping. Finally, whole genome maps of LA-MRSA isolates originating from two unrelated veterinarians and their household members showed that veterinarians may carry and transmit different LA-MRSA strains at the same time. No such conclusions could be drawn based spa-typing and MLVA. Although PFGE seems to be suitable for molecular typing of LA-MRSA, WGM provides a much higher discriminatory power. Furthermore, whole genome mapping can provide a comparison with other maps within 2 days after the bacterial culture is received, making it suitable to investigate transmission events and outbreaks caused by LA-MRSA. PMID:23805225

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

    PubMed

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

    2013-02-01

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

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

    PubMed Central

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

    2010-01-01

    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

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

    PubMed

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

    1995-02-01

    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

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

    PubMed

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

    2014-03-01

    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

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

    PubMed Central

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

    2014-01-01

    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

  17. [MRSA bloodstream infections in hospitals in Frankfurt/Main, Germany, 2010 : Results of the mandatory notification and suggestions for improvement].

    PubMed

    Heudorf, U; Otto, U; Gottschalk, R

    2011-09-01

    Since 1 July 2009 in accordance with the statuary order based on the German law for infectious diseases (Infektionsschutzgesetz), MRSA in blood and liquor must be notified to the public health authorities. The aim of extension of the notification to report is to improve the surveillance of nosocomial infections and the prevention of nosocomial MRSA infections. In addition to MRSA detection, data on symptoms and risk factors, e.g., medical devices, must also be reported. In this report, data of bloodstream MRSA infections in hospitals in Frankfurt/Main, Germany, for the first complete year (2010)were evaluated. In 2010, 58 MRSA-positive bloodstream infections were reported by the 17 hospitals in Frankfurt to the health protection authorities, i.e., 0.0360 MRSA/1,000 patient-days (range: 0- 0.109/1,000 patient-days). However, 10 of these infections initially had not been reported to the public health department in charge for the hospitals, but to the health departments according to the patient's addresses. Although most of the infections were reported from large hospitals (>100,000 patient-days/year), the highest incidences (0.0416/1,000 patient-days) were reported from small hospitals (<50,000 patient-days/year). Of the blood specimen, 13 (22.4%) were drawn on the first day of hospital stay, thus, indicating an imported infection. While 90% of the patients with MRSA in the bloodstream suffered from fever, 80% had sepsis and 34.5% suffered from pneumonia. Medical devices, such as central venous catheters and PEG, were reported from 60% of the patients. In the MRE network Rhine-Main region, the public health authorities asked for some more detailed information, such as risk factors for MRSA colonization (history for MRSA, recent hospital stay or antibiotic therapy, skin disorders, dialysis, residence in a retirements home), and for screening results as well as for the MRSA management, i.e., isolation of the patient and, if necessary, the contact patient. In 55% of the cases, the patients were identified by the clinics themselves as being patients with MRSA risk factors, mainly because of a history of MRSA (29%), recent hospital stay (71%), and antibiotic therapy during the last 6 months (52%). Screening was performed in 31 (53%) of the patients, most of them (71%) with positive MRSA nose swab. If the patients were screened, significantly fewer contact patients had to be screened and isolated later. Thus, to improve surveillance data on MRSA bloodstream infections, the notification route to the public health authorities responsible for the clinic hosting the patient must be strictly obeyed in order to avoid underreporting und underassessment of nosocomial infection. Although asking for clinical symptoms may be useful to validate the result in some cases, focus should be placed on risk factors and risk management, including screening and isolation. Only then can the aim of improving surveillance and reduction of nosocomial MRSA infection be achieved. PMID:21887627

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

    PubMed

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

    2013-07-01

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

  19. One-year experience with modified BD GeneOhm MRSA assay for detection of methicillin-resistant Staphylococcus aureus from pooled nasal, skin, and throat samples.

    PubMed

    Svent-Kucina, Natasa; Pirs, Mateja; Mueller-Premru, Manica; Cvitkovic-Spik, Vesna; Kofol, Romina; Seme, Katja

    2009-02-01

    We report our 1-year experience with modified GeneOhm MRSA assay (formerly IDI-MRSA) for pooled surveillance specimens in low methicillin-resistant Staphylococcus aureus (MRSA) prevalence clinical setting. We have successfully modified the GeneOhm MRSA assay protocol during the specimen preparation step by adding an extra washing step followed by pooling of up to 3 samples per patient (nose, skin, with or without throat) at the lysis step. The sensitivity of the modified assay compared with conventional cultivation was 94.3%, specificity 99.2%, negative predictive value 99.2%, and positive predictive value 94.3%. The modified test is reliable and performed well compared with conventional culture methods in our clinical setting with low-level prevalence of MRSA colonization. Our findings support the use of pooling of the patients samples as a cost-effective way of screening for MRSA colonization. PMID:19081695

  20. Eczema vaccinatum resulting from the transmission of vaccinia virus from a smallpox vaccinee: an investigation of potential fomites in the home environment.

    PubMed

    Lederman, Edith; Miramontes, Roque; Openshaw, John; Olson, Victoria A; Karem, Kevin L; Marcinak, John; Panares, Rodrigo; Staggs, Wayne; Allen, Donna; Weber, Stephen G; Vora, Surabhi; Gerber, Susan I; Hughes, Christine M; Regnery, Russell; Collins, Limone; Diaz, Pamela S; Reynolds, Mary G; Damon, Inger

    2009-01-14

    On March 3, 2007, a 2-year-old boy was hospitalized with eczema vaccinatum. His two siblings, one with eczema, were subsequently removed from the home. Swabs of household items obtained on March 13th were analyzed for orthopoxvirus DNA signatures with real-time PCR. Virus culture was attempted on positive specimens. Eight of 25 household samples were positive by PCR for orthopoxvirus; of these, three yielded viable vaccinia virus in culture. Both siblings were found to have serologic evidence of orthopoxvirus exposure. These findings have implications for smallpox preparedness, especially in situations where some household members are not candidates for vaccination. PMID:19027813

  1. Preventing Introduction of Livestock Associated MRSA in a Pig Population – Benefits, Costs, and Knowledge Gaps from the Swedish Perspective

    PubMed Central

    Hæggman, Sara; Mieziewska, Kristina; Nilsson, Svante; Viske, Diana

    2015-01-01

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

  2. Antibacterial and synergic effects of gallic acid-grafted-chitosan with ?-lactams against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Lee, Dae-Sung; Eom, Sung-Hwan; Kim, Young-Mog; Kim, Hye Seon; Yim, Mi-Jin; Lee, Sang-Hoon; Kim, Do-Hyung; Je, Jae-Young

    2014-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is spreading worldwide, emphasizing the need to search for new antibiotics. The anti-MRSA activities of gallic acid-grafted-chitosans (GA-g-chitosans) were investigated against 2 MRSA standards and 10 MRSA clinical isolates by determining the minimum inhibitory concentrations (MICs). GA-g-chitosan (I), which has the highest gallic acid content, exhibited the strongest anti-MRSA activities, with MICs of 32-64 ?g/mL. A time-kill investigation revealed that GA-g-chitosan (I) exhibited a bactericidal effect at twice the MIC, also demonstrating good thermal and pH stability. Investigation of cell envelope integrity showed the release of intracellular components with an increasing absorbance value at 260 nm, indicating cell envelope damage caused by the GA-g-chitosan (I), which was further confirmed by transmission electron microscopy. When GA-g-chitosans were combined with ?-lactams, including ampicillin and penicillin, synergistic effects were observed on the 2 standard MRSA strains and on the 10 clinical isolates, with fractional inhibitory indices ranging from 0.125 to 0.625. In the time-kill dynamic confirmation test, synergistic bactericidal effects were observed for the combinations of GA-g-chitosans with ?-lactams, and over 4.0?log CFU/mL reductions were observed after 24 h when combination treatment was used. These results may prove GA-g-chitosans to be a potent agent when combined with ampicillin and penicillin for the elimination of MRSA. PMID:25216286

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

    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

  5. Topical Lyogel Containing Corticosteroid Decreases IgE Expression and Enhances the Therapeutic Efficacy Against Atopic Eczema.

    PubMed

    Ng, Shiow-Fern; Anuwi, Nurul-Asmaa; Tengku-Ahmad, Tengku-Noraisyah

    2015-06-01

    Hydrocortisone cream intended for atopic eczema often produces unwanted side effects after long-term use. These side effects are essentially due to repeated percutaneous administration of the medication for skin dermatitis, as atopic eczema is a relapsing disorder. Hence, there is a need to develop a new hydrocortisone formulation that will deliver the drug more effectively and require a reduced dosing frequency; therefore, the side effects could be minimized. In this study, a hydroxypropyl methylcellulose (HPMC) lyogel system based on 80% organic and 20% aqueous solvents containing 1% hydrocortisone was formulated. The hydrocortisone lyogel physicochemical characteristics, rheological properties, stability profile, and in vitro Franz cell drug release properties, as well as the in vivo therapeutic efficacies and dermal irritancy in Balb/c mice were investigated. The HPMC lyogel appeared clear and soft and was easy to rub on the skin. The lyogel also showed a higher drug release profile compared with commercial hydrocortisone cream. Similar to the cream, HPMC lyogels exhibited pseudoplastic behavior. From the mouse model, the hydrocortisone lyogel showed higher inflammatory suppressive effects than the cream. However, it did not reduce the transepidermal water loss as effectively as the control did. The dermal irritancy testing revealed that the hydrocortisone lyogel caused minimal irritation. In conclusion, HPMC lyogel is a promising vehicle to deliver hydrocortisone topically, as it showed a higher drug release in vitro as well as enhanced therapeutic efficacy in resolving eczematous inflammatory reaction compared with commercial cream. PMID:25511806

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

    PubMed

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

    2015-01-01

    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

  7. An evidence-based review of linezolid for the treatment of methicillin-resistant Staphylococcus aureus (MRSA): place in therapy

    PubMed Central

    Watkins, Richard R; Lemonovich, Tracy L; File, Thomas M

    2012-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA), including community-associated and hospital-associated strains, is a major cause of human morbidity and mortality. Treatment options have become limited due to the emergence of MRSA strains with decreased sensitivity to vancomycin, which has long been the first-line therapy for serious infections. This has prompted the search for novel antibiotics that are efficacious against MRSA. Linezolid, an oxazolidinone class of antibiotic, was approved by the Food and Drug Administration in 2000 for treatment of MRSA infections. Since then, there have been a multitude of clinical trials and research studies evaluating the effectiveness of linezolid against serious infections, including pneumonia (both community- and hospital-acquired), skin and soft-tissue infections such as diabetic foot ulcers, endocarditis, osteomyelitis, prosthetic devices, and others. The primary aim of this review is to provide an up-to-date evaluation of the clinical evidence for using linezolid to treat MRSA infections, with a focus on recently published studies, including those on nosocomial pneumonia. Other objectives are to analyze the cost-effectiveness of linezolid compared to other agents, and to review the pharmokinetics and pharmacodynamics of linezolid, emphasizing the most current concepts. PMID:23271985

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

    PubMed

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

    2015-07-01

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

  9. Risk factors for acquisition of methicillin-resistant Staphylococcus aureus (MRSA) by trauma patients in the intensive care unit.

    PubMed

    Marshall, C; Wolfe, R; Kossmann, T; Wesselingh, S; Harrington, G; Spelman, D

    2004-07-01

    In a previous study in the intensive care unit (ICU) of the Alfred Hospital, Melbourne, Australia, it was demonstrated that trauma patients were at particular risk of becoming colonized by methicillin-resistant Staphylococcus aureus (MRSA). We examined risk factors for MRSA acquisition in these patients using a cohort study comparing the 31 patients who acquired MRSA with 65 who did not. Data collected included ICU length of stay (LOS), mechanism of trauma, site of injury, type of surgery, trauma severity and antibiotic usage. Odds ratios (OR) were determined and adjusted for LOS. LOS in the ICU was a significant univariate predictor of MRSA acquisition (OR 13.7). When adjusted for LOS, mechanism of trauma (OR 10.4), laparotomy (OR 6.3) and administration of ticarcillin/clavulanic acid (OR 4.5) or glycopeptides (OR 5.9) remained significant. We confirmed our previous finding that LOS was associated with MRSA acquisition. Receipt of antibiotics correlated with reported literature. Novel associations were road trauma as a mechanism and laparotomy. PMID:15236855

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

    PubMed Central

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

    2004-01-01

    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

  11. Use of the antimicrobial peptide Epinecidin-1 to protect against MRSA infection in mice with skin injuries.

    PubMed

    Huang, Han-Ning; Rajanbabu, Venugopal; Pan, Chieh-Yu; Chan, Yi-Lin; Wu, Chang-Jer; Chen, Jyh-Yih

    2013-12-01

    Methicillin-resistant Staphylococcus aureus (MRSA) causes infections through open skin injuries, and its resistance makes treatment difficult. The antimicrobial peptide Epinecidin-1 (Epi-1) has been reported to possess antibacterial, antifungal, antiviral, and antitumor functions. This study investigated the antimicrobial activity of Epi-1 against skin trauma-mediated MRSA infection in mice. One square centimeter of outer skin was excised from the ventral region of mice, and a lethal dose of MRSA was applied in the presence or absence of methicillin, vancomycin, or Epi-1. While untreated mice and mice treated with methicillin died within four days, mice treated with Epi-1 survived infection. Epi-1 decreased MRSA bacterial counts in the wounded region, enhanced wound closure, and increased angiogenesis at the injury site. Treatment with Epi-1 decreased serum levels of the proinflammatory cytokines TNF-?, IL-6, and MCP-1, and regulated the recruitment of monocytes and clearance of lymphocytes around the wounded region during healing. In conclusion, Epi-1 may be effective at treating clinical MRSA, and may enhance wound recovery when combined with collagen. PMID:24075409

  12. Induction of MRSA Biofilm by Low-Dose ?-Lactam Antibiotics: Specificity, Prevalence and Dose-Response Effects

    PubMed Central

    Ng, Mandy; Epstein, Samuel B.; Callahan, Mary T.; Piotrowski, Brian O.; Simon, Gary L.; Roberts, Afsoon D.; Keiser, John F.; Kaplan, Jeffrey B.

    2014-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital- and community-associated infections. The formation of adherent clusters of cells known as biofilms is an important virulence factor in MRSA pathogenesis. Previous studies showed that subminimal inhibitory (sub-MIC) concentrations of methicillin induce biofilm formation in the community-associated MRSA strain LAC. In this study we measured the ability sub-MIC concentrations of eight other ?-lactam antibiotics and six non-?-lactam antibiotics to induce LAC biofilm. All eight ?-lactam antibiotics, but none of the non-?-lactam antibiotics, induced LAC biofilm. The dose-response effects of the eight ?-lactam antibiotics on LAC biofilm varied from biphasic and bimodal to near-linear. We also found that sub-MIC methicillin induced biofilm in 33 out of 39 additional MRSA clinical isolates, which also exhibited biphasic, bimodal and linear dose-response curves. The amount of biofilm formation induced by sub-MIC methicillin was inversely proportional to the susceptibility of each strain to methicillin. Our results demonstrate that induction of biofilm by sub-MIC antibiotics is a common phenotype among MRSA clinical strains and is specific for ?-lactam antibiotics. These findings may have relevance to the use of ?-lactam antibiotics in clinical and agricultural settings. PMID:24659939

  13. Induction of MRSA Biofilm by Low-Dose ?-Lactam Antibiotics: Specificity, Prevalence and Dose-Response Effects.

    PubMed

    Ng, Mandy; Epstein, Samuel B; Callahan, Mary T; Piotrowski, Brian O; Simon, Gary L; Roberts, Afsoon D; Keiser, John F; Kaplan, Jeffrey B

    2014-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital- and community-associated infections. The formation of adherent clusters of cells known as biofilms is an important virulence factor in MRSA pathogenesis. Previous studies showed that subminimal inhibitory (sub-MIC) concentrations of methicillin induce biofilm formation in the community-associated MRSA strain LAC. In this study we measured the ability sub-MIC concentrations of eight other ?-lactam antibiotics and six non-?-lactam antibiotics to induce LAC biofilm. All eight ?-lactam antibiotics, but none of the non-?-lactam antibiotics, induced LAC biofilm. The dose-response effects of the eight ?-lactam antibiotics on LAC biofilm varied from biphasic and bimodal to near-linear. We also found that sub-MIC methicillin induced biofilm in 33 out of 39 additional MRSA clinical isolates, which also exhibited biphasic, bimodal and linear dose-response curves. The amount of biofilm formation induced by sub-MIC methicillin was inversely proportional to the susceptibility of each strain to methicillin. Our results demonstrate that induction of biofilm by sub-MIC antibiotics is a common phenotype among MRSA clinical strains and is specific for ?-lactam antibiotics. These findings may have relevance to the use of ?-lactam antibiotics in clinical and agricultural settings. PMID:24659939

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

    PubMed Central

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

    2011-01-01

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

  15. Postponing elective hospitalizations for pre-admission MRSA screening and decolonization. A study evaluating eligibility and acceptance among patients of a German university hospital.

    PubMed

    Giese, Arnd; Bous, Jan; Werner, Sebastian; Lemm, Friederike; Wilhelm, Michael; Henning, Bernhard F

    2013-03-01

    There is evidence that pre-admission screening and decolonization (PreASD) of MRSA can reduce costs in elective surgical patients. It is not known whether this strategy could also be successfully applied to general medical patients of a tertiary referral hospital with multiple specialties. Our study retrospectively evaluates the eligibility of patients for MRSA-PreASD in a setting of active targeted MRSA surveillance. We carried out a survey among eligible patients to assess acceptance and feasibility of MRSA-PreASD. Of 10,496 admissions to our university hospital 8912 (84.9%) were screened for MRSA-risk factors. In 5382 admissions at risk swabs were taken and analyzed. Using the Appropriateness Evaluation Protocol (AEP) we retrospectively assessed how many of the 5382 admissions at risk could have been postponed for the duration of an MRSA-PreASD. 36 (17%) of 212 admissions with proven MRSA colonization and 2175 (42%) of 5170 patients without detectable MRSA could have been sent home for MRSA-PreASD to be electively admitted later. Of the 36 admissions (35 patients) with proven MRSA eligible for PreASD 23 patients (65%) responded to an interview. 22 of those (95.6%) would have agreed to PreASD. Additional costs for a screening protocol adapted to the needs of MRSA-PreASD of 52,061€ were estimated. Additional hospitalization costs of 6100-9300€ per MRSA case in Germany have been published. In our study population the successful pre-admission decolonization of 22 cases (63% of 35 patients eligible) may therefore have saved about 134,000-205,000€. Thus from an economic point of view our concept should be justified. In conclusion a relevant number of affected admissions to our tertiary referral hospital is eligible for an MRSA-PreASD. The majority of patients with proven MRSA-colonization eligible for a pre-admission decolonization treatment would prefer such an approach over being isolated at the hospital. The implementation of an MRSA-PreASD-protocol may reduce costs. PMID:22683064

  16. Randomized, Double-Blind, Placebo-Controlled Study on Decolonization Procedures for Methicillin-Resistant Staphylococcus aureus (MRSA) among HIV-Infected Adults

    PubMed Central

    Weintrob, Amy; Bebu, Ionut; Agan, Brian; Diem, Alona; Johnson, Erica; Lalani, Tahaniyat; Wang, Xun; Bavaro, Mary; Ellis, Michael; Mende, Katrin; Crum-Cianflone, Nancy

    2015-01-01

    Background HIV-infected persons have increased risk of MRSA colonization and skin and soft-tissue infections (SSTI). However, no large clinical trial has examined the utility of decolonization procedures in reducing MRSA colonization or infection among community-dwelling HIV-infected persons. Methods 550 HIV-infected adults at four geographically diverse US military HIV clinics were prospectively screened for MRSA colonization at five body locations every 6 months during a 2-year period. Those colonized were randomized in a double-blind fashion to nasal mupirocin (Bactroban) twice daily and hexachlorophene (pHisoHex) soaps daily for 7 days compared to placeboes similar in appearance but without specific antibacterial activity. The primary endpoint was MRSA colonization at 6-months post-randomization; secondary endpoints were time to MRSA clearance, subsequent MRSA infections/SSTI, and predictors for MRSA clearance at the 6-month time point. Results Forty-nine (9%) HIV-infected persons were MRSA colonized and randomized. Among those with 6-month colonization data (80% of those randomized), 67% were negative for MRSA colonization in both groups (p = 1.0). Analyses accounting for missing 6-month data showed no significant differences could have been achieved. In the multivariate adjusted models, randomization group was not associated with 6-month MRSA clearance. The median time to MRSA clearance was similar in the treatment vs. placebo groups (1.4 vs. 1.8 months, p = 0.35). There was no difference on subsequent development of MRSA infections/SSTI (p = 0.89). In a multivariable model, treatment group, demographics, and HIV-specific factors were not predictive of MRSA clearance at the 6-month time point. Conclusion A one-week decolonization procedure had no effect on MRSA colonization at the 6-month time point or subsequent infection rates among community-dwelling HIV-infected persons. More aggressive or novel interventions may be needed to reduce the burden of MRSA in this population. Trial Registration ClinicalTrials.gov NCT00631566 PMID:26018036

  17. Prevalence and properties of mecC methicillin-resistant Staphylococcus aureus (MRSA) in bovine bulk tank milk in Great Britain

    PubMed Central

    Paterson, G. K.; Morgan, F. J. E.; Harrison, E. M.; Peacock, S. J.; Parkhill, J.; Zadoks, R. N.; Holmes, M. A.

    2014-01-01

    Objectives mecC methicillin-resistant Staphylococcus aureus (MRSA) represent a newly recognized form of MRSA, distinguished by the possession of a divergent mecA homologue, mecC. The first isolate to be identified came from bovine milk, but there are few data on the prevalence of mecC MRSA among dairy cattle. The aim of this study was to conduct a prevalence study of mecC MRSA among dairy farms in Great Britain. Methods Test farms were randomly selected by random order generation and bulk tank samples were tested for the presence of mecC MRSA by broth enrichment and plating onto chromogenic agar. All MRSA isolated were screened by PCR for mecA and mecC, and mecC MRSA were further characterized by multilocus sequence typing, spa typing and antimicrobial susceptibility testing. Results mecC MRSA were detected on 10 of 465 dairy farms sampled in England and Wales (prevalence 2.15%, 95% CI 1.17%–3.91%), but not from 625 farms sampled in Scotland (95% CI of prevalence 0%–0.61%). Seven isolates belonged to sequence type (ST) 425, while the other three belonged to clonal complex 130. Resistance to non-?-lactam antibiotics was uncommon. All 10 isolates produced a negative result by slide agglutination for penicillin-binding protein 2a. mecA MRSA ST398 was detected on one farm in England. Conclusions mecC MRSA is widely distributed among dairy farms in Great Britain, but this distribution is not uniform across the whole country. These results provide an important baseline dataset to monitor the epidemiology of this emerging form of MRSA. PMID:24155057

  18. 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...

  19. Prevalence of symptoms of asthma, rhinitis, and atopic eczema among Brazilian children and adolescents identified by the International Study of Asthma and Allergies in Childhood (ISAAC) - Phase 3

    Microsoft Academic Search

    Dirceu Solé; Gustavo F. Wandalsen; Inês Cristina Camelo-Nunes; Charles K. Naspitz

    2006-01-01

    Objective: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema among schoolchildren aged 6 to 7 years and adolescents aged 13 to 14 years in 20 Brazilian cities by using the standardized ISAAC written questionnaire, and to assess the association of this prevalence with latitude, altitude and average annual temperature of collaborating centers. Methods: Schoolchildren and adolescents

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

    PubMed Central

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

    2012-01-01

    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

  1. 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

    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

    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

  2. Outbreak analysis and typing of MRSA isolates by automated repetitive-sequence-based PCR in a region with multiple strain types causing epidemics.

    PubMed

    Hirvonen, J J; Pasanen, T; Tissari, P; Salmenlinna, S; Vuopio, J; Kaukoranta, S-S

    2012-11-01

    The usefulness and performance of repetitive-sequence-based polymerase chain reaction (rep-PCR), the DiversiLab system, in the epidemiological surveillance for methicillin-resistant Staphylococcus aureus (MRSA) strain typing was assessed. MRSA isolates from five distinct outbreaks with precise epidemiological data (n?=?69) and from the culture collection of well-characterized MRSA strains (n?=?132) consisting of 35 spa and 23 pulsed-field gel electrophoresis (PFGE) types were analyzed. The typing results of the DiversiLab system in outbreak analysis were compared to the spa and PFGE typing methods. The DiversiLab system proved to be a reliable tool for the rapid first-line typing of MRSA isolates, showing a good reliability in distinguishing MRSA strains in an area where several MRSA types were causing epidemics. This, however, required that the automatic clustering was combined with manual interpretation using the pattern overlay function when the strain types showing high similarity were clustered together. All outbreaks were distinguished with the DiversiLab system and the PFGE method, but not with the spa typing method. The overall discriminatory power of the DiversiLab system in differentiating diverse MRSA strains proved to be good. We also demonstrated that, in addition to the genetic relatedness analysis of MRSA strains, it is important to obtain accurate epidemiological information in order to perform reliable epidemiological surveillance studies. PMID:22644057

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

    PubMed Central

    2015-01-01

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

  4. Synthesis and potent in vitro activity of novel 1H-benzimidazoles as anti-MRSA agents.

    PubMed

    Karata?, Hacer; Alp, Mehmet; Yildiz, Sulhiye; Göker, Hakan

    2012-08-01

    A new class of 1H-benzimidazolecarboxamidines was synthesized and evaluated for in vitro antibacterial and antifungal activities, including drug-resistant bacterial strains. The most potent compound (32) has the same ratio of anti-MRSA activity as Vancomycin (minimal inhibitory concentrations value 0.78 ?g/mL). The mechanism of action for 1H-benzimidazolecarboxamidine appears to be different from existing antibacterial agents. These compounds have potential for development as a new class of potent anti-MRSA agent. PMID:22497759

  5. Nasal carriage of MRSA: the role of mupirocin and outlook for resistance.

    PubMed

    Hill, R L; Casewell, M W

    1990-01-01

    Since the first attempts (1) to eradicate nasal carriage of Staphylococcus aureus with local applications of penicillin, many other topical and systemic antimicrobial agents have been tested, all with limited success. More recently, mupirocin has been much more successful and, in a controlled trial, nasal carriage of S. aureus was eliminated in all subjects and when re-colonisation eventually took place, only 29% had relapsed with their pre-treatment strain. During an MRSA outbreak at a London hospital, standard infection control measures failed to prevent colonisation and infection of more than two hundred patients, but the use of mupirocin was associated with epidemiological control. Of forty patients and thirty-two staff studied, 98.6% of staff and 90.1% of patient-weeks were free of nasal MRSA after treatment. Although resistance to at least 40 mg/l of mupirocin can be produced in vitro and resistant S. aureus have been isolated from patients undergoing prolonged skin treatment with mupirocin, there has been no evidence for the emergence of mupirocin resistance as a mechanism for the relapse of nasal carriage. PMID:2129029

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

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

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

  7. Antibacterial effect of essential oils from two medicinal plants against Methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Tohidpour, A; Sattari, M; Omidbaigi, R; Yadegar, A; Nazemi, J

    2010-02-01

    Antimicrobial properties of plants essential oils (EOs) have been investigated through several observations and clinical studies which purpose them as potential tools to overcome the microbial drug resistance problem. The aim of this research is to study the antibacterial effect of two traditional plants essential oils, Thymus vulgaris and Eucalyptus globulus against clinical isolates of Methicillin resistant Staphylococcus aureus (MRSA) and other standard bacterial strains through disk diffusion and agar dilution methods. Gas Chromatography (GC) and Gas Chromatography/Mass Spectrometry (GC/MS) analysis examined the chemical composition of the oils. Results revealed both of oils to possess degrees of antibacterial activity against Gram (+) and Gram (-) bacteria. T. vulgaris EO showed better inhibitory effects than E. globulus essential oil. GC analysis of T. vulgaris resulted in thymol as the oil major compound whereas GC/MS assay exhibited eucalyptol as the most abundant constitute of E. globulus EO. These results support previous studies on these oils and suggest an additional option to treat MRSA infections. Clinical and further analytical trials of these data are necessary to confirm the obtained outcomes. PMID:19576738

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

    PubMed Central

    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

    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

  9. [Tinea capitis profunda due to Trichophyton verrucosum with cMRSA superinfection in an infant].

    PubMed

    Blömer, R-H; Keilani, N; Faber, A; Rodeck, B; Krüger, C; Uhrlaß, S; Gräser, Y; Nenoff, P

    2012-08-01

    A 28-month-old boy developed a cutaneous and subcutaneous lesion of the scalp together with alopecia. Treatment with sulfadiazine silver ointment and oral administration of cefaclor failed. The boy lived on a farm where cows and calves were present. He presented with a 5 cm erythematous, erosive, edematous, and sharply defined lesion with yellow crusts and circumscribed alopecia on the temporoparietal scalp. Peripheral hairs were easily epilated. Swabs from the wound revealed cMRSA (community acquired methicillin-resistant Staphylococcus aureus, Panton Valentine Leukocidin [PVL] toxin negative). There was no improvement after treatment with cefuroxime intravenously over 3 days. Therapy was changed to vancomycin and fosfomycin. Because of the purulent abscess, surgical incision was performed. PCR (polymerase chain reaction)-Elisa assay detected Trichophyton (T.) interdigitale-DNA from wound secretion and skin biopsy. Because of the clinical and molecular diagnosis of tinea capitis, oral antifungal therapy with fluconazole 5 mg kg(-1) body weight was started, along with cotrimoxazole and fosfomycin for the cMRSA. After 4 weeks incubation, the causative agent T. verrucosum was grown on culture and its identity confirmed by sequencing of the "internal transcribed spacer" (ITS) region of the ribosomal DNA. After 4 weeks of fluconazole, the lesion was nearly healed. PMID:22406762

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

    PubMed

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

    2010-04-01

    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

  11. Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among Swiss veterinary health care providers: detection of livestock- and healthcare-associated clones.

    PubMed

    Wettstein Rosenkranz, K; Rothenanger, E; Brodard, I; Collaud, A; Overesch, G; Bigler, B; Marschall, J; Perreten, V

    2014-07-01

    We screened a total of 340 veterinarians (including general practitioners, small animal practitioners, large animal practitioners, veterinarians working in different veterinary services or industry), and 29 veterinary assistants for nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus pseudintermedius (MRSP) at the 2012 Swiss veterinary annual meeting. MRSA isolates (n = 14) were detected in 3.8 % (95 % CI 2.1 - 6.3 %) of the participants whereas MRSP was not detected. Large animal practitioners were carriers of livestock-associated MRSA (LA-MRSA) ST398-t011-V (n = 2), ST398-t011-IV (n = 4), and ST398-t034-V (n = 1). On the other hand, participants working with small animals harbored human healthcare-associated MRSA (HCA-MRSA) which belonged to epidemic lineages ST225-t003-II (n = 2), ST225-t014-II (n = 1), ST5-t002-II (n = 2), ST5-t283-IV (n = 1), and ST88-t186-IV (n = 1). HCA-MRSA harbored virulence factors such as enterotoxins, ?-hemolysin converting phage and leukocidins. None of the MRSA isolates carried Panton-Valentine leukocidin (PVL). In addition to the methicillin resistance gene mecA, LA-MRSA ST398 isolates generally contained additional antibiotic resistance genes conferring resistance to tetracycline [tet(M) and tet(K)], trimethoprim [dfrK, dfrG], and the aminoglycosides gentamicin and kanamycin [aac(6')-Ie - aph(2')-Ia]. On the other hand, HCA-MRSA ST5 and ST225 mainly contained genes conferring resistance to the macrolide, lincosamide and streptogramin B antibiotics [erm(A)], to spectinomycin [ant(9)-Ia], amikacin and tobramycin [ant(4')-Ia], and to fluoroquinolones [amino acid substitutions in GrlA (S84L) and GyrA (S80F and S81P)]. MRSA carriage may represent an occupational risk and veterinarians should be aware of possible MRSA colonization and potential for developing infection or for transmitting these strains. Professional exposure to animals should be reported upon hospitalization and before medical intervention to allow for preventive measures. Infection prevention measures are also indicated in veterinary medicine to avoid MRSA transmission between humans and animals, and to limit the spread of MRSA both in the community, and to animal and human hospitals. PMID:24973319

  12. Reassociation of dreams. II. An LSD study of sexual conflicts in eczema and asthma.

    PubMed

    Abramson, H A

    1976-07-01

    This second paper on the reassociation of dreams confirms 1. the value of reassociating a key dream (The Beetle Bug Dream) and 2. the use of lysergic acid diethyl amide (LSD) as an adjunct to psychoanalytic therapy. The patient (Joyce) was a young mother whose very severe eczema and asthma were accompanied by an incapacitating depression. The following summary of the three interviews indicate briefly the psychodynamic materials developed which helped Joyce uncover her confused sexual identifications and fear of lesbianism. In Interview 96 the initial Beetle Bug Dream was studied cautiously. On analysis the tentacles of the Beetle Bugs symbolically represented the hands of a man mauling a girl's skin. A sexual approach by a man is considered an attack. "Bugs get under the skin. If Jack (my husband) touches my skin, that spot itches." A second Beetle Bug is described. The special aspect of this unique Bug is that it was not threatening. This Bug is discussed in terms of the transference: the silent analyst and a father who responded to her childhood travail by silence are compared. Reassociation of the Beetle Bug Dream without LSD took place one year later. The session (Interview 235) lasted about 45 minutes and the verbatim recording occupied 12 typewritten pages. Free association led to the realization that the patient was programmed in part to identify with her father--a silent, passive individual. It was apparent that a psychological struggle for femininity, induced by the confused identification led to a threat of penetration by the sting of the Beetle Bug and, where a man was involved, penetration by the penis. Interview 236 (three days later) was conducted under LSD 25. The Beetle Bug Dream again formed the basis of this interview, which lasted four hours and occupied 46 pages of typewritten, verbatim material. A new feeling of independence from maternal influence is felt. "It used to be if I just thought of her, I could start scratching." The relationship with her husband is complicated by "deep, dark secrets." She is afraid of her husband. Her mother emphasized she was "one" with her father. Contact with aggressive males during adolescence, as well as seductive episodes were disturbing. In camp she feared that she might be a lesbian. This fear persisted into adult life. The threat of the Beetle Bug sting is developed further. Hostile feelings toward the penis are revealed in detail, The part of the penis in the vagina could be chopped off--the penis was what the sting of the Beetle Bug would be if it penetrated the skin. The bridegroom attacks the bride. An unwanted pregnancy is equivalent to the broken sting remaining in the skin. These revelations led to insight regarding unusual violent anger toward her child during toilet training. The data support the view that publication of verbatim recordings are a necessary condition for establishing psychoanalytic procedures as a basic science of medicine and of the validity of psychodynamic theory... PMID:1010810

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

    PubMed

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

    2015-06-01

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

  14. Transmission of endemic ST22-MRSA-IV on four acute hospital wards investigated using a combination of spa, dru and pulsed-field gel electrophoresis typing.

    PubMed

    Creamer, E; Shore, A C; Rossney, A S; Dolan, A; Sherlock, O; Fitzgerald-Hughes, D; Sullivan, D J; Kinnevey, P M; O'Lorcain, P; Cunney, R; Coleman, D C; Humphreys, H

    2012-11-01

    The transmission of meticillin-resistant Staphylococcus aureus (MRSA) between individual patients is difficult to track in institutions where MRSA is endemic. We investigated the transmission of MRSA where ST22-MRSA-IV is endemic on four wards using demographic data, patient and environmental screening, and molecular typing of isolates. A total of 939 patients were screened, 636 within 72 h of admission (on admission) and 303 >72 h after admission, and 1,252 environmental samples were obtained. Isolates were typed by spa, dru and pulsed-field gel electrophoresis (PFGE) typing. A composite dendrogram generated from the three sets of typing data was used to divide isolates into 'dendrogram groups' (DGs). Ten percent of patients (92/939) were MRSA-positive; 7 % (44/636) on admission and 16 % (48/303) >72 h after admission (p?=?0.0007). MRSA was recovered from 5 % of environmental specimens (65/1,252). Most isolates from patients (97 %, 85/88) and the environment (97 %, 63/65) exhibited the ST22-MRSA-IV genotype. Four DGs (DG1, DG4, DG16 and DG17) accounted for 58 % of ST22-MRSA-IV isolates from patients. Epidemiological evidence suggested cross-transmission among 44/92 patients (48 %) but molecular typing confirmed probable cross-transmission in only 11 instances (13 %, 11/88), with the majority of cross-transmission (64 %; 7/11) occurring on one ward. In the setting of highly clonal endemic MRSA, the combination of local epidemiology, PFGE, spa and dru typing provided valuable insights into MRSA transmission. PMID:22814876

  15. Generalized vaccinia, progressive vaccinia, and eczema vaccinatum are rare following smallpox (vaccinia) vaccination: United States surveillance, 2003.

    PubMed

    Vellozzi, Claudia; Lane, J Michael; Averhoff, Francisco; Maurer, Toby; Norton, Scott; Damon, Inger; Casey, Christine

    2005-09-01

    Generalized vaccinia (GV), progressive vaccinia (PV), and eczema vaccinatum (EV) are adverse reactions following smallpox vaccination. We investigated all reports suggestive of GV, PV, or EV among United States civilian smallpox vaccinees during 2003 and applied standard case definitions. We identified 29 reports of possible GV among 38,440 vaccinees; 2 (7%) of the reports met the case definition. One case of GV was confirmed by identifying vaccinia from a lesion distant from the vaccine site using polymerase chain reaction. The other case was classified as probable GV, because confirmatory testing was not done. We identified 3 potential EV cases and 7 potential PV cases, none of which met the standard case definition. GV, PV, and EV were rare or absent following smallpox vaccination after careful screening of potential vaccinees. GV may be difficult to distinguish from other rashes, and confirmatory testing is recommended. Careful prevaccination screening probably contributed to the low incidence of these adverse reactions following smallpox vaccination. PMID:16080092

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2012-01-01

    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

  18. A Prospective Audit of Complex Wound and Graft Infections in Great Britain and Ireland: the Emergence of MRSA

    Microsoft Academic Search

    A. R. Naylor; P. D. Hayes; S. Darke

    2001-01-01

    Background a number of studies have examined the outcome of complex wound and graft infections, but most include small numbers of patients collected over a prolonged period of time. To date, there is little information on the clinical outcome of infections involving methicillin-resistant Staphylococcus aureus (MRSA). Methods between February 1998 and January 1999, two prospective multi-centre audits were performed in

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

    E-print Network

    Oliver, Douglas L.

    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

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

    PubMed Central

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

    2013-01-01

    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

  1. X-ray CT and pneumonia inhibition properties of gold-silver nanoparticles for targeting MRSA induced pneumonia.

    PubMed

    Huo, Da; Ding, Jing; Cui, Yi X; Xia, Lu Y; Li, Hui; He, Jian; Zhou, Zheng Y; Wang, Hong W; Hu, Yong

    2014-08-01

    Non-invasive assay for the early stage diagnosis of methicillin resistant Staphylococcus aureus (MRSA) related pneumonia is of great clinical importance and still a great challenge. In this paper, we reported a novel kind of Au@Ag core-shell theranostic nanoparticles (NPs) conjugated with MRSA specific antibody on their surface. Compared with the raw Au@Ag NPs, these antibody modified NPs (AAMA NPs) showed 10.66 fold enhancement targeting to the MRSA in vitro. In vivo target efficacy was measured with rats bearing pneumonia induced by different pathogens. Computed tomography (CT) results revealed that these AAMA NPs had higher CT contrast enhancement (498 HU), than those of raw Au@Ag and Omnipaque (oth <100 HU). In addition, lesions labeled by AAMA NPs could be distinguished from lung parenchyma by taking advantage of spectra CT. Bio-distribution analysis confirmed that these AAMA NPs accumulated in the MRSA rich site. Both BAL and Elisa assays indicated that these AAMA NPs greatly alleviated the inflammation reaction by reducing bacterial proliferation and cytokine production. Pathological study showed that these NPs exerted negligible long term cytotoxicity in vivo. PMID:24836950

  2. An Outbreak of Severe Infections with Community-Acquired MRSA Carrying the Panton-Valentine Leukocidin Following Vaccination

    PubMed Central

    Chi Thuong, Tang; Dac Tho, Nguyen; Thi Hoa, Ngo; Minh Phuong, Nguyen Thi; Van Tuan, Le; Song Diep, To; Lindsay, Jodi; The Dung, Nguyen; Van Cam, Bach; Quoc Thinh, Le; Thanh Hai, Le; Dieu Linh, Le; Campbell, James; Kim Tien, Nguyen Thi; Vinh Chau, Nguyen Van; Cockfield, Joshua; Truong Giang, Le; Van Nghiem, Phan; Hoang Son, Le; Tan Son, Huynh; Van Phung, Le; Counahan, Megan; Bentsi-Enchill, Adwoa; Brown, Richard; Simmerman, James; Tran Chinh, Nguyen; Tinh Hien, Tran; Farrar, Jeremy; Schultsz, Constance

    2007-01-01

    Background Infections with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are emerging worldwide. We investigated an outbreak of severe CA-MRSA infections in children following out-patient vaccination. Methods and Findings We carried out a field investigation after adverse events following immunization (AEFI) were reported. We reviewed the clinical data from all cases. S. aureus recovered from skin infections and from nasal and throat swabs were analyzed by pulse-field gel electrophoresis, multi locus sequence typing, PCR and microarray. In May 2006, nine children presented with AEFI, ranging from fatal toxic shock syndrome, necrotizing soft tissue infection, purulent abscesses, to fever with rash. All had received a vaccination injection in different health centres in one District of Ho Chi Minh City. Eight children had been vaccinated by the same health care worker (HCW). Deficiencies in vaccine quality, storage practices, or preparation and delivery were not found. Infection control practices were insufficient. CA-MRSA was cultured in four children and from nasal and throat swabs from the HCW. Strains from children and HCW were indistinguishable. All carried the Panton-Valentine leukocidine (PVL), the staphylococcal enterotoxin B gene, the gene complex for staphylococcal-cassette-chromosome mec type V, and were sequence type 59. Strain HCM3A is epidemiologically unrelated to a strain of ST59 prevalent in the USA, although they belong to the same lineage. Conclusions We describe an outbreak of infections with CA-MRSA in children, transmitted by an asymptomatic colonized HCW during immunization injection. Consistent adherence to injection practice guidelines is needed to prevent CA-MRSA transmission in both in- and outpatient settings. PMID:17786194

  3. Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis.

    PubMed

    Steinmetz, T; Eliakim-Raz, N; Goldberg, E; Leibovici, L; Yahav, D

    2015-07-01

    Recent Infectious Diseases Society of America guidelines for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections recommend maintaining vancomycin trough concentrations of 15-20 mg/L for serious infections. We conducted a systematic review and meta-analysis of all studies assessing the impact of low (<15 mg/L) vs. high (?15 mg/L) vancomycin trough level on the efficacy of MRSA infections treatment. Four prospective and 12 retrospective studies were included (2003 participants). No significant difference was demonstrated between low and high vancomycin trough level for the outcome of all-cause mortality (odds ratio (OR) 1.07, 95% confidence interval (CI) 0.78-1.46, I(2) = 28%). In studies evaluating mainly MRSA pneumonia, there was significantly higher mortality with low vancomycin level (OR 1.78, 95% CI 1.11-2.84). No significant difference was demonstrated in treatment failure rates (OR 1.25, 95% CI 0.88-1.78, I(2) = 51%). However, excluding one outlier study from the analysis, treatment failure became significantly higher in patients with low vancomycin trough level (OR 1.46, 95% CI 1.12-1.91, I(2) = 16%). Microbiologic failure rates were significantly higher in patients with low vancomycin levels (OR 1.56, 95% CI 1.08-2.26, I(2) = 0%). Nephrotoxicity was significantly higher with vancomycin levels of ?15 mg/L. However, no cases of irreversible renal damage were reported. Current data on the effectiveness of higher vancomycin trough levels in the treatment of MRSA infections are limited to few prospective and mainly retrospective studies. Our findings support the current recommendations for maintaining vancomycin trough levels of ?15 mg/L in the treatment of severe MRSA infections, although no difference in all-cause mortality was observed. PMID:25887712

  4. Evaluation of the BD Max MRSA XT Assay for Use with Different Swab Types

    PubMed Central

    Hofko, Marjeta; Stock, Christian; Zimmermann, Stefan

    2014-01-01

    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

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

    PubMed

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

    2014-12-01

    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

  6. Total synthesis and absolute configuration assignment of MRSA active garcinol and isogarcinol.

    PubMed

    Socolsky, Cecilia; Plietker, Bernd

    2015-02-01

    A short total synthesis of (±)-garcinol and (±)-isogarcinol, two endo-type?B PPAPs with reported activity against methiciline resistant Staphylococcus aureus (MRSA), is presented. The separation of framework-constructing from framework-decorating steps and the application of two highly regio- and stereoselective Pd-catalysed allylations, that is, the Pd-catalysed decarboxylative Tsuji-Trost allylation and the diastereoselective Pd-catalysed allyl-allyl cross-coupling, are key elements that allowed the total synthesis to be accomplished within 13 steps starting from acetylacetone. After separation of the enantiomers the absolute configurations of the four natural products (i.e., (-)-garcinol, (+)-guttiferone?E (i.e., ent-garcinol), (-)-isogarcinol, and (+)-isoxanthochymol (i.e., ent-isogarcinol)) were assigned based on ECD spectroscopy. PMID:25537962

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

    SciTech Connect

    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

    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.

  8. Emergence of Hospital- and Community-Associated Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus aureus Genotype ST772-MRSA-V in Ireland and Detailed Investigation of an ST772-MRSA-V Cluster in a Neonatal Intensive Care Unit

    PubMed Central

    Shore, Anna C.; Corcoran, Suzanne; Tecklenborg, Sarah; Coleman, David C.; O'Connell, Brian

    2012-01-01

    Sequence type 22 (ST22) methicillin-resistant Staphylococcus aureus (MRSA) harboring staphylococcal cassette chromosome mec (SCCmec) IV (ST22-MRSA-IV) has predominated in Irish hospitals since the late 1990s. Six distinct clones of community-associated MRSA (CA-MRSA) have also been identified in Ireland. A new strain of CA-MRSA, ST772-MRSA-V, has recently emerged and become widespread in India and has spread into hospitals. In the present study, highly similar MRSA isolates were recovered from seven colonized neonates in a neonatal intensive care unit (NICU) in a maternity hospital in Ireland during 2010 and 2011, two colonized NICU staff, one of their colonized children, and a NICU environmental site. The isolates exhibited multiantibiotic resistance, spa type t657, and were assigned to ST772-MRSA-V by DNA microarray profiling. All isolates encoded resistance to macrolides [msr(A) and mpb(BM)] and aminoglycosides (aacA-aphD and aphA3) and harbored the Panton-Valentine leukocidin toxin genes (lukF-PV and lukS-PV), enterotoxin genes (sea, sec, sel, and egc), and one of the immune evasion complex genes (scn). One of the NICU staff colonized by ST772-MRSA-V was identified as the probable index case, based on recent travel to India. Seven additional hospital and CA-ST772-MRSA-V isolates recovered from skin and soft tissue infections in Ireland between 2009 and 2011 exhibiting highly similar phenotypic and genotypic characteristics to the NICU isolates were also identified. The clinical details of four of these patients revealed connections with India through ethnic background or travel. Our study indicates that hospital-acquired and CA-ST772-MRSA-V is currently emerging in Ireland and may have been imported from India on several occasions. PMID:22189119

  9. Genetic diagnosis of community-acquired MRSA: a multiplex real-time PCR method for Staphylococcal cassette chromosome mec typing and detecting toxin genes.

    PubMed

    Motoshima, Maiko; Yanagihara, Katsunori; Morinaga, Yoshitomo; Matsuda, Junichi; Sugahara, Kazuyuki; Yamada, Yasuaki; Kohno, Shigeru; Kamihira, Shimeru

    2010-02-01

    Methicillin-resistant Staphylococcus aureus (MRSA) causes a wide range of infections in health care settings and community environments. In particular, community-acquired MRSA (CA-MRSA) is important for clinicians because many fatal cases in healthy populations have been reported. Staphylococcal cassette chromosome mec (SCCmec) is a mobile genetic element and carries the central determinant for broad-spectrum beta-lactam resistance encoded by the mecA gene. The emergence of MRSA is due to the acquisition and insertion of the SCCmec element into the chromosome. CA-MRSA is characterized as SCCmec type IV. Thus, we aimed to establish a novel multiplex real-time PCR method to distinguish SCCmec type, which enables us to evaluate the pathogenicity of MRSA. A total of 778 MRSA were isolated at Nagasaki University Hospital from 2000 to 2007. All isolates were subjected to minimal inhibitory concentration testing and PCR for SCCmec typing and detecting genes of toxins: tst (toxic shock syndrome toxin 1), sec (encoded enterotoxin type c), etb (exfoliative toxin type b), and lukS/F-PV (Panton-Valentine leukocidin). PCR was performed to amplify a total of 10 genes in the same run. The 667 MRSA clones detected from pus in 778 clones were classified as SCCmec type II (77.7%), type IV (19.2%), and type I (3.0%). 87.5% of SCCmec type II clone had tst and sec genes. No isolate was lukS/F-PV positive. The present study indicates the high rate of lukS/F-PV-negative SCCmec type IV in Nagasaki. Our PCR method is convenient for typing MRSA and detecting toxins in Japan. PMID:20139668

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  12. The most important contact sensitizers in Polish children and adolescents with atopy and chronic recurrent eczema as detected with the extended European Baseline Series.

    PubMed

    Czarnobilska, Ewa; Obtulowicz, Krystyna; Dyga, Wojciech; Spiewak, Radoslaw

    2011-03-01

    The differential diagnostic work-up of children with chronic eczema should involve patch testing, also in cases with confirmed atopy. In our previous study, contact allergy was detected in every second child with chronic eczema. The aim of the present study was to identify the most important sensitizers in atopic children with eczema. During an allergy screening program, 103 consecutive children aged 7-8 and 93 adolescents aged 16-17 were enrolled. The inclusion criterion was chronic recurrent eczema as detected with the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and atopy, defined as positive skin prick test to one or more common airborne or food allergens. The children were patch-tested with the newly extended European Baseline Series (EBS, 28 test substances) supplemented with propolis, thimerosal, benzalkonium chloride, and 2-phenoxyethanol. In total, 67.0% children and 58.1% adolescents were found patch test positive. Among children, 35.9% reacted to nickel, 16.5% propolis, 11.7% thimerosal, 9.7% cobalt, each 6.8% fragrance mix (FM) I and chromium, and 5.8% to FM II. Among adolescents, 37.6% reacted to thimerosal, 19.4% to nickel, 6.5% to cobalt, and 5.4% to propolis. We demonstrate the advantage of using FM II - a new addition to the EBS that detects a relatively high proportion of contact hypersensitivity among children. An important sensitizer from outside EBS is propolis, which according to the frequency of sensitization occupies rank 2 in children and rank 4 in adolescents. These data show that propolis should be included into routine patch testing in children. PMID:20969635

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

    Microsoft Academic Search

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

    2008-01-01

    Atopic eczema (AE) is a chronic skin disease. Recent reports indicate that the worldwide prevalence of AE is increasing and\\u000a that various environmental factors are implicated in its aetiology. Climatic conditions have been related with AE prevalence,\\u000a and Spain has varying climatic conditions. The aim of this study is to document the possible climatic influence on the prevalence\\u000a of AE

  14. Association of attention-deficit\\/hyperactivity disorder and atopic eczema modified by sleep disturbance in a large population-based sample

    Microsoft Academic Search

    Marcel Romanos; Manfred Gerlach; Andreas Warnke; Jochen Schmitt

    2009-01-01

    BackgroundA cross-sectional study was performed in a population-based German sample (n=13 318 children and adolescents aged 3–17) to replicate the recently reported independent association of atopic eczema (AE) and attention-deficit\\/hyperactivity disorder (ADHD) and to further investigate the role of environmental and behavioural factors.MethodsThe odds ratio (OR) was calculated with allergic comorbidity and various environmental factors considered as confounders and sleeping

  15. High-Dose Ultraviolet A1 (UVA1), but Not UVA\\/UVB Therapy, Decreases IgE-Binding Cells in Lesional Skin of Patients with Atopic Eczema

    Microsoft Academic Search

    Jürgen Grabbe; Pia Welker; Stefanie Humke; Markus Grewe; Erwin Schöpf; Beate M. Henz; Jean Krutmann

    1996-01-01

    In order to further elucidate the mechanisms by which high-dose ultraviolet A1 (UVA1) therapy leads to improvement in patients with atopic eczema, we assessed skin sections from patients before and after high-dose UVA1 therapy (n = 5) or conventional UVA\\/UVB therapy (n = 4) for changes in Langerhans cells and mast cells expressing the high-affinity IgE receptor Fc?RI and in

  16. Successful treatment of young-onset adult T cell leukemia/lymphoma and preceding chronic refractory eczema and corneal injury by allogeneic hematopoietic stem cell transplantation.

    PubMed

    Miyamura, Fumiya; Kako, Shinichi; Yamagami, Hiroko; Sato, Ken; Sato, Miki; Terasako, Kiriko; Kimura, Shun-Ichi; Nakasone, Hideki; Aoki, Satoko; Okuda, Shinya; Yamazaki, Rie; Oshima, Kumi; Yoshinaga, Kentaro; Higuchi, Takakazu; Nishida, Junji; Demitsu, Toshio; Kakehashi, Akihiro; Kanda, Yoshinobu

    2009-10-01

    Only some carriers of human T cell lymphotropic virus type I (HTLV-1) develop adult T cell leukemia/lymphoma (ATLL) after a long latency period, and an association has been reported between chronic refractory eczema, known as infective dermatitis, and young-onset ATLL. A 25-year-old female developed ATLL and underwent allogeneic hematopoietic stem cell transplantation (HSCT) in non-remission. She had chronic refractory eczema and corneal injury at the onset of ATLL. Remission of ATLL was achieved, and the HTLV-1 proviral load decreased after HSCT. In addition, her pre-existing eczema and corneal injuries almost disappeared. More than a year has passed since the transplantation was performed, and she has had no recurrence of either ATLL or lesions in the skin and eye. Her clinical course suggests a possible association between skin and eye lesions and HTLV-1 infection. Changes in the immunological condition after HSCT might play a key role. Special attention is needed when HTLV-1 carriers develop eye or skin lesions. PMID:19705056

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    2009-06-01

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

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

    PubMed Central

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

    2014-01-01

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

  20. Development of eczema vaccinatum in atopic mouse models and efficacy of MVA vaccination against lethal poxviral infection.

    PubMed

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

    2014-01-01

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

  1. Antibacterial activity of stilbene oligomers against vancomycin-resistant Enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) and their synergism with antibiotics.

    PubMed

    Sakagami, Yoshikazu; Sawabe, Akiyoshi; Komemushi, Sadao; All, Zulfiqar; Tanaka, Toshiyuki; Iliya, Ibrahim; Iinuma, Munekazu

    2007-03-01

    Two resveratrol trimers, gnemonol B isolated from Gnetum gnemon and gnetin E obtained from the Gnetum species, were found to exhibit strong antibacterial activities against vancomycin-resistant Enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA). The MIC values of gnemonol B against five strains of VRE and nine strains of MRSA were 12.5 and 6.25 microg/ml, respectively. The MIC values of gnetin E against five strains of VRE and nine strains of MRSA ranged from 12.5 to 25microg/ml. These compounds also showed synergistic effects when used in combination with commercially available antibiotics according to the evaluation method using FIC indices. These findings suggested that the application of the test compounds alone or in combination with antibiotics might be useful in controlling and treating VRE and MRSA infections PMID:17408003

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

    PubMed

    Agner, T

    1992-01-01

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

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

    PubMed Central

    2014-01-01

    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

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

    PubMed

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

    2015-08-01

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

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

    PubMed Central

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

    2014-01-01

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

  6. MRSA screening: can one swab be used for both culture and rapid testing? An evaluation of chromogenic culture and subsequent Hain GenoQuick PCR amplification/detection.

    PubMed

    Sherlock, O; Dolan, A; Humphreys, H

    2010-07-01

    The use of a single swab for both MRSA culture and for rapid testing by PCR was evaluated, using the Hain GenoQuick (GQM) methicillin resistant Staphylococcus aureus (MRSA) assay for the rapid detection of MRSA, as a single swab would be the preferred option for routine diagnostic testing. GQM detected current prevalent Irish MRSA strains incorporating all known SSCmec types, including Panton-Valentine leukocidin-positive strains. Using the GQM method, all methicillin-resistant coagulase-negative staphylococci tested were confirmed to be negative, although three of seven gentamicin-resistant methicillin-sensitive Staphylococcus aureus strains tested were identified as MRSA. The theoretical ex-vivo limit of detection of the assay was 704 CFU per GQM assay reaction (1.7 × 10(4)?CFU/mL) when MRSA suspensions were used for DNA extraction, or 1.4 × 10(3)?CFU/swab (1.4 × 10(4)?CFU/mL) using MRSA absorbed onto Copan screening swabs. Swab processing on chromogenic agar prior to PCR resulted in some inhibition of the PCR reaction, increasing the limit of detection of the assay by a factor of four. Based on 540 single swab screening specimens (nasal and groin) processed first for culture assay, then by GQM, the specificity and positive predictive value were both 100%, the negative predictive value was 92%, and the sensitivity was 57%. Culture followed by PCR from a single specimen is not optimal for the rapid detection of MRSA. Further laboratory validation of the GQM assay is required to determine the true diagnostic sensitivity and value of this kit in routine microbiology laboratories, modifying the protocol for single specimens, or using two specimens. PMID:19889057

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

    PubMed Central

    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

    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

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

    PubMed Central

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

    2012-01-01

    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

  9. The STAT6 Gene Increases Propensity of Atopic Dermatitis Patients Toward Disseminated Viral Skin Infections

    PubMed Central

    Howell, Michael D; Gao, Peisong; Kim, Byung Eui; Lesley, Leighann J; Streib, Joanne E; Taylor, Patricia A; Zaccaro, Daniel J; Boguniewicz, Mark; Beck, Lisa A; Hanifin, Jon M; Schneider, Lynda C; Hata, Tissa R; Gallo, Richard L; Kaplan, Mark H; Barnes, Kathleen C; Leung, Donald YM

    2011-01-01

    Background Atopic dermatitis is a chronic inflammatory skin disease associated with increased susceptibility to recurrent skin infections. Objective To determine why a subset of atopic dermatitis patients have an increased risk of developing disseminated viral skin infections. Methods Human subjects with atopic dermatitis with a history of eczema herpeticum and various control groups were enrolled. Vaccinia virus expression was measured by PCR and immunofluorescent staining in skin biopsies from each study group after incubation with vaccinia virus. Transgenic mice with a constitutively active STAT6 gene were characterized for response to vaccinia virus skin inoculation. Genotyping for ten STAT6 single nucleotide polymorphisms (SNP) was performed in a European American sample (n=444). Results Vaccinia virus gene and protein expression were significantly increased in the skin of eczema herpeticum subjects, as compared to other subject groups, following incubation with vaccinia virus in vitro. Antibody neutralization of IL-4 and IL-13 resulted in lower vaccinia virus replication in subjects with a history of eczema herpeticum. Mice that expressed a constitutively active STAT6, compared to wild type mice, had increased mortality and satellite lesion formation following vaccinia virus skin inoculation. Significant associations were observed between STAT6 SNPs and eczema herpeticum (rs3024975, rs841718, rs167769, and rs703817) and IFN? production. The strongest association was observed for a 2-SNP (CT) haplotype (ADEH+ vs ADEH?, 24.9% vs 9.2% P = 5.17×10?6). Conclusion The STAT6 gene increases viral replication in the skin of atopic dermatitis patients with a history of eczema herpeticum. Further genetic association studies and functional investigations are warranted. PMID:21762972

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

    PubMed Central

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

    2015-01-01

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

  11. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in 12 New York hospitals. MRSA Collaborative Study Group.

    PubMed

    Roberts, R B; de Lencastre, A; Eisner, W; Severina, E P; Shopsin, B; Kreiswirth, B N; Tomasz, A

    1998-07-01

    Consecutive single-patient methicillin-resistant Staphylococcus aureus (MRSA) isolates (270) from 12 hospitals (8217 beds) in metropolitan New York City were collected during May 1996. In 11 of 12 hospitals, MRSA was most frequent in the general medical services. DNA typing ("fingerprinting") revealed that mecA:Tn554:PFGE (pulsed-field gel electrophoresis) type I:A:A accounted for 113 (42%) of 270 isolates, was detected in all hospitals, and was the predominant clone in 9. Thirteen of 15 I:E:F isolates were from 1 hospital, and the remaining 2 were from another hospital of the same health system. Type V:NH:E was isolated from 22 (79%) of the 28 patients with AIDS, including 8 of 9 patients from an additional hospital. Subtype V:NH:E2 was recovered from 11 patients, 9 of whom had AIDS, including all 5 AIDS patients from one floor of a nursing home affiliated with a third hospital. By using both mecA:Tn554 probes and PFGE, MRSA clusters and outbreaks may be detected and provide a rationale for appropriate infection control intervention. PMID:9652436

  12. Reversal of Ampicillin Resistance in MRSA via Inhibition of Penicillin-Binding Protein 2a by Acalypha wilkesiana

    PubMed Central

    Lim, Kuan-Hon

    2014-01-01

    The inhibitory activity of a semipure fraction from the plant, Acalypha wilkesiana assigned as 9EA-FC-B, alone and in combination with ampicillin, was studied against methicillin-resistant Staphylococcus aureus (MRSA). In addition, effects of the combination treatment on PBP2a expression were investigated. Microdilution assay was used to determine the minimal inhibitory concentrations (MIC). Synergistic effects of 9EA-FC-B with ampicillin were determined using the fractional inhibitory concentration (FIC) index and kinetic growth curve assay. Western blot experiments were carried out to study the PBP2a expression in treated MRSA cultures. The results showed a synergistic effect between ampicillin and 9EA-FC-B treatment with the lowest FIC index of 0.19 (synergism ? 0.5). The presence of 9EA-FC-B reduced the MIC of ampicillin from 50 to 1.56??g?mL?1. When ampicillin and 9EA-FC-B were combined at subinhibitory level, the kinetic growth curves were suppressed. The antibacterial effect of 9EA-FC-B and ampicillin was shown to be synergistic. The synergism is due the ability of 9EA-FC-B to suppress the activity of PBP2a, thus restoring the susceptibility of MRSA to ampicillin. Corilagin was postulated to be the constituent responsible for the synergistic activity showed by 9EA-FC-B. PMID:25101303

  13. Student Self-Screening for Methicillin-Resistant Staphylococcus Aureus (MRSA) Nasal Colonization in Hand Hygiene Education

    PubMed Central

    Lum, Tia; Picardo, Kristin; Westbay, Theresa; Barnello, Amber; Fine, Lynn

    2014-01-01

    Objective. To determine the feasibility and effectiveness of adding a hand hygiene exercise in self-screening for Methicillin-Resistant Staphylococcus Aureus (MRSA) nasal colonization to a health care delivery course for first-year pharmacy (P1) students. Design. About one month after students were trained in hand hygiene technique and indications, faculty members demonstrated how to self-screen for MRSA nasal colonization. Students were then asked to screen themselves during the required class time. Aggregated class results were shared and compared to prevalence estimates for the general population and health care providers. Assessment. The 71 students present in class on the day of the self-screening exercise chose to participate. A survey comparing presecreening and postscreening responses indicated incremental improvements in student knowledge and awareness of health care associated infections and motivation to perform hand hygiene. On the written exam, student performance demonstrated improved knowledge compared to previous class years. Conclusion. Self-screening for MRSA nasal colonization in a health care delivery course for P1 students increased students’ motivation to perform hand hygiene techniques and follow indications promulgated by the World Health Organization. PMID:25258443

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

    PubMed

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

    2014-01-01

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

  15. Exposure of Clinical MRSA Heterogeneous Strains to ?-Lactams Redirects Metabolism to Optimize Energy Production through the TCA Cycle

    PubMed Central

    Keaton, Mignon A.; Rosato, Roberto R.; Plata, Konrad B.; Singh, Christopher R.; Rosato, Adriana E.

    2013-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as one of the most important pathogens both in health care and community-onset infections. The prerequisite for methicillin resistance is mecA, which encodes a ?-lactam-insensitive penicillin binding protein PBP2a. A characteristic of MRSA strains from hospital and community associated infections is their heterogeneous expression of resistance to ?-lactam (HeR) in which only a small portion (?0.1%) of the population expresses resistance to oxacillin (OXA) ?10 µg/ml, while in other isolates, most of the population expresses resistance to a high level (homotypic resistance, HoR). The mechanism associated with heterogeneous expression requires both increase expression of mecA and a mutational event that involved the triggering of a ?-lactam-mediated SOS response and related lexA and recA genes. In the present study we investigated the cellular physiology of HeR-MRSA strains during the process of ?-lactam-mediated HeR/HoR selection at sub-inhibitory concentrations by using a combinatorial approach of microarray analyses and global biochemical profiling employing gas chromatography/mass spectrometry (GC/MS) and liquid chromatography/mass spectrometry (LC/MS) to investigate changes in metabolic pathways and the metabolome associated with ?-lactam-mediated HeR/HoR selection in clinically relevant heterogeneous MRSA. We found unique features present in the oxacillin-selected SA13011-HoR derivative when compared to the corresponding SA13011-HeR parental strain that included significant increases in tricarboxyl citric acid (TCA) cycle intermediates and a concomitant decrease in fermentative pathways. Inactivation of the TCA cycle enzyme cis-aconitase gene in the SA13011-HeR strain abolished ?-lactam-mediated HeR/HoR selection demonstrating the significance of altered TCA cycle activity during the HeR/HoR selection. These results provide evidence of both the metabolic cost and the adaptation that HeR-MRSA clinical strains undergo when exposed to ?-lactam pressure, indicating that the energy production is redirected to supply the cell wall synthesis/metabolism, which in turn contributes to the survival response in the presence of ?-lactam antibiotics. PMID:23940684

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

    PubMed Central

    Workman, Rella

    2014-01-01

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

  17. High incidence of oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with bovine mastitis in China.

    PubMed

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

    2014-01-01

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

  18. [Investigations into the use of respiratory masks for reducing the MRSA-exposure of veterinarians visiting regularly pig herds--first experiences].

    PubMed

    Nathaus, Rolf; Schulz, Jochen; Hartung, Jörg; Cuny, Christiane; Fetsch, Alexandra; Blaha, Thomas; Meemken, Diana

    2011-01-01

    The study presents first experiences on the controlled use of respiratory masks against Methicillin-resistant Staphylococcus aureus (MRSA) in a multi-person veterinary pig practice. Seven veterinarians entered the trial (five wearing masks, two wearing no masks) after the veterinarians had performed a decolonisation protocol. The pig herds were visited regularly by the veterinarians during the study period. The five "trial" veterinarians wore gloves and respiratory masks for at least 30 days and 30 farm visits. The two "control" veterinarians wore gloves only. Nasal swabs were collected at a seven day interval. Swabs and ten masks per "trial" veterinarian were bacteriologically tested for MRSA including MLST- and spa-typing. The study showed a high MRSA-exposure for the veterinarians, since 68% of the masks were tested positive for MRSA. However, four vets stayed MRSA-negative while using the masks. Only one of the"trial" veterinarians became positive after two weeks. After the masks were not worn any more, two veterinarians returned to colonisation soon again. The two "control" veterinarians turned positive after 26 and 54 days, respectively. The high finding-rates of MRSA in the masks proof an enormous risk of nasal colonisation during routine work.The results of our study do not proof the potential of respiratory masks to prevent nasal colonisation of veterinarians with MRSA. However, there are no hints, that the proper use of masks could be a risk factor for becoming colonised. Further details of the proper use of masks and the quantification of their protective potential need further studies on a larger scale. PMID:21465769

  19. 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

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

    2013-12-14

    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

  20. Bacteriophage-aided intracellular killing of engulfed methicillin-resistant Staphylococcus aureus (MRSA) by murine macrophages.

    PubMed

    Kaur, Sandeep; Harjai, Kusum; Chhibber, Sanjay

    2014-05-01

    Phages are known to effectively kill extracellularly multiplying bacteria as they do not have the ability of intracellular penetration within the animal cells. However, the present manuscript focuses on studying the impact of surface-adsorbed phage particles on the killing of engulfed Staphylococcus aureus inside phagocytic cells. Mouse peritoneal macrophages were isolated and cultured, followed by evaluation of their ability of bacterial uptake and killing. The intracellular killing potential of macrophages in the presence of unadsorbed free phage as well as phage adsorbed onto S. aureus 43300 was studied. Phage added alone to macrophage preparation did not influence intracellular killing of engulfed S. aureus by macrophages. However, phage adsorbed onto host bacterial cells (utilizing host bacteria as a vehicle to carry the lytic phage into the phagocytic compartment) brought about time-dependent and titre-dependent significant reduction in the number of viable intracellular cocci. Phage particles that shuttled inside the macrophage along with bacteria also significantly reduced cytotoxic damage caused by methicillin-resistant S. aureus (MRSA). This in turn enhanced the bactericidal killing potential of phagocytic cells. In earlier studies the inability of phages to kill intracellular bacteria has been thought to be a major drawback of phage therapy. For the first time results of this study confirm the killing ability of the broad host range lytic phage MR-5 of both extracellular as well as intracellular engulfed S. aureus inside macrophages. This approach shall not only restrict intracellular proliferation of staphylococci within the myeloid cells but also protect the host from further relapse of infection and treatment failures. PMID:24633444

  1. Variants of the FADS1 FADS2 Gene Cluster, Blood Levels of Polyunsaturated Fatty Acids and Eczema in Children within the First 2 Years of Life

    Microsoft Academic Search

    Peter Rzehak; Carel Thijs; Marie Standl; Monique Mommers; Claudia Glaser; Eugène Jansen; Norman Klopp; Gerard H. Koppelman; Paula Singmann; Dirkje S. Postma; Stefanie Sausenthaler; Pieter C. Dagnelie; Piet A. van den Brandt; Berthold Koletzko; Joachim Heinrich

    2010-01-01

    BackgroundAssociation of genetic-variants in the FADS1-FADS2-gene-cluster with fatty-acid-composition in blood of adult-populations is well established. We analyze this genetic-association in two children-cohort-studies. In addition, the association between variants in the FADS-gene-cluster and blood-fatty-acid-composition with eczema was studied.Methods and Principal FindingsData of two population-based-birth-cohorts in the Netherlands and Germany (KOALA, LISA) were pooled (n = 879) and analyzed by (logistic) regression

  2. Prevalence of asthma, rhinitis and eczema among children in 2 Canadian cities: the International Study of Asthma and Allergies in Childhood

    PubMed Central

    Habbick, B F; Pizzichini, M M; Taylor, B; Rennie, D; Senthilselvan, A; Sears, M R

    1999-01-01

    BACKGROUND: Wide variations in the prevalence of asthma, rhinitis and eczema have been reported between regions within Canada and between different countries. The International Study of Asthma and Allergies in Childhood (ISAAC) was developed to provide a standardized tool and methodology to ascertain the prevalence of asthma and allergies in different regions. Comparisons of prevalence rates across geographic regions and at different times may help to identify factors that contribute to the development of these conditions in individuals. METHODS: Two Canadian centres, Hamilton and Saskatoon, participated in the ISAAC. A standard questionnaire was distributed through schools and completed by 13- and 14-year-old children and by the parents of 6- and 7-year-old children. Prevalence rates and 95% confidence intervals were calculated for asthma, wheezing, rhinitis and eczema. RESULTS: The overall response rates were 75.1% among the children 6 and 7 years old and 68.6% among those 13 and 14 years old. Among the younger children, the lifetime prevalence of asthma was 17.2% in Hamilton and 11.2% in Saskatoon; the corresponding rates among the older children were 19.2% and 12.2% respectively. The prevalence of wheezing in the 12 months before the survey in the younger group was 20.1% in Hamilton and 14.1% in Saskatoon; in the older group it was 30.6% and 24.0% respectively. The prevalence of rhinitis in the 12 months before the survey was 28.6% in Hamilton and 22.6% in Saskatoon in the younger group and 45.8% and 33.8% respectively in the older group. The prevalence of eczema was slightly higher in Saskatoon in both age groups. INTERPRETATION: High prevalence rates of asthma, rhinitis and eczema exist among school children in Hamilton and Saskatoon, similar to rates in other Western countries. Further studies are required to determine the factors associated with the high rates in the 2 regions and possible reasons for the higher rates in Hamilton. PMID:10405666

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

    PubMed Central

    2011-01-01

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

  4. A Panton-Valentine Leucocidin (PVL)Positive Community-Acquired Methicillin-Resistant Staphylococcus aureus (MRSA) Strain, Another Such Strain Carrying a Multiple-Drug Resistance Plasmid, and Other More-Typical PVL-Negative MRSA Strains Found in Japan

    Microsoft Academic Search

    Yoko Takizawa; Ikue Taneike; Saori Nakagawa; Tomohiro Oishi; Yoshiyuki Nitahara; Nobuhiro Iwakura; Kyoko Ozaki; Misao Takano; Teruko Nakayama; Tatsuo Yamamoto

    2005-01-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was collected from children with bullous impetigo in 2003 and 2004. One strain collected in 2003 was Panton-Valentine leucocidin (PVL) positive. In 2004, a multiple-drug-resistant PVL CA-MRSA strain was isolated from an athlete with a cutaneous abscess. These strains were analyzed by multilocus sequence typing, spa typing, agr typing, coagulase typing, staphylococcal cassette chromosome mec

  5. Development of a PCR-free electrochemical point of care test for clinical detection of methicillin resistant Staphylococcus aureus (MRSA).

    PubMed

    Corrigan, D K; Schulze, H; Henihan, G; Hardie, A; Ciani, I; Giraud, G; Terry, J G; Walton, A J; Pethig, R; Ghazal, P; Crain, J; Campbell, C J; Templeton, K E; Mount, A R; Bachmann, T T

    2013-11-21

    An MRSA assay requiring neither labeling nor amplification of target DNA has been developed. Sequence specific binding of fragments of bacterial genomic DNA is detected at femtomolar concentrations using electrochemical impedance spectroscopy (EIS). This has been achieved using systematic optimisation of probe chemistry (PNA self-assembled monolayer film on gold electrode), electrode film structure (the size and nature of the chemical spacer) and DNA fragmentation, as these are found to play an important role in assay performance. These sensitivity improvements allow the elimination of the PCR step and DNA labeling and facilitate the development of a simple and rapid point of care test for MRSA. Assay performance is then evaluated and specific direct detection of the MRSA diagnostic mecA gene from genomic DNA, extracted directly from bacteria without further treatment is demonstrated for bacteria spiked into saline (10(6) cells per mL) on gold macrodisc electrodes and into human wound fluid (10(4) cells per mL) on screen printed gold electrodes. The latter detection level is particularly relevant to clinical requirements and point of care testing where the general threshold for considering a wound to be infected is 10(5) cells per mL. By eliminating the PCR step typically employed in nucleic acid assays, using screen printed electrodes and achieving sequence specific discrimination under ambient conditions, the test is extremely simple to design and engineer. In combination with a time to result of a few minutes this means the assay is well placed for use in point of care testing. PMID:24093127

  6. Targeting of PBP1 by ?-lactams Determines recA/SOS Response Activation in Heterogeneous MRSA Clinical Strains

    PubMed Central

    Plata, Konrad B.; Riosa, Sarah; Singh, Christopher R.; Rosato, Roberto R.; Rosato, Adriana E.

    2013-01-01

    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

  7. Viral infections in atopic dermatitis: pathogenic aspects and clinical management.

    PubMed

    Wollenberg, Andreas; Wetzel, Stefanie; Burgdorf, Walter H C; Haas, Jürgen

    2003-10-01

    A number of different widespread and disseminated viral infections can occur in patients with atopic dermatitis. Eczema molluscatum is troublesome but not dangerous. Although eczema vaccinatum is rare, it is life-threatening and of increased concern as smallpox vaccinations are reintroduced as a response to possible bioterrorism. There is little information on the course of smallpox itself in atopic dermatitis. Eczema herpeticum is the most common member of this group; recent advances in understanding its pathogenesis might contribute to a more successful management of this serious complication. PMID:14564342

  8. Mechanism of Honey Bacteriostatic Action Against MRSA and VRE Involves Hydroxyl Radicals Generated from Honey’s Hydrogen Peroxide

    PubMed Central

    Brudzynski, Katrina; Lannigan, Robert

    2012-01-01

    It has been recently reported that honey hydrogen peroxide in conjunction with unknown honey components produced cytotoxic effects resulting in bacterial growth inhibition and DNA degradation. The objective of this study was twofold: (a) to investigate whether the coupling chemistry involving hydrogen peroxide is responsible for a generation of hydroxyl radicals and (b) whether •OH generation affects growth of multi-drug resistant clinical isolates. The susceptibility of five different strains of methicillin-resistant Staphylococcus aureus (MRSA) and four strains of vancomycin-resistant Enterococcus faecium (VRE) isolates from infected wounds to several honeys was evaluated using broth microdilution assay. Isolates were identified to genus and species and their susceptibility to antibiotics was confirmed using an automated system (Vitek®, Biomérieux®). The presence of the mec(A) gene, nuc gene and van(A) and (B) genes were confirmed by polymerase chain reaction. Results showed that no clinical isolate was resistant to selected active honeys. The median difference in honeys MICs against these strains ranged between 12.5 and 6.25% v/v and was not different from the MIC against standard Escherichia coli and Bacillus subtilis. Generation of •OH during bacteria incubation with honeys was analyzed using 3?-(p-aminophenyl) fluorescein (APF) as the •OH trap. The •OH participation in growth inhibition was monitored directly by including APF in broth microdilution assay. The growth of MRSA and VRE was inhibited by •OH generation in a dose-dependent manner. Exposure of MRSA and VRE to honeys supplemented with Cu(II) augmented production of •OH by 30-fold and increased honey bacteriostatic potency from MIC90 6.25 to MIC90< 0.78% v/v. Pretreatment of honeys with catalase prior to their supplementation with Cu ions fully restored bacterial growth indicating that hydroxyl radicals were produced from H2O2 via the Fenton-type reaction. In conclusion, we have demonstrated for the first time that bacteriostatic effect of honeys on MRSA and VRE was dose-dependently related to generation of •OH from honey H2O2. PMID:22347223

  9. Mechanism of Honey Bacteriostatic Action Against MRSA and VRE Involves Hydroxyl Radicals Generated from Honey's Hydrogen Peroxide.

    PubMed

    Brudzynski, Katrina; Lannigan, Robert

    2012-01-01

    It has been recently reported that honey hydrogen peroxide in conjunction with unknown honey components produced cytotoxic effects resulting in bacterial growth inhibition and DNA degradation. The objective of this study was twofold: (a) to investigate whether the coupling chemistry involving hydrogen peroxide is responsible for a generation of hydroxyl radicals and (b) whether (•)OH generation affects growth of multi-drug resistant clinical isolates. The susceptibility of five different strains of methicillin-resistant Staphylococcus aureus (MRSA) and four strains of vancomycin-resistant Enterococcus faecium (VRE) isolates from infected wounds to several honeys was evaluated using broth microdilution assay. Isolates were identified to genus and species and their susceptibility to antibiotics was confirmed using an automated system (Vitek(®), Biomérieux(®)). The presence of the mec(A) gene, nuc gene and van(A) and (B) genes were confirmed by polymerase chain reaction. Results showed that no clinical isolate was resistant to selected active honeys. The median difference in honeys MICs against these strains ranged between 12.5 and 6.25% v/v and was not different from the MIC against standard Escherichia coli and Bacillus subtilis. Generation of (•)OH during bacteria incubation with honeys was analyzed using 3'-(p-aminophenyl) fluorescein (APF) as the (•)OH trap. The (•)OH participation in growth inhibition was monitored directly by including APF in broth microdilution assay. The growth of MRSA and VRE was inhibited by (•)OH generation in a dose-dependent manner. Exposure of MRSA and VRE to honeys supplemented with Cu(II) augmented production of (•)OH by 30-fold and increased honey bacteriostatic potency from MIC(90) 6.25 to MIC(90)< 0.78% v/v. Pretreatment of honeys with catalase prior to their supplementation with Cu ions fully restored bacterial growth indicating that hydroxyl radicals were produced from H(2)O(2) via the Fenton-type reaction. In conclusion, we have demonstrated for the first time that bacteriostatic effect of honeys on MRSA and VRE was dose-dependently related to generation of (•)OH from honey H(2)O(2). PMID:22347223

  10. Galloylated flavonol rhamnosides from the leaves of Calliandra tergemina with antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    Chan, Elaine Wan Ling; Gray, Alexander I; Igoli, John O; Lee, Sui Mae; Goh, Joo Kheng

    2014-11-01

    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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  13. Synthesis and in vitro activity of dicationic bis-benzimidazoles as a new class of anti-MRSA and anti-VRE agents.

    PubMed

    Hu, Laixing; Kully, Maureen L; Boykin, David W; Abood, Norman

    2009-03-01

    A new class of novel bis-benzimidazole diamidine compounds have been synthesized and evaluated for in vitro antibacterial activities, including drug-resistant bacterial strains. Anti-MRSA and anti-VRE activities of the most potent compound 1 were more active than Vancomycin. The mechanism of action for this class of compounds appears to be different from existing antibiotics. Bis-benzimidazole diamidine compounds have potential for further investigation as a new class of potent anti-MRSA and anti-VRE agents. PMID:19208475

  14. Recommendations for the prevention and control of methicillin-resistant Staphylococcus aureus isolates (MRSA) in hospitals and other healthcare facilities.

    PubMed

    2009-01-01

    The Commission for Hospital Hygiene and Infection Control (KRINKO) at the Robert Koch-Institute Berlin published the "Recommendations for Preventing and Controlling Methicillin-Resistant Staphylococcus aureus (MRSA) Strains in Hospitals and Other Medical Facilities" in the Federal Health Gazette in 1999 [1]. These recommendations were translated for the current edition of GMS Krankenhaushygiene Interdisziplinär by the German Society of Hospital Hygiene.KRINKO's work is legitimated by section sign 23 para. 2 of the Infection Protection Act. Regarding the legal nature of the KRINKO recommendations, it should be noted that they are neither a formal act or an administrative regulation. The KRINKO recommendations are instead an evidence-based consensus of particularly qualified experts. The consensus is reached by including the Federal States' authorities and all competent professional bodies and associations. This is to guarantee that the KRINKO recommendations reflect the state-of-the-art of medical science, and are met with a high degree of user acceptance. The recommendations are published in the Federal Health Gazette and on the RKI's Internet pages (http://www.rki.de/).Link to the German original edition of the MRSA recommendations. PMID:20204101

  15. Predictors of Clinical Success in the Treatment of Patients with Methicillin-Resistant Staphylococcus aureus (MRSA) Nosocomial Pneumonia (NP)

    PubMed Central

    Shorr, Andrew F.; Puzniak, Laura A.; Biswas, Pinaki; Niederman, Michael S.

    2015-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) remains an important pathogen in nosocomial pneumonia and is associated with significant morbidity and mortality. Clinical outcomes for nosocomial pneumonia are dependent on patient age, co-morbidities, severity of illness and appropriate antibiotic therapy. The objective of this secondary analysis was to identify baseline clinical variables that are associated with clinical success at the end of the study observation period. Data from a randomized blinded trial (NCT00084266) comparing linezolid (600-mg twice daily) to vancomycin (15-mg/kg twice daily, dose-adjusted) for the treatment of culture-proven MRSA pneumonia were analyzed to evaluate baseline clinical and demographic factors that may predict clinical success at end of study (EOS) (7-30 days after end of treatment). A multivariate logistic regression was conducted to identify baseline factors that are associated with clinical success. Patients treated with linezolid (OR 1.55 95% CI: 1.013, 2.355), no vasopressor receipt (OR 2.30, 95% CI: 1.303, 4.069), unilateral involvement (OR 1.70, 95% CI: 1.078, 2.681) and normal renal function (eGFR 30-80 vs >80 OR 0.48, 95% CI: 0.303, 0.750) were more likely to have clinical success. From a clinical standpoint, identifying reliable predictors of outcome and who might benefit more from one therapy versus another can help inform treatment decisions. PMID:26196695

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-09-24

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

  18. Caco-2 cells permeability evaluation of nifuroxazide derivatives with potential activity against methicillin-resistant Staphylococcus aureus (MRSA).

    PubMed

    B Fernandes, Mariane; Gonçalves, José E; C Tavares, Leoberto; Storpirtis, Sílvia

    2015-07-01

    Throughout the period of evaluation and selection in drug development, the assessment of the permeability potential of a compound to achieve an efficient refinement of the molecular structure has been widely appraised by the transport of substances across cell monolayers. This study aims to develop in vitro assays through Caco-2 cells in order to analyze the permeability of 5-nitro-heterocyclic compounds analogues to nifuroxazide with antimicrobial activity, especially showing promising activity against multidrug-resistant Staphylococcus aureus (MRSA). Caco-2 cell monolayers cultivated for 21 days in Transwell® plates were used for the in vitro permeability assays. The quantification of the nifuroxazide derivatives in the basolateral chambers was performed by a validated high performance liquid chromatography with UV (HPLC-UV) method. Apparent permeability values (Papp) show that these compounds can be considered as new drug candidates with the potential to present high absorption in vivo, according to the classifications of Yee and Biganzoli. The thiophenic derivatives showed permeability values higher than the furanic ones, being AminoTIO the compound with the greatest potential for the development of a new drug against MRSA, since it showed the best cytotoxicity, permeability and solubility ratio among all the derivatives. PMID:24918173

  19. TCA Cycle-Mediated Generation of ROS Is a Key Mediator for HeR-MRSA Survival under ?-Lactam Antibiotic Exposure

    PubMed Central

    Rosato, Roberto R.; Fernandez, Regina; Paz, Liliana I.; Singh, Christopher R.; Rosato, Adriana E.

    2014-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Khan, Yosef M.

    2012-01-01

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

  2. Syntheses and anti-MRSA activities of the C3 analogs of mansonone F, a potent anti-bacterial sesquiterpenoid: insights into

    E-print Network

    Suh, Young-Ger

    Syntheses and anti-MRSA activities of the C3 analogs of mansonone F, a potent anti-bacterial, the discovery of novel classes of anti-bacterial agents employing new mode of action is of great concern due anti-bacterial sesquiterpenoid.5 It has been shown to have excellent anti-bacterial activities against

  3. Eradication of MRSA from carriers by means of whole-body washing with an antiseptic in combination with mupirocin nasal ointment.

    PubMed

    Sloot, N; Siebert, J; Höffler, U

    1999-12-01

    Patients who are infected or colonised by MRSA should be isolated. However, isolation is very costly in terms of time and work. In order to shorten the period of isolation, attempts are being made to eradicate this organism from patients by means of whole-body washing in addition to nasal mupirocin treatment. The effectiveness of such washes has not yet been adequately confirmed by studies. From September 1997 to August 1998, therefore, in a clinical trial of MRSA eradication, 28 patients were washed for a period of five days with a 1:1 diluted preparation based on octenidine dihydrochloride. At the same time, the nose was treated with mupirocin. Before washing was begun, on day 4 during washing and on days 1, 4 and 7 after washing was completed, smears were taken from each patient from the nose, pharynx, forehead hairline, groin, axilla and wounds, and in the case of women from the sub-mammary area. Elimination of the MRSA was achieved in 21 out of 28 cases; in four cases the washing was discontinued on account of skin redness, in three cases no elimination could be achieved during the control period. In order to ensure the success of eradication and to minimise skin reactions due to the washing, the wash procedure must be standardised, and decontamination controlled microbiologically. The study confirms that MRSA can be eradicated by means of washing with an antiseptic combined with mupirocin treatment. PMID:10631792

  4. Eradication of MRSA from carriers by means of whole-body washing with an antiseptic in combination with Mupirocin nasal ointment

    Microsoft Academic Search

    Norbert Sloot; Jörg Siebert; Ulrich Höffler

    1999-01-01

    Patients who are infected or colonised by MRSA should be isolated. However, isolation is very costly in terms of time and work. In order to shorten the period of isolation, attempts are being made to eradicate this organism from patients by means of whole-body washing in addition to nasal mupirocin treatment. The effectiveness of such washes has not yet been

  5. A randomized, double-blind therapeutic trial of 0.25% desoxymethasone and 0.1% hydrocortisone 17-butyrate in the treatment of varicose eczema.

    PubMed

    Henry, M; Hanks, G; Whelan, A

    1980-01-01

    A double-blind, randomized trial was carried out in 60 patients with varicose (hypostatic) eczema to compare the efficacy and tolerance of treatment with 0.25% desoxymethasone in an oily cream base, the oily cream base alone, and 0.1% hydrocortisone 17-butyrate cream. The creams were applied twice daily and patients' progress followed for up to 38 days. Clinical ratings based on an assessment of individual signs and symptoms, the area of skin involved and the physician's overall impression demonstrated a significant difference from the oily cream base in favour of both active treatments within the first 10 days. No significant difference between the two active treatments was shown. All three treatments were well tolerated by the patients. PMID:6988176

  6. Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One

    PubMed Central

    2010-01-01

    The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One showed large worldwide variations in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, up to 10 to 20 fold between countries. Ecological analyses were undertaken with ISAAC Phase One data to explore factors that may have contributed to these variations, and are summarised and reviewed here. In ISAAC Phase One the prevalence of symptoms in the past 12 months of asthma, rhinoconjunctivitis and eczema were estimated from studies in 463,801 children aged 13 - 14 years in 155 centres in 56 countries, and in 257,800 children aged 6-7 years in 91 centres in 38 countries. Ecological analyses were undertaken between symptom prevalence and the following: Gross National Product per capita (GNP), food intake, immunisation rates, tuberculosis notifications, climatic factors, tobacco consumption, pollen, antibiotic sales, paracetamol sales, and outdoor air pollution. Symptom prevalence of all three conditions was positively associated with GNP, trans fatty acids, paracetamol, and women smoking, and inversely associated with food of plant origin, pollen, immunisations, tuberculosis notifications, air pollution, and men smoking. The magnitude of these associations was small, but consistent in direction between conditions. There were mixed associations of climate and antibiotic sales with symptom prevalence. The potential causality of these associations warrant further investigation. Factors which prevent the development of these conditions, or where there is an absence of a positive correlation at a population level may be as important from the policy viewpoint as a focus on the positive risk factors. Interventions based on small associations may have the potential for a large public health benefit. PMID:20092649

  7. In vitro activities of oritavancin and comparators against meticillin-resistant Staphylococcus aureus (MRSA) isolates harbouring the novel mecC gene.

    PubMed

    Arhin, Francis F; Sarmiento, Ingrid; Moeck, Gregory

    2014-07-01

    Meticillin-resistant Staphylococcus aureus (MRSA) is routinely detected by amplification of the mecA gene. Recently, MRSA isolates harbouring a novel mec gene (mecC) that is not detected by mecA amplification have been reported. In this study, the activities of the lipoglycopeptide oritavancin as well as the comparators vancomycin, daptomycin and linezolid against 14 mecC MRSA isolates were studied by broth microdilution minimum inhibitory concentration (MIC) and time-kill assays at clinically relevant concentrations of each antibacterial agent. Oritavancin, vancomycin, daptomycin and linezolid MIC90 values (MIC required to inhibit 90% of the isolates) against the mecC isolates were 0.06, 1, 1 and 2mg/L, respectively. In time-kill assays, oritavancin at concentrations reflective of its free peak in plasma of patients receiving a single 1200 mg intravenous dose and the level 24h thereafter was bactericidal against all isolates tested, attaining 3 log kill relative to the starting inoculum between 5 min and 15 min. Vancomycin both at its free peak and free trough concentrations was also bactericidal against all isolates, attaining bactericidal activity between 6h and 24h. Daptomycin was bactericidal only at its free peak concentration, attaining bactericidal activity between 30 min and 4h against the tested isolates. Linezolid was bacteriostatic (<3 log kill relative to the starting inoculum) against the tested isolates. Oritavancin's in vitro activity against mecC MRSA isolates was indistinguishable from that against mecA MRSA isolates both in MIC and time-kill assays. PMID:24906505

  8. Co-Therapy Using Lytic Bacteriophage and Linezolid: Effective Treatment in Eliminating Methicillin Resistant Staphylococcus aureus (MRSA) from Diabetic Foot Infections

    PubMed Central

    Chhibber, Sanjay; Kaur, Tarsem; Sandeep Kaur

    2013-01-01

    Background Staphylococcus aureus remains the predominant pathogen in diabetic foot infections and prevalence of methicillin resistant S.aureus (MRSA) strains further complicates the situation. The incidence of MRSA in infected foot ulcers is 15–30% and there is an alarming trend for its increase in many countries. Diabetes acts as an immunosuppressive state decreasing the overall immune functioning of body and to worsen the situation, wounds inflicted with drug resistant strains represent a morbid combination in diabetic patients. Foot infections caused by MRSA are associated with an increased risk of amputations, increased hospital stay, increased expenses and higher infection-related mortality. Hence, newer, safer and effective treatment strategies are required for treating MRSA mediated diabetic foot infections. The present study focuses on the use of lytic bacteriophage in combination with linezolid as an effective treatment strategy against foot infection in diabetic population. Methodology Acute hindpaw infection with S.aureus ATCC 43300 was established in alloxan induced diabetic BALB/c mice. Therapeutic efficacy of a well characterized broad host range lytic bacteriophage, MR-10 was evaluated alone as well as in combination with linezolid in resolving the course of hindpaw foot infection in diabetic mice. The process of wound healing was also investigated. Results and Conclusions A single administration of phage exhibited efficacy similar to linezolid in resolving the course of hindpaw infection in diabetic animals. However, combination therapy using both the agents was much more effective in arresting the entire infection process (bacterial load, lesion score, foot myeloperoxidase activity and histopathological analysis). The entire process of tissue healing was also hastened. Use of combined agents has been known to decrease the frequency of emergence of resistant mutants, hence this approach can serve as an effective strategy in treating MRSA mediated foot infections in diabetic individuals who do not respond to conventional antibiotic therapy. PMID:23418497

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

    PubMed Central

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

    2015-01-01

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

  10. Concurrent analysis of nose and groin swab specimens by the IDI-MRSA PCR assay is comparable to analysis by individual-specimen PCR and routine culture assays for detection of colonization by methicillin-resistant Staphylococcus aureus.

    PubMed

    Bishop, Emma J; Grabsch, Elizabeth A; Ballard, Susan A; Mayall, Barrie; Xie, Shirley; Martin, Rhea; Grayson, M Lindsay

    2006-08-01

    The IDI-MRSA assay (Infectio Diagnostic, Inc., Sainte-Foy, Quebec, Canada) with the Smart Cycler II rapid DNA amplification system (Cepheid, Sunnyvale, CA) appears to be sensitive and specific for the rapid detection of nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). We assessed the sensitivity and specificity of this assay under conditions in which both the nose and cutaneous groin specimens were analyzed together and compared the accuracy of this PCR approach to that when these specimens were tested separately and by culture assays in an inpatient population with known high rates (12 to 15%) of MRSA colonization. Of 211 patients screened, 192 had results assessable by all three methods (agar-broth culture, separate nose and groin IDI-MRSA assay, and combined nose-groin IDI-MRSA assay), with MRSA carriage noted in 31/192 (16.1%), 41/192 (21.4%), and 36/192 (18.8%) patients by each method, respectively. Compared to agar culture results, the sensitivity and specificity of the combined nose-groin IDI-MRSA assay were 88.0% and 91.6%, respectively, whereas when each specimen was processed separately, the sensitivities were 90.0% (nose) and 83.3% (groin) and the specificities were 91.7% (nose) and 90.2% (groin). IDI-MRSA assay of a combined nose-groin specimen appears to have an accuracy similar to that of the current recommended PCR protocol, providing results in a clinically useful time frame, and may represent a more cost-effective approach to using this assay for screening for MRSA colonization. PMID:16891510

  11. Ten-year decrease of acquired methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at a single institution: the result of a multifaceted program combining cross-transmission prevention and antimicrobial stewardship

    PubMed Central

    2012-01-01

    Background In France, the proportion of MRSA has been over 25% since 2000. Prevention of hospital-acquired (HA) MRSA spread is based on isolation precautions and antibiotic stewardship. At our institution, before 2000, the Infection Disease and the Infection Control teams had failed to reduce HA-MRSA rates. Objectives and methods We implemented a multifaceted hospital-wide prevention program and measured the effects on HA-MRSA colonization and bacteremia rates between 2000 and 2009. From 2000 to 2003, active screening and decontamination of ICU patients, hospital wide alcohol based hand rubs (ABHR) use, control of specific classes of antibiotics, compliance audits, and feed-backs to the care providers were successively implemented. The efficacy of the program was assessed by HA-MRSA colonized and bacteremic patient rates per 1000 patient-days in patients hospitalized for more than twenty-four hours. Results Compliance with the isolation practices increased between 2000 and 2009. Consumption of ABHR increased from 6.8?L to 27.5?L per 1000 patient-days. The use of antibiotic Defined Daily Doses (DDD) per 1000 patient-days decreased by 31%. HA-MRSA colonization decreased by 84% from 1.09 to 0.17 per 1000 patient-days and HA-MRSA bacteremia by 93%, from 0.15 to 0.01 per 1000 patient-days (p?MRSA, a multifaceted prevention program allows for sustainable reduction in HA-MRSA bacteremia rates. PMID:22958346

  12. Use of gaseous ozone for eradication of methicillin-resistant Staphylococcus aureus from the home environment of a colonized hospital employee.

    PubMed

    de Boer, Hero E L; van Elzelingen-Dekker, Carla M; van Rheenen-Verberg, Cora M F; Spanjaard, Lodewijk

    2006-10-01

    An intensive care nurse with eczema was repeatedly treated for methicillin-resistant Staphylococcus aureus (MRSA) carriage. Because cultures remained positive for MRSA, her house was investigated. Thirty-four percent of environmental samples yielded MRSA. Her children and cat were free of MRSA. The house was decontaminated with gaseous ozone. All subsequent cultures were negative for MRSA. This decontamination cost Euros 2,000 (approximately Dollars 2,400). PMID:17006820

  13. Use of Gaseous Ozone for Eradication of Methicillin-Resistant Staphylococcus aureus From the Home Environment of a Colonized Hospital Employee

    Microsoft Academic Search

    Hero E. L. de Boer; Carla M. van Elzelingen-Dekker; Cora M. F. van Rheenen-Verberg; Lodewijk Spanjaard

    An intensive care nurse with eczema was repeatedly treated for meth- icillin-resistant Staphylococcus aureus (MRSA) carriage. Because cul- tures remained positive for MRSA, her house was investigated. Thirty-four percent of environmental samples yielded MRSA. Her children and cat were free of MRSA. The house was decontaminated with gaseous ozone. All subsequent cultures were negative for MRSA. This decontamination cost i2,000

  14. A randomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol

    PubMed Central

    Thompson, Gillian; Blackwood, Bronagh; McMullan, Ronan; Alderdice, Fiona A; Trinder, T John; Lavery, Gavin G; McAuley, Danny F

    2008-01-01

    Background Over the past ten years MRSA has become endemic in hospitals and is associated with increased healthcare costs. Critically ill patients are most at risk, in part because of the number of invasive therapies that they require in the intensive care unit (ICU). Washing with 5% tea tree oil (TTO) has been shown to be effective in removing MRSA on the skin. However, to date, no trials have evaluated the potential of TTO body wash to prevent MRSA colonization or infection. In addition, detecting MRSA by usual culture methods is slow. A faster method using a PCR assay has been developed in the laboratory, but requires evaluation in a large number of patients. Methods/Design This study protocol describes the design of a multicentre, phase II/III prospective open-label randomized controlled clinical trial to evaluate whether a concentration of 5% TTO is effective in preventing MRSA colonization in comparison with a standard body wash (Johnsons Baby Softwash) in the ICU. In addition we will evaluate the cost-effectiveness of TTO body wash and assess the effectiveness of the PCR assay in detecting MRSA in critically ill patients. On admission to intensive care, swabs from the nose and groin will be taken to screen for MRSA as per current practice. Patients will be randomly assigned to be washed with the standard body wash or TTO body wash. On discharge from the unit, swabs will be taken again to identify whether there is a difference in MRSA colonization between the two groups. Discussion If TTO body wash is found to be effective, widespread implementation of such a simple colonization prevention tool has the potential to impact on patient outcomes, healthcare resource use and patient confidence both nationally and internationally. Trial Registration [ISRCTN65190967] PMID:19040726

  15. Predictors of mortality in patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia: the role of empiric antibiotic therapy.

    PubMed

    Gómez, J; García-Vázquez, E; Baños, R; Canteras, M; Ruiz, J; Baños, V; Herrero, J A; Valdés, M

    2007-04-01

    The objective of this study was to evaluate prognostic factors and the influence of different empiric antibiotic therapies on outcome and mortality in a cohort of 100 inpatients with bacteraemia (84 cases nosocomial) caused by methicillin-resistant Staphylococcus aureus (MRSA). Patients were investigated by means of a standard protocol at a 944-bed hospital in the years 2000-2004. Empiric antibiotic therapies included vancomycin (n = 49), teicoplanin (n = 20), linezolid (n = 17), other antibiotics active in vitro (n = 7), and inactive antibiotics (n = 7). Overall mortality was 40% (12% among linezolid-treated patients; 46.3% among glycopeptide-treated patients). In bivariate analyses, the following factors were statistically associated with higher mortality: rapidly fatal underlying disease, altered mental status, metabolic acidosis, and acute severe clinical condition at the onset of bacteraemia; development of complications (septic shock, renal failure, and disseminated intravascular coagulopathy); empiric monotherapy with glycopeptides (vs combination therapy with an aminoglycoside); and inadequate empiric treatment. Empiric therapy with linezolid was associated with lower mortality. In multivariate analysis, risk factors associated with higher mortality included acute severity of illness (OR 7.49; 95%CI 1.19-25.3) and altered mental status (OR 4.83; 95%CI 1.22-19.15) at onset, complications (OR 3.42; 95%CI 1.02-17.46), and inappropriate empiric treatment (OR 7.6; 95%CI 1.87-31.14). In multivariate analysis limited to patients who received empiric therapy with either linezolid (n = 17) or glycopeptides (n = 69), linezolid was associated with greater rates of survival (OR 7.7; 95%CI 1.1-53) and microbiological eradication (OR 11.76; 95%CI 1.46-90.9) but not with fewer complications (OR 0.71; 95%CI 0.16-3.25). In conclusion, the main prognostic factors associated with mortality in patients with MRSA bacteraemia are complications, acute severe clinical condition at onset, and inappropriate empiric treatment. Empiric therapy with linezolid was associated with greater survival and more successful microbiological eradication but did not reduce complications. PMID:17318479

  16. Evaluation of MRSA-Screen, a Simple Anti-PBP 2a Slide Latex Agglutination Kit, for Rapid Detection of Methicillin Resistance in Staphylococcus aureus

    Microsoft Academic Search

    MATTHIAS CAVASSINI; ALINE WENGER; KATIA JATON; DOMINIQUE S. BLANC; JACQUES BILLE

    1999-01-01

    The MRSA-Screen test (Denka Seiken Co., Ltd., Tokyo, Japan), consisting of a slide latex agglutination kit that detects PBP 2a with a monoclonal antibody, was blindly compared to the oxacillin disk diffusion test, the oxacillin-salt agar screen, and PCR of the mecA gene for the detection of methicillin resistance in Staphylococcus aureus. A total of 120 methicillin-susceptible S. aureus (MSSA)

  17. Quercetin 3-O-rutinoside mediated inhibition of PBP2a: computational and experimental evidence to its anti-MRSA activity.

    PubMed

    Rani, Nidhi; Vijayakumar, Saravanan; Thanga Velan, Lakshmi Palanisamy; Arunachalam, Annamalai

    2014-12-01

    The PBP2a is a cell wall synthesizing protein, which causes resistivity in methicillin resistant Staphylococcus aureus (MRSA) from ?-lactam antibiotics but it is susceptible to 5th generation cephalosporin, ceftobiprole. Ceftobiprole inhibits the growth of MRSA by targeting the PBP2a-mediated cell wall synthesis, but it is reported to have adverse side effects. Due to this, there is a constant need to develop natural alternatives, which are generally free from adverse side effects. Hence in this study, in silico based docking analysis was performed with 37 quercetin derivatives towards PBP2a inhibition and their efficiencies were compared with ?-lactam antibiotic, ceftobiprole. The docking studies suggested that quercetin 3-O-rutinoside (ZINC5280805) interacted efficiently with PBP2a, attaining the highest LibDock score (187.32) compared to other quercetin derivatives. The structural stability and dynamics of the identified lead with PBP2a were validated through molecular dynamics simulation. Simulation results such as RMSD, RMSF, and Rg values indicated that the stability of quercetin 3-O-rutinoside with PBP2a was better, with respect to the un-ligated PBP2a. Furthermore, the quercetin 3-O-rutinoside was subjected to an antibacterial susceptibility test and found to have antibacterial activity at 500, 700, and 900 ?M concentration. Also, morphological changes in the bacterial colony and bacterial surface were observed using a scanning electron microscope, when MRSA was treated with 900 ?M concentration of quercetin 3-O-rutinoside. Collectively, results from this study suggest that the quercetin 3-O-rutinoside has the capability to inhibit PBP2a and hence could be used as an alternative or in combination with other drugs in treating MRSA infection. PMID:25286279

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

    PubMed

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

    2015-03-23

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

  19. Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study

    Microsoft Academic Search

    J A Cepeda MRCP; B Cooper; S Hayman; Jorge A Cepeda; Tony Whitehouse; Janeane Hails; Karen Jones; Felicia Kwaku; Lee Taylor; Barry Cookson; Steve Shaw; Chris Kibbler; Mervyn Singer

    2005-01-01

    Background Hospital-acquired infection due to meticillin-resistant Staphylococcus aureus (MRSA) is common within intensive-care units. Single room or cohort isolation of infected or colonised patients is used to reduce spread, but its benefit over and above other contact precautions is not known. We aimed to assess the effectiveness of moving versus not moving infected or colonised patients in intensive-care units to

  20. Molecular modeling, dynamics studies and virtual screening of Fructose 1, 6 biphosphate aldolase-II in community acquired- methicillin resistant Staphylococcus aureus (CA-MRSA)

    PubMed Central

    Yadav, Pramod Kumar; Singh, Gurmit; Gautam, Budhayash; Singh, Satendra; Yadav, Madhu; Srivastav, Upasana; Singh, Brijendra

    2013-01-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has recently emerged as a nosocomial pathogen to the community which commonly causes skin and soft-tissue infections (SSTIs). This strain (MW2) has now become resistant to the most of the beta-lactam antibiotics; therefore it is the urgent need to identify the novel drug targets. Recently fructose 1,6 biphosphate aldolase-II (FBA) has been identified as potential drug target in CA-MRSA. The FBA catalyses the retro-ketolic cleavage of fructose-1,6-bisphosphate (FBP) to yield dihydroxyacetone phosphate (DHAP) and glyceraldehyde-3-phosphate (G3P) in glycolytic pathway. In the present research work the 3D structure of FBA was predicted using the homology modeling method followed by validation. The molecular dynamics simulation (MDS) of the predicted model was carried out using the 2000 ps time scale and 1000000 steps. The MDS results suggest that the modeled structure is stable. The predicted model of FBA was used for virtual screening against the NCI diversity subset-II ligand databases which contain 1364 compounds. Based on the docking energy scores, it was found that top four ligands i.e. ZINC01690699, ZINC13154304, ZINC29590257 and ZINC29590259 were having lower energy scores which reveal higher binding affinity towards the active site of FBA. These ligands might act as potent inhibitors for the FBA so that the menace of antimicrobial resistance in CA-MRSA can be conquered. However, pharmacological studies are required to confirm the inhibitory activity of these ligands against the FBA in CA-MRSA. PMID:23423142

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

    PubMed

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

    2015-05-01

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

  2. Teicoplanin as an Effective Alternative to Vancomycin for Treatment of MRSA Infection in Chinese Population: A Meta-analysis of Randomized Controlled Trials

    PubMed Central

    Bu, Tao; Chen, Xiaofeng; Bi, Jiaqi; Zhou, Junli; Yao, Zhenjiang

    2013-01-01

    Objective To evaluate whether teicoplanin could be an alternative to vancomycin for treatment of MRSA infection in Chinese population using a meta-analysis in randomized controlled trials. Methods The following databases were searched: Chinese Biomedical Literature database (CBM), Chinese Journal Full-text database (CNKI), Wanfang database, Medline database, Ovid database and Cochrane Library. Articles published from 2002 to 2013 that studied teicoplanin in comparison to vancomycin in the treatment of MRSA infected patients were collected. Overall effects, publishing bias analysis and sensitivity analysis on clinical cure rate, microbiologic eradication rate and adverse events rate were performed by using Review Manager 5.2 and Stata 11.0 softwares. Results Twelve articles met entry criteria. There was no statistically significant difference between the two groups regarding the clinical cure rate (risk ratio [RR], teicoplanin vs vancomycin, 0.94; 95% CI, 0.74?1.19; P?=?0.60), microbiological cure rate (risk ratio [RR], teicoplanin vs vancomycin, 0.99; 95% CI, 0.91?1.07; P?=?0.74) and adverse event rate (risk ratio [RR], teicoplanin vs vancomycin, 0.86; 95% CI, 0.40?1.84; P?=?0.70). Conclusions The meta-analysis results indicate that the two therapies are similar in both efficacy and safety, thus teicoplanin can act as an effective alternative to vancomycin for treating patients infected by MRSA. PMID:24260299

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

    PubMed

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

    2015-08-01

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

  4. Comparison of air samples, nasal swabs, ear-skin swabs and environmental dust samples for detection of methicillin-resistant Staphylococcus aureus (MRSA) in pig herds.

    PubMed

    Agersø, Y; Vigre, H; Cavaco, L M; Josefsen, M H

    2014-08-01

    To identify a cost-effective and practical method for detection of methicillin-resistant Staphylococcus aureus (MRSA) in pig herds, the relative sensitivity of four sample types: nasal swabs, ear-skin (skin behind the ears) swabs, environmental dust swabs and air was compared. Moreover, dependency of sensitivity on within-herd prevalence was estimated. spa-typing was applied in order to study strain diversity. The sensitivity of one air sample was equal to the sensitivity of ten pools of five nasal swabs and relatively independent of within-herd prevalence [predicted to be nearly perfect (99%) for within-herd prevalence ?25%]. The results indicate that taking swabs of skin behind the ears (ten pools of five) was even more sensitive than taking nasal swabs (ten pools of five) at the herd level and detected significantly more positive samples. spa types t011, t034 and t4208 were observed. In conclusion, MRSA detection by air sampling is easy to perform, reduces costs and analytical time compared to existing methods, and is recommended for initial testing of herds. Ear-skin swab sampling may be more sensitive for MRSA detection than air sampling or nasal swab sampling. PMID:24229727

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

    PubMed Central

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

    2014-01-01

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

  6. A double-blind comparison of 0.25% and 0.05% desoxymethasone, 0.1% betamethasone valerate and 1% hydrocortisone creams in the treatment of eczema.

    PubMed

    Ashton, R E; Catterall, M; Morley, N; Fairris, G; Joseph, D N

    1987-01-01

    The efficacy and acceptability of 0.25% and 0.05% desoxymethasone, 0.1% betamethasone valerate and 1% hydrocortisone creams were compared in patients with eczema. A double-blind parallel group multi-centre design was employed in which 96 patients were recruited by four centres. Patients used one cream for a 3-week period and follow-up assessment visits were made at weekly intervals. Efficacy variables were: erythema/redness, scaling, itching and extent of area affected. These variables were assessed by both the investigator and the patient. The 0.25% desoxymethasone was the most effective treatment, producing the greatest degree of improvement in all clinical parameters, hydrocortisone was the least effective and 0.05% desoxymethasone was of intermediate effectiveness. The 0.1% betamethasone produced similar results to 0.25% desoxymethasone for half the assessments; for the other half the results were similar to 0.05% desoxymethasone. No adverse effects were reported during the study. The results are discussed in terms of physical properties of the vehicles and corticosteroid potency. PMID:3301455

  7. Multidrug-Resistant and Methicillin-Resistant Staphylococcus aureus (MRSA) in Hog Slaughter and Processing Plant Workers and Their Community in North Carolina (USA)

    PubMed Central

    Neyra, Ricardo Castillo; Frisancho, Jose Augusto; Rinsky, Jessica L.; Resnick, Carol; Carroll, Karen Colleen; Rule, Ana Maria; Ross, Tracy; You, Yaqi; Price, Lance B.

    2014-01-01

    Background: Use of antimicrobials in industrial food-animal production is associated with the presence of antimicrobial-resistant Staphylococcus aureus (S. aureus) among animals and humans. Hog slaughter/processing plants process large numbers of animals from industrial animal operations and are environments conducive to the exchange of bacteria between animals and workers. Objectives: We compared the prevalence of multidrug-resistant S. aureus (MDRSA) and methicillin-resistant S. aureus (MRSA) carriage among processing plant workers, their household members, and community residents. Methods: We conducted a cross-sectional study of hog slaughter/processing plant workers, their household members, and community residents in North Carolina. Participants responded to a questionnaire and provided a nasal swab. Swabs were tested for S. aureus, and isolates were tested for antimicrobial susceptibility and subjected to multilocus sequence typing. Results: The prevalence of S. aureus was 21.6%, 30.2%, and 22.5% among 162 workers, 63 household members, and 111 community residents, respectively. The overall prevalence of MDRSA and MRSA tested by disk diffusion was 6.9% and 4.8%, respectively. The adjusted prevalence of MDRSA among workers was 1.96 times (95% CI: 0.71, 5.45) the prevalence in community residents. The adjusted average number of antimicrobial classes to which S. aureus isolates from workers were resistant was 2.54 times (95% CI: 1.16, 5.56) the number among isolates from community residents. We identified two MDRSA isolates and one MRSA isolate from workers as sequence type 398, a type associated with exposure to livestock. Conclusions: Although the prevalence of S. aureus and MRSA was similar in hog slaughter/processing plant workers and their household and community members, S. aureus isolates from workers were resistant to a greater number of antimicrobial classes. These findings may be related to the nontherapeutic use of antimicrobials in food-animal production. Citation: Castillo Neyra R, Frisancho JA, Rinsky JL, Resnick C, Carroll KC, Rule AM, Ross T, You Y, Price LB, Silbergeld EK. 2014. Multidrug-resistant and methicillin-resistant Staphylococcus aureus (MRSA) in hog slaughter and processing plant workers and their community in North Carolina (USA). Environ Health Perspect 122:471–477;?http://dx.doi.org/10.1289/ehp.1306741 PMID:24508836

  8. Decolonisation of MRSA, S. aureus and E. coli by Cold-Atmospheric Plasma Using a Porcine Skin Model In Vitro

    PubMed Central

    Maisch, Tim; Shimizu, Tetsuji; Li, Yang-Fang; Heinlin, Julia; Karrer, Sigrid; Morfill, Gregor; Zimmermann, Julia L.

    2012-01-01

    In the last twenty years new antibacterial agents approved by the U.S. FDA decreased whereas in parallel the resistance situation of multi-resistant bacteria increased. Thus, community and nosocomial acquired infections of resistant bacteria led to a decrease in the efficacy of standard therapy, prolonging treatment time and increasing healthcare costs. Therefore, the aim of this work was to demonstrate the applicability of cold atmospheric plasma for decolonisation of Gram-positive (Methicillin-resistant Staphylococcus aureus (MRSA), Methicillin-sensitive Staphylococcus aureus) and Gram-negative bacteria (E. coli) using an ex vivo pig skin model. Freshly excised skin samples were taken from six month old female pigs (breed: Pietrain). After application of pure bacteria on the surface of the explants these were treated with cold atmospheric plasma for up to 15 min. Two different plasma devices were evaluated. A decolonisation efficacy of 3 log10 steps was achieved already after 6 min of plasma treatment. Longer plasma treatment times achieved a killing rate of 5 log10 steps independently from the applied bacteria strains. Histological evaluations of untreated and treated skin areas upon cold atmospheric plasma treatment within 24 h showed no morphological changes as well as no significant degree of necrosis or apoptosis determined by the TUNEL-assay indicating that the porcine skin is still vital. This study demonstrates for the first time that cold atmospheric plasma is able to very efficiently kill bacteria applied to an intact skin surface using an ex vivo porcine skin model. The results emphasize the potential of cold atmospheric plasma as a new possible treatment option for decolonisation of human skin from bacteria in patients in the future without harming the surrounding tissue. PMID:22558091

  9. [Atopic dermatitis and pox-virus superinfections (author's transl)].

    PubMed

    Dupré, A; Christol, B; Lassère, J

    1981-01-01

    Subjects afflicted with atopic dermatitis are particularly predisposed to such viral superinfections as verruca, herpes (eczema herpeticum) and vaccinia (eczema vaccinatum). Knowledge of superinfection by the molluscum contagiosum virus is more recent and the authors describe one case. The orf virus (responsible for ovine ecthyma contagiosum), however, has never been described as responsible for the profuse superinfection of an atopic eczema. The authors observed one case of this in a child, atypical as result of his age (16 months), the cervical localization and the aspect, which was a telangiectasic granuloma type of the initial element, and finally of the satellization observed one week later. This child suffered from a generalized atopic eczema. Propagation of the orf lesions could have been favored by scratching, local corticoid treatment and by the deficit in cellular immunity observed in patient with atopic dermatitis. Indeed, viral superinfections, which are unusual by their profusion or their chronic nature, are often observed in immunodepressed subjects. PMID:6275765

  10. Serum interleukin 17, interleukin 23, and interleukin 10 values in children with atopic eczema/dermatitis syndrome (AEDS): association with clinical severity and phenotype.

    PubMed

    Leonardi, Salvatore; Cuppari, Caterina; Manti, Sara; Filippelli, Martina; Parisi, Giuseppe Fabio; Borgia, Francesco; Briuglia, Silvana; Cannavò, Patrizia; Salpietro, Annamaria; Arrigo, Teresa; Salpietro, Carmelo

    2015-01-01

    To date cytokines profile in AEDS is poorly described in children. We evaluated the interleukin (IL)-17, IL-23, and IL-10 levels in atopic eczema/dermatitis syndrome (AEDS) children and healthy controls, in atopic AEDS (aAEDS) and nonatopic (naAEDS) subtypes and their relationship with disease severity. A total of 181 children with aAEDS and 93 healthy children were evaluated. According to the skin-prick test (SPT) for allergens and serum total IgE, all patients were subdivided in two groups: 104 aAEDS and 77 naAEDS. In all patients, serum IL-17, IL-23, and IL-10 levels were detected. Serum IL-17 and IL-23 levels were significantly higher, and serum IL-10 levels were significantly lower in AEDS children than healthy group (p < 0.001). Moreover, serum IL-17 and IL-23 levels were significantly higher in aAEDS than in naAEDS subtypes (p < 0.001). Differently, serum IL-10 levels resulted similar in both subtypes. There was a correlation between Score Atopic Dermatitis (SCORAD) index and both IL-17 and IL-23 and an inverse correlation between SCORAD index and IL-10 in aAEDS and naAEDS types. Serum IL-17 and IL-23 values were positively related to total IgE levels (p < 0.0001) in aAEDS. Further increase of IL-17 and IL-23 levels was detected in aAEDS subjects with atopic diseases such as asthma and rhinitis than children with only allergic sensitization. Our study confirms the role of IL-17, IL-23, and IL-10 and their relationship with the severity of AEDS. We firstly found a correlation between high IL-17/IL-23 axis levels and different phenotypes of AEDS in children, suggesting its role as marker of "atopic march" and disease severity. PMID:25562560

  11. N-palmitoylethanolamine and N-acetylethanolamine are effective in asteatotic eczema: results of a randomized, double-blind, controlled study in 60 patients

    PubMed Central

    Yuan, Chao; Wang, Xue-Min; Guichard, Alexandre; Tan, Yi-Mei; Qian, Chun-Yan; Yang, Li-Jie; Humbert, Philippe

    2014-01-01

    Background Asteatotic eczema (AE) is characterized by itchy, dry, rough, and scaling skin. The treatments for AE are mainly emollients, usually containing urea, lactic acid, or a lactate salt. N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA) are both endogenous lipids used as novel therapeutic tools in the treatment of many skin diseases. The purpose of this study was to compare a PEA/AEA emollient with a traditional emollient in the treatment of AE. Methods A monocentric, randomized, double-blind, comparative trial was conducted in 60 AE patients to evaluate and compare the efficacy of the two emollients. The level of skin dryness among the subjects ranged from mild to moderate. The subjects’ skin barrier function and the current perception threshold were tested for 28 days by clinical scoring and bioengineering technology. Results The results showed that, although some aspects were improved in both groups, the group using the emollient containing PEA/AEA presented a better skin surface change in capacitance. However, the most impressive finding was the ability of the PEA/AEA emollient to increase the 5 Hz current perception threshold to a normal level after 7 days, with a significant difference between values at baseline and after 14 days. A current perception threshold of 5 Hz was positively and significantly correlated with skin surface hydration and negatively correlated with transepidermal water loss in the PEA/AEA emollient group. Conclusion Compared with traditional emollients, regular application of a topical PEA/AEA emollient could improve both passive and active skin functions simultaneously. PMID:25071367

  12. Detection of mecC-positive Staphylococcus aureus (CC130-MRSA-XI) in diseased European hedgehogs (Erinaceus europaeus) in Sweden.

    PubMed

    Monecke, Stefan; Gavier-Widen, Dolores; Mattsson, Roland; Rangstrup-Christensen, Lena; Lazaris, Alexandros; Coleman, David C; Shore, Anna C; Ehricht, Ralf

    2013-01-01

    Recently, a novel mec gene conferring beta-lactam resistance in Staphylococcus aureus has been discovered. This gene, mecC, is situated on a SCCmec XI element that has to date been identified in clonal complexes 49, 130, 425, 599 and 1943. Some of the currently known isolates have been identified from animals. This, and observations of mecA alleles that do not confer beta-lactam resistance, indicate that mec genes might have a reservoir in Staphylococcus species from animals. Thus it is important also to screen wildlife isolates for mec genes. Here, we describe mecC-positive Staphylococcus aureus (ST130-MRSA-XI) and the lesions related to the infection in two diseased free-ranging European hedgehogs (Erinaceus europaeus). One was found dead in 2003 in central Sweden, and suffered from S. aureus septicaemia. The other one, found on the island of Gotland in the Baltic Sea in 2011, showed a severe dermatitis and was euthanised. ST130-MRSA-XI isolates were isolated from lesions from both hedgehogs and were essentially identical to previously described isolates from humans. Both isolates carried the complete SCCmec XI element. They lacked the lukF-PV/lukS-PV and lukM/lukF-P83 genes, but harboured a gene for an exfoliative toxin homologue previously described from Staphylococcus hyicus, Staphylococcus pseudintermedius and other S. aureus of the CC130 lineage. To the best of our knowledge, these are the first reported cases of CC130-MRSA-XI in hedgehogs. Given that one of the samples was taken as early as 2003, this was the earliest detection of this strain and of mecC in Sweden. This and several other recent observations suggest that CC130 might be a zoonotic lineage of S. aureus and that SCCmec XI/mecC may have originated from animal pathogens. PMID:23776626

  13. Detection of mecC-Positive Staphylococcus aureus (CC130-MRSA-XI) in Diseased European Hedgehogs (Erinaceus europaeus) in Sweden

    PubMed Central

    Monecke, Stefan; Gavier-Widen, Dolores; Mattsson, Roland; Rangstrup-Christensen, Lena; Lazaris, Alexandros; Coleman, David C.; Shore, Anna C.; Ehricht, Ralf

    2013-01-01

    Recently, a novel mec gene conferring beta-lactam resistance in Staphylococcus aureus has been discovered. This gene, mecC, is situated on a SCCmec XI element that has to date been identified in clonal complexes 49, 130, 425, 599 and 1943. Some of the currently known isolates have been identified from animals. This, and observations of mecA alleles that do not confer beta-lactam resistance, indicate that mec genes might have a reservoir in Staphylococcus species from animals. Thus it is important also to screen wildlife isolates for mec genes. Here, we describe mecC-positive Staphylococcus aureus (ST130-MRSA-XI) and the lesions related to the infection in two diseased free-ranging European hedgehogs (Erinaceus europaeus). One was found dead in 2003 in central Sweden, and suffered from S. aureus septicaemia. The other one, found on the island of Gotland in the Baltic Sea in 2011, showed a severe dermatitis and was euthanised. ST130-MRSA-XI isolates were isolated from lesions from both hedgehogs and were essentially identical to previously described isolates from humans. Both isolates carried the complete SCCmec XI element. They lacked the lukF-PV/lukS-PV and lukM/lukF-P83 genes, but harboured a gene for an exfoliative toxin homologue previously described from Staphylococcus hyicus, Staphylococcus pseudintermedius and other S. aureus of the CC130 lineage. To the best of our knowledge, these are the first reported cases of CC130-MRSA-XI in hedgehogs. Given that one of the samples was taken as early as 2003, this was the earliest detection of this strain and of mecC in Sweden. This and several other recent observations suggest that CC130 might be a zoonotic lineage of S. aureus and that SCCmec XI/mecC may have originated from animal pathogens. PMID:23776626

  14. In vitro activity of oritavancin against community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), vancomycin-intermediate S. aureus (VISA), vancomycin-resistant S. aureus (VRSA) and daptomycin-non-susceptible S. aureus (DNSSA).

    PubMed

    Saravolatz, Louis D; Pawlak, Joan; Johnson, Leonard B

    2010-07-01

    Isolates of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), vancomycin-intermediate S. aureus (VISA), vancomycin-resistant S. aureus (VRSA) and daptomycin non-susceptible S. aureus (DNSSA) are increasing in frequency and new antistaphylococcal therapies are needed. Microdilution testing using Mueller-Hinton broth was used to determine the minimal inhibitory concentrations (MICs) of oritavancin and nine additional antimicrobial agents against 92 CA-MRSA, 23 VISA, 7 DNSSA and 10 VRSA isolates. Minimal bactericidal concentrations were also determined. Pulsed-field gel electrophoresis (PFGE) was performed. Staphylococcal cassette chromosome mec (SCCmec) typing as well as assays for Panton-Valentine leukocidin (PVL) and arginine catabolic mobile element (ACME) genes were performed. Oritavancin was more bactericidal than any of the other comparators against CA-MRSA and demonstrated excellent activity against VRSA and VISA. PMID:20413274

  15. Prospective comparison of a new chromogenic medium, MRSASelect, to CHROMagar MRSA and mannitol-salt medium supplemented with oxacillin or cefoxitin for detection of methicillin-resistant Staphylococcus aureus.

    PubMed

    Stoakes, Luba; Reyes, Romina; Daniel, Janis; Lennox, Gwen; John, Michael A; Lannigan, Robert; Hussain, Zafar

    2006-02-01

    MRSASelect agar was compared to CHROMagar, mannitol-salt agar with oxacillin, and mannitol-salt agar with cefoxitin (MSA-CFOX) for the isolation of methicillin-resistant Staphylococcus aureus (MRSA). The sensitivities and specificities were 97.3% and 99.8%, 82.9% and 99.1%, 80.2% and 79%, and 99.1% and 84.8%, respectively. MSA-CFOX and MRSASelect had a high sensitivity. MRSASelect, however, was more specific and proved to be a more reliable and rapid medium for the detection of MRSA. PMID:16455933

  16. The Tipper-Strominger Hypothesis and Triggering of Allostery in Penicillin-Binding Protein 2a of Methicillin-Resistant Staphylococcus aureus (MRSA).

    PubMed

    Fishovitz, Jennifer; Taghizadeh, Negin; Fisher, Jed F; Chang, Mayland; Mobashery, Shahriar

    2015-05-27

    The transpeptidases involved in the synthesis of the bacterial cell wall (also known as penicillin-binding proteins, PBPs) have evolved to bind the acyl-d-Ala-d-Ala segment of the stem peptide of the nascent peptidoglycan for the physiologically important cross-linking of the cell wall. The Tipper-Strominger hypothesis stipulates that ?-lactam antibiotics mimic the acyl-d-Ala-d-Ala moiety of the stem and, thus, are recognized by the PBPs with bactericidal consequences. We document that this mimicry exists also at the allosteric site of PBP2a of methicillin-resistant Staphylococcus aureus (MRSA). Interactions of different classes of ?-lactam antibiotics, as mimics of the acyl-d-Ala-d-Ala moiety at the allosteric site, lead to a conformational change, across a distance of 60 Å to the active site. We directly visualize this change using an environmentally sensitive fluorescent probe affixed to the protein loops that frame the active site. This conformational mobility, documented in real time, allows antibiotic access to the active site of PBP2a. Furthermore, we document that this allosteric trigger enables synergy between two different ?-lactam antibiotics, wherein occupancy at the allosteric site by one facilitates occupancy by a second at the transpeptidase catalytic site, thus lowering the minimal-inhibitory concentration. This synergy has important implications for the mitigation of facile emergence of resistance to these antibiotics by MRSA. PMID:25964995

  17. Treatment failure and costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections: A South Texas Ambulatory Research Network (STARNet) study

    PubMed Central

    Labreche, Matthew J.; Lee, Grace C.; Attridge, Russell T.; Mortensen, Eric M.; Koeller, Jim; Du, Liem C.; Nyren, Natalie R.; Treviño, Lucina B.; Treviño, Sylvia B.; Peña, Joel; Mann, Michael W.; Muñoz, Abilio; Marcos, Yolanda; Rocha, Guillermo; Koretsky, Stella; Esparza, Sandra; Finnie, Mitchell; Dallas, Steven D.; Parchman, Michael L.; Frei, Christopher R.

    2013-01-01

    Objective To measure the incidence of treatment failure and associated costs in patients with methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs). Methods This was a prospective, observational study in 13 primary care clinics. Primary care providers collected clinical data, wound swabs, and 90-day follow-up information. Patients were considered to have “moderate or complicated” SSTIs if they had a lesion ? 5 cm in diameter or diabetes mellitus. Treatment failure was evaluated within 90 days of the initial visit. Cost estimates were obtained from federal sources. Results Overall, treatment failure occurred in 21% of patients (n=21/98) at a mean additional cost of $1,933.71 per patient. Treatment failure occurred in 27% of patients in the moderate or complicated group and 11% of patients in the mild or uncomplicated group (p = 0.08). In a subgroup analysis of patients who received I&D, patients with moderate or complicated SSTIs had higher rates of treatment failure than patients with mild or uncomplicated SSTIs (36% vs. 10%; p = 0.04). Conclusions One in five patients presenting to a primary care clinic for a MRSA SSTI will likely require additional interventions as a result of treatment failure at an associated cost of almost $2,000 per patient. Baseline risk stratification and new treatment approaches are needed to reduce treatment failures and costs in the primary care setting. PMID:24004702

  18. Characterization of the staphylococcal cassette chromosome mec insertion site in 108 isolates lacking the mecA gene and identified as methicillin-resistant Staphylococcus aureus by the Xpert MRSA assay.

    PubMed

    Stojanov, M; Blanc, D S

    2014-11-01

    During a 3-year period, 848 patients were detected as carriers of methicillin-resistant Staphylococcus aureus (MRSA) by the Xpert MRSA assay (Cepheid). Among them, 108 patients (12.7 %) were colonized with strains showing methicillin-susceptible phenotypes and absence of the mecA gene, despite being positive with the rapid polymerase chain reaction (PCR) assay. DNA sequences of the staphylococcal cassette chromosome mec (SCCmec) insertion site of these "false-positive" strains was determined by direct sequencing of the genomic DNA. More than half (53.7 %) of the strains had DNA sequences unrelated to either SCC or SCCmec and one-third had DNA sequences related to non-mec SCC. Only 10.2 % of the strains carried sequences related to SCCmec, suggesting that a sequence containing the mecA gene was lost from an SCCmec. These findings differ from the general idea that all methicillin-susceptible S. aureus having positive Xpert MRSA assay results are essentially MRSA that lost the mecA gene. PMID:24906440

  19. Eczema (Atopic Dermatitis) in Infants

    MedlinePLUS

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  20. Natural advances in eczema care.

    PubMed

    Eichenfield, Lawrence F; Fowler, Joseph F; Rigel, Darrell S; Taylor, Susan C

    2007-12-01

    Atopic dermatitis (AD) is a chronic relapsing dermatitis characterized by increased transepidermal water loss (TEWL) and subjective symptoms of pruritus, inflammation, skin sensitivity, and dryness. AD is a frequent issue for individuals of color, though it may be underrecognized. Therapy for AD is based on reducing pruritus and inflammation, and normalizing skin surface lipids, particularly ceramides. Topical corticosteroids are the gold-standard treatment for controlling disease flares, but a variety of active natural ingredients can be used adjunctively to help control itch, inflammation, and dryness. Oatmeal, particularly avenanthramides, a newly discovered oat fraction, may be of particular value in restoring the cutaneous barrier and reducing symptoms of AD. Feverfew, licorice, and dexpanthenol also have been shown to be effective in the management of inflammation. Licorice, which has some skin-lightening activity, may be helpful in patients with postinflammatory hyperpigmentation (PIH). The compromised skin barrier in AD is especially vulnerable to UV radiation exposure. Several new long-lasting photostable sunscreen ingredients provide longer durations of protection with improved cosmetic attributes. PMID:18277662

  1. Increased Cell Wall Teichoic Acid Production and D-alanylation Are Common Phenotypes among Daptomycin-Resistant Methicillin-Resistant Staphylococcus aureus (MRSA) Clinical Isolates

    PubMed Central

    Bertsche, Ute; Yang, Soo-Jin; Kuehner, Daniel; Wanner, Stefanie; Mishra, Nagendra N.; Roth, Tobias; Nega, Mulugeta; Schneider, Alexander; Mayer, Christoph; Grau, Timo; Bayer, Arnold S.; Weidenmaier, Christopher

    2013-01-01

    Multiple mechanisms have been correlated with daptomycin-resistance (DAP-R) in Staphylococcus aureus. However, one common phenotype observed in many DAP-R S. Aureus strains is a thickened cell wall (CW). The first evidence for an impact of CW-linked glycopolymers on this phenotype was recently demonstrated in a single, well-characterized DAP-R methicillin-susceptible S. aureus (MSSA) strain. In this isolate the thickened CW phenotype was linked to an increased production and D-alanylation of wall teichoic acids (WTA). In the current report, we extended these observations to methicillin-resistant daptomycin-sensitive/daptomyin-resistant (DAP-S/DAP-R) strain-pairs. These pairs included methicillin-resistant S. aureus (MRSA) isolates with and without single nucleotide polymorphisms (SNPs) in mprF (a genetic locus linked to DAP-R phenotype). We found increased CW dry mass in all DAP-R vs DAP-S isolates. This correlated with an increased expression of the WTA biosynthesis gene tagA, as well as an increased amount of WTA in the DAP-R vs DAP-S isolates. In addition, all DAP-R isolates showed a higher proportion of WTA D-alanylation vs their corresponding DAP-S isolate. We also detected an increased positive surface charge amongst the DAP-R strains (presumably related to the enhanced D-alanylation). In comparing the detailed CW composition of all isolate pairs, substantive differences were only detected in one DAP-S/DAP-R pair. The thickened CW phenotype, together with an increased surface charge most likely contributes to either: i) a charge-dependent repulsion of calcium complexed-DAP; and/or ii) steric-limited access of DAP to the bacterial cell envelope target. Taken together well-defined perturbations of CW structural and functional metrics contribute to the DAP-R phenotype and are common phenotypes in DAP-R S. Aureus isolates, both MSSA and MRSA. Note: Although “daptomycin-nonsusceptibility” is the generally accepted terminology, we have utilized the term “daptomycin resistance” for ease of presentation in this manuscript PMID:23785522

  2. Host Gene Expression Profiling and In Vivo Cytokine Studies to Characterize the Role of Linezolid and Vancomycin in Methicillin-Resistant Staphylococcus aureus (MRSA) Murine Sepsis Model

    PubMed Central

    Sharma-Kuinkel, Batu K.; Zhang, Yurong; Yan, Qin; Ahn, Sun Hee; Fowler, Vance G.

    2013-01-01

    Linezolid (L), a potent antibiotic for Methicillin Resistant Staphylococcus aureus (MRSA), inhibits bacterial protein synthesis. By contrast, vancomycin (V) is a cell wall active agent. Here, we used a murine sepsis model to test the hypothesis that L treatment is associated with differences in bacterial and host characteristics as compared to V. Mice were injected with S. aureus USA300, and then intravenously treated with 25 mg/kg of either L or V at 2 hours post infection (hpi). In vivo alpha-hemolysin production was reduced in both L and V-treated mice compared to untreated mice but the reduction did not reach the statistical significance [P?=?0.12 for L; P?=?0.70 for V). PVL was significantly reduced in L-treated mice compared to untreated mice (P?=?0.02). However the reduction of in vivo PVL did not reach the statistical significance in V- treated mice compared to untreated mice (P?=?0.27). Both antibiotics significantly reduced IL-1? production [P?=?0.001 for L; P?=?0.006 for V]. IL-6 was significantly reduced with L but not V antibiotic treatment [P<0.001 for L; P?=?0.11 for V]. Neither treatment significantly reduced production of TNF-?. Whole-blood gene expression profiling showed no significant effect of L and V on uninfected mice. In S. aureus-infected mice, L altered the expression of a greater number of genes than V (95 vs. 42; P?=?0.001). Pathway analysis for the differentially expressed genes identified toll-like receptor signaling pathway to be common to each S. aureus-infected comparison. Expression of immunomodulatory genes like Cxcl9, Cxcl10, Il1r2, Cd14 and Nfkbia was different among the treatment groups. Glycerolipid metabolism pathway was uniquely associated with L treatment in S. aureus infection. This study demonstrates that, as compared to V, treatment with L is associated with reduced levels of toxin production, differences in host inflammatory response, and distinct host gene expression characteristics in MRSA sepsis. PMID:23565251

  3. Comparison of the Vitek Gram-Positive Susceptibility 106 Card and the MRSA-Screen Latex Agglutination Test for Determining Oxacillin Resistance in Clinical Bloodstream Isolates of Staphylococcus aureus

    Microsoft Academic Search

    T. Yamazumi; S. A. Marshall; W. W. Wilke; D. J. Diekema; M. A. Pfaller; R. N. Jones

    2001-01-01

    The Vitek automated susceptibility testing system with a modified Gram-Positive Susceptibility (GPS) 106 Card (bioMerieux Vitek, Inc., Hazelwood, Mo.) and a rapid slide latex agglutination test (MRSA-Screen; Denka Seiken Co., Ltd., Tokyo, Japan) were evaluated for their ability to detect oxacillin resistance in Staphylococcus aureus. The oxacillin-salt agar screen (OS) test, the reference broth microdilution method, and the detection of

  4. Comparison of the Vitek Gram-Positive Susceptibility 106 Card, the MRSA-Screen Latex Agglutination Test, and mecA Analysis for Detecting Oxacillin Resistance in a Geographically Diverse Collection of Clinical Isolates of Coagulase-Negative Staphylococci

    Microsoft Academic Search

    T. Yamazumi; I. Furuta; D. J. Diekema; M. A. Pfaller; R. N. Jones

    2001-01-01

    The Vitek automated susceptibility testing system with a modified gram-positive susceptibility (GPS) 106 card (bioMerieux Vitek, Inc., Hazelwood. Mo.) and a rapid slide latex agglutination test (MRSA-Screen test; Denka Seiken Co., Ltd., Tokyo, Japan) were evaluated for their abilities to detect oxacillin resistance in co- agulase-negative staphylococci (CoNS). The reference broth microdilution method and the detection of the mecA gene

  5. Synthesis, characterization, and evaluation of antibacterial effect of Ag nanoparticles against Escherichia coli O157:H7 and methicillin-resistant Staphylococcus aureus (MRSA)

    PubMed Central

    Paredes, Daissy; Ortiz, Claudia; Torres, Rodrigo

    2014-01-01

    Silver nanoparticles (AgNPs) have been shown great interest because of their potential antibacterial effect. Recently, this has been increased due to resistance in some pathogenic bacteria strains to conventional antibiotics, which has initiated new studies to search for more effective treatments against resistant microorganisms. For these reasons, AgNPs have become an important approach for applications in nanobiotechnology in the development of antibiotic treatment of different bacterial infections. This study was aimed at synthesizing AgNPs using cysteine as a reducer agent and cetyl-tri-methyl-ammonium bromide as a stabilizer in order to obtain more efficient treatment against the pathogen bacteria Escherichia coli O157:H7. These AgNPs were characterized through UV-Vis spectroscopy, transmission electron microscopy, and dynamic light scattering. From these analyses, formation of spherical nanoparticles with an average size of 55 nm was confirmed. Finally, minimal inhibitory concentration (MIC) and minimal bactericide concentration (MBC) of these AgNPs against pathogenic strains E. coli O157:H7 and methicillin-resistant Staphylococcus aureus (MRSA) were determined in both solid and liquid media. MIC and MBC values were around 0.25 ?g/mL and 1 ?g/mL, respectively. These parameters were comparable to those reported in the literature and were even more effective than other synthesized AgNPs. PMID:24729707

  6. The impact of ?-toxin on host cell plasma membrane permeability and cytokine expression during human blood infection by CA-MRSA USA300.

    PubMed

    Nygaard, Tyler K; Pallister, Kyler B; Zurek, Oliwia W; Voyich, Jovanka M

    2013-11-01

    This investigation examines the influence of ?-toxin (Hla) expression by CA-MRSA on host immune cell integrity and cytokine expression during infection of human blood. Flow cytometry analysis of human blood infected by Staphylococcus aureus PFGE type USA300 or a USA300?hla demonstrated that Hla expression significantly increased plasma membrane permeability of human CD14(+) monocytes. The increased susceptibility of human CD14(+) monocytes to Hla toxicity paralleled the high cell-surface expression on these cell types of ADAM10. USA300 rapidly associated with PMNs and monocytes but not T cells following inoculation of human blood. Transcription analysis indicated a strong up-regulation of proinflammatory cytokine transcription following infection of human blood by USA300 and USA300?hla. CBAs and ELISAs determined that IL-6, IL-10, TNF-?, IFN-?, IL-1?, IL-8, and IL-4 are significantly up-regulated during the initial phases of human blood infection by USA300 relative to mock-infected blood but failed to distinguish any significant differences in secreted cytokine protein concentrations during infection by USA300?hla relative to USA300. Collectively, these findings demonstrate that expression of Hla by USA300 has a significant impact on human CD14(+) monocyte plasma membrane integrity but is not exclusively responsible for the proinflammatory cytokine profile induced by USA300 during the initial stages of human blood infection. PMID:24026286

  7. The herbal-derived honokiol and magnolol enhances immune response to infection with methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA).

    PubMed

    Choi, Eun-Jin; Kim, Hyung-Ip; Kim, Ji-Ae; Jun, Soo Youn; Kang, Sang Hyeon; Park, Dong June; Son, Seok-Jun; Kim, Younghoon; Shin, Ok Sarah

    2015-05-01

    The emergence of antibiotic resistant strains such as methicillin-resistant Staphylococcus aureus (MRSA) reminds us an urgent need to develop a new immune-modulating agent for preventing S. aureus infection. In this study, we found that herbal medicines, honokiol and magnolol, caused a significant cellular immune modulatory effect during S. aureus infection. In mouse macrophages, these compounds drove upregulation of an antioxidant effect in response to S. aureus, resulting in a dampened total cellular reactive oxygen species (ROS) production and decreased production of inflammatory cytokines/chemokines, whereas honokiol induced increased types I and III interferon messenger RNA (mRNA) expression levels in response to MSSA infection. Moreover, the internalization of S. aureus by human alveolar epithelial cells was inhibited by these compounds. Furthermore, honokiol and magnolol treatment promoted a delay in killing during MSSA infection in Caenorhabditis elegans, suggesting antimicrobial function in vivo. In conclusion, honokiol and magnolol may be considered as attractive immune-modulating treatment for S. aureus infection. PMID:25586586

  8. Human herpes simplex virus: life cycle and development of inhibitors.

    PubMed

    Kukhanova, M K; Korovina, A N; Kochetkov, S N

    2014-12-01

    WHO reports that 90% of human population is infected by different types of herpesviruses, which develop latency or cause oral and genital herpes, conjunctivitis, eczema herpeticum, and other diseases. Herpesvirus almost always accompanies HIV-infection and complicates AIDS treatment. Herpes simplex virus type 1 is one of the most wide spread viruses from the Herpesviridae family. HSV virion, genome structure, replication mechanisms, antiherpes drug development strategies, including design of prodrugs, and mutations causing ACV-resistance in clinical HSV isolates are discussed in this review. PMID:25749169

  9. Low level laser therapy (AlGaInP) applied at 5J/cm2 reduces the proliferation of Staphylococcus aureus MRSA in infected wounds and intact skin of rats*

    PubMed Central

    Silva, Daniela Conceição Gomes Gonçalves e; Plapler, Helio; da Costa, Mateus Matiuzzi; Silva, Silvio Romero Gonçalves e; de Sá, Maria da Conceição Aquino; Silva, Benedito Sávio Lima e

    2013-01-01

    BACKGROUND Laser therapy is a low cost, non-invasive procedure with good healing results. Doubts exist as to whether laser therapy action on microorganisms can justify research aimed at investigating its possible effects on bacteria-infected wounds. OBJECTIVE To assess the effect of low intensity laser on the rate of bacterial contamination in infected wounds in the skin of rats. METHODS An experimental study using 56 male Wistar rats. The animals were randomly divided into eight groups of seven each. Those in the "infected" groups were infected by Staphylococcus aureus MRSA in the dorsal region. Red laser diode (AlGaInP) 658nm, 5J/cm2 was used to treat the animals in the "treated" groups in scan for 3 consecutive days. Samples were drawn before inoculating bacteria and following laser treatment. For statistical analysis we used the nonparametric Wilcoxon (paired data) method with a significance level of p <0.05. RESULTS The statistical analysis of median values showed that the groups submitted to laser treatment had low bacterial proliferation. CONCLUSION The laser (AlGaInP), with a dose of 5J/cm2 in both intact skin and in wounds of rats infected with Staphylococcus aureus MRSA, is shown to reduce bacterial proliferation. PMID:23539003

  10. Disseminated coxsackievirus A6 affecting children with atopic dermatitis.

    PubMed

    Lynch, M D; Sears, A; Cookson, H; Lew, T; Laftah, Z; Orrin, L; Zuckerman, M; Creamer, D; Higgins, E

    2015-07-01

    Coxsackievirus A6 (CV-A6) is an emerging pathogen that has in recent years been associated with atypical hand, foot and mouth disease. This manifests as a generalized papular or vesicular eruption, which may be associated with fever and systemic disturbance. We report a series of six children presenting to a single centre in the UK with disseminated CV-A6 infection on a background of atopic dermatitis (AD). Our patients exhibited a widespread papular or vesicular eruption in association with exacerbation of AD. Several of our cases mimicked eczema herpeticum, but the extent was more generalized, and individual lesions were discrete rather than clustered and were less circumscribed in character. This series highlights that CV-A6 infection may be encountered in the UK, and should be considered in the differential diagnosis of an acute exacerbation of AD, particularly in children. PMID:25677678

  11. Methicillin-Resistant Staphylococcus aureus (MRSA) Diagnosis

    MedlinePLUS

    ... gov . Related Links Antibacterial Resistance Leadership Group (ARLG) Microbiology and Infectious Diseases Resources for Researchers NIAID Antimicrobial ... from the infection site and sent to a microbiology laboratory for testing. If S. aureus is found, the ...

  12. [Allergic contact eczema caused by isothiazolin-3-one derivatives].

    PubMed

    Foussereau, J; Brändle, I; Boujnah-Khouadja, A

    1984-01-01

    Observations concerning contact dermatitis to derivatives of isothiazolin-3-one are reported. A systematic review of the literature of previously published cases is reported. A verified contact dermatitis to benzisothiazolin-3-one of a laborer in a rubber factory is discussed. Another case of occupational dermatitis concerns an allergy to a commercial product, containing 2-n-octyl-4-isothiazolin-3-one as a preservative and utilized by shoe factory workers. Additionally, cases of an allergy to cosmetic preparations, containing a mixture of 5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one, are elaborated. PMID:6241142

  13. [Comparison between 2 steroid dosage forms in psoriasis and eczema].

    PubMed

    Björnberg, A; Hellgren, L

    1975-01-01

    This trial was designed to evaluate the clinical effect of a new Topical steroid, the desoximetasone (test name A 41 304 from Hoechst Aktiengesellschaft). A randomized, double-blind, right-left comparative trial has been carried out in 22 patients with atopic dermatitis and on 24 patients with psoriasis. As a comparative drug, a betamethasone 17-valerate preparation, being the strongest on the market, has been used. The new compound showed a better effect on both indications, the difference being significant (p less than 0,005) on psoriasis. PMID:779298

  14. Dyshidrotic eczema: relevance to the immune response in situ

    Microsoft Academic Search

    Ana Maria Abreu Velez; Frank J. Pinto; Michael S. Howard

    2009-01-01

    Context: Pompholyx (called dyshidrosis by some) is one of the most common conditions and its immune response is presently poorly understood. Case report: We describe a 58 year old African American female with a clinical history of rheumatoid arthritis and type II diabetes who presented a chronic five-year, itchy vesicular\\/blistering rash involving her hands and feet. A lesional skin biopsy

  15. Cross-reactivity with Tagetes in Arnica contact eczema

    Microsoft Academic Search

    C. Pirker; T. Möslinger; D. Y. Koller; M. Goutz; R. Jarisch

    1992-01-01

    A 69-year-old patient, with known mercury and adhesive plaster allergy, developed facial dermatitis within 24 h of contact with arnica (Arnica). Skin testing showed positive reactions to arnica and, among various other plants of the Compositae, also to Tagetes sp. hybr. (marigold). Cross-reactivity between Tagetes and arnica has not previously been described.

  16. Epidemiologic Similarities in Pediatric Community-Associated Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus in the San Francisco Bay Area

    PubMed Central

    Hsiang, Michelle S.; Shiau, Rita; Nadle, Joelle; Chan, Liana; Lee, Brian; Chambers, Henry F.; Pan, Erica

    2012-01-01

    Background. Risk factors differentiating methicillin-resistant Staphylococcus aureus (MRSA) from methicillin-sensitive S aureus (MSSA) infections in the pediatric community have been unclear. Methods. We performed a prospective case-comparison investigation of clinical, epidemiological, and molecular factors in pediatric community–associated (CA) MRSA and MSSA cases in the San Francisco Bay Area. Chart reviews were conducted in 270 CA-MRSA and 313 CA-MSSA cases. Fifty-eight CA-MRSA (21.4%) and 95 CA-MSSA (30.4%) cases were interviewed. Molecular typing was performed on 111 isolates. Results. MSSA represented 53.7% of CA cases and was more likely to cause invasive disease (6.2% vs 1.1%, P = .004). Few potential epidemiologic risk factors distinguished CA-MRSA from CA-MSSA. No differences were found in factors related to crowding, cleanliness, or prior antibiotic use. Compromised skin integrity due to eczema (24.3% vs 13.5%, P = .001) was associated with CA-MSSA. Many exposures to potentially infected or colonized contacts or contaminated objects were assessed; only three were associated with CA-MSSA: having a household contact who had surgery in the past year (18.9% vs 6.0%, P = .02), and regular visits to a public shower (9.1% vs 2.0%, P = .01) or gym (12.6% vs 3.3%, P = .04). Molecular typing identified clonal complex 8 as the predominant genetic lineage among CA-MRSA (96.4%) and CA-MSSA (39.3%) isolates. Conclusions. In the context of recent heightened focus on CA-MRSA, the burden of serious disease caused by CA-MSSA among children should not be overlooked. MRSA and MSSA may be growing epidemiologically similar; thus, research, clinical, and public health efforts should focus on S aureus as a single entity. PMID:23687577

  17. Glyconanobiotics: Novel carbohydrated nanoparticle antibiotics for MRSA and Bacillus anthracis

    PubMed Central

    Abeylath, Sampath C.; Turos, Edward; Dickey, Sonja; Limb, Daniel V.

    2008-01-01

    This report describes the synthesis and evaluation of glycosylated polyacrylate nanoparticles that have covalently-bound antibiotics within their framework. The requisite glycosylated drug monomers were prepared from one of three known antibiotics, an N-sec-butylthio ?-lactam, ciprofloxacin, and a penicillin, by acylation with 3-O-acryloyl-1,2-O-isopropylidene-5,6 bis((chlorosuccinyl)oxy)-D-glucofuranose (7) or 6-O-acetyl-3-O-acryloyl-1,2-O-isopropylidene-5-(chlorosuccinyl)oxy-?-D-glucofuranose (10). These acrylated monomers were subjected to emulsion polymerization in a 7:3 (w:w) mixture of butyl acrylate-styrene in the presence of sodium dodecyl sulfate as surfactant (3 weight %) and potassium persulfate as a radical initiator (1 weight %). The resulting nanoparticle emulsions were characterized by dynamic light scattering and found to have similar diameters (~40 nm) and size distributions to those of our previously studied systems. Microbiological testing showed that the N-sec-butylthio ?-lactam and ciprofloxacin nanoparticles both have powerful in vitro activities against methicillin-resistant Staphylococcus aureus and Bacillus anthracis, while the penicillin-bound nanoparticles have no antimicrobial activity. This indicates the need for matching a suitable antibiotic with the nanoparticle carrier. Overall, the study shows that even relatively large, polar acrylate monomers (MW>1000 amu) can be efficiently incorporated into the nanoparticle matrix by emulsion polymerization, providing opportunities for further advances in nanomedicine. PMID:18063370

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

    MedlinePLUS

    ... doctors, nurses, and other healthcare providers: Clean their hands with soap and water or an alcohol-based hand rub ... doctors, nurses, and other healthcare providers clean their hands with soap and water or an alcohol-based hand rub ...

  19. Chapter 20: Atopic dermatitis.

    PubMed

    Sabin, Bradley R; Peters, Neill; Peters, Anju T

    2012-01-01

    Atopic dermatitis (AD), also known as atopic eczema, is a chronic relapsing inflammatory dermatosis characterized by pruritus, xerosis, and a close association with IgE-mediated sensitization to aeroallergens and foods. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). The distribution of lesions varies by age. Infants tend to have lesions on the cheeks and scalp, and very young children typically have involvement over the extremities cheeks, forehead, and neck. Rash in the diaper area of infants is rarely AD. Lesions in older children and adults are usually located in flexural areas, such as the antecubital and popliteal fossae, along with the head and neck. Acute lesions of AD begin as erythematous papules and serous exudates. Secondary lesions include excoriations and crusted erosions due to scratching. Subacute lesions appear as erythematous scaling papules and plaques. If the itch and rash progress uncontrolled, chronic lichenified AD develops featuring accentuated skin markings with hyperpigmentation. Trigger avoidance, skin hydration, and topical steroids are the first steps for improvement. In acute lesions of AD, the Th2 cells produce IL-4, IL-13, and IL-31, which may potentiate barrier dysfunction and contribute to pruritus. In chronic lesions, the Th1 cells predominate and secrete interferon gamma and IL-12. Barrier dysfunction from filaggrin predisposes patients to AD. Skin superinfection, particularly with Staphylococcus aureus, is common, and cultures of affected lesions help guide therapy. Eczema herpeticum from herpes simplex virus can be life-threatening in AD patients. PMID:22794693

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

    E-print Network

    Bishop, Christopher M.

    , Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, United Kingdom, 2 Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, United Kingdom, 3 School of Social and Community Medicine, University of Bristol

  1. [Contact eczema and epicutaneous tests--distribution of allergens and changes in the spectrum in Vienna].

    PubMed

    Aberer, W; Reiter, E

    1991-01-01

    Thousands of contact antigens have been defined. It is, however, remarkable that only a small group of substances (15 to 20) have proved to be frequent or otherwise important causes of allergic contact dermatitis. In agreement with reports from comparable centres, metals are high up on the "hitlist" of frequent allergens (nickel 24%, cobalt 9%, chromates 6%), followed by ingredients of cosmetics and toiletries (fragrances 16%, balsam of Peru 10%, Kathon 5%), whilst already way back are topical medicines (neomycin 4%, parabens 3%, lanolin 2%, benzocaine 1%) and rubber additives (thiuram-mix 2% and carba-mix 1%). Almost all other substances lie below the 1% limit. There was only one remarkable exception in comparison with the results of most other European studies, namely thiomersal, which is widely distributed as a preservative in vaccines in Austria and climbed to second place, with a sensitization rate of 18%. Although the phenylborate mercurials (historic sensitizations due to topical antiseptics) still reached a surprisingly high incidence of 6%, there were hardly any cases of cross-sensitization with thiomersal. A comparison with the international literature illustrates Austria-specific trends and a change in the spectrum over the past years. Interpretation of patch testing requires great specialist knowledge and experience. PMID:2068817

  2. Old King coal - molecular mechanisms underlying an ancient treatment for atopic eczema.

    PubMed

    McLean, W H Irwin; Irvine, Alan D

    2013-02-01

    Traditional remedies for common disorders have been known for centuries, but insight into their mechanism of action is often limited. In this issue of the JCI, Joost Schalkwijk's research group at the Radboud University Nijmegen Medical Centre in The Netherlands advances our understanding of why topical coal tar is an effective treatment for atopic dermatitis (AD), both rationalizing the use of this traditional medicine, and providing the scientific basis for new therapeutic approaches. PMID:23348733

  3. Mouse Study Hints At Treatment for Itch-Related Ills Like Eczema

    MedlinePLUS

    ... at Mount Sinai St. Luke's and Mount Sinai Roosevelt in New York City. He believes the new ... dermatology, Mount Sinai St. Luke's and Mount Sinai Roosevelt, New York City; Buck Institute for Research on ...

  4. Transgenic Mice Expressing IFN-? in the Epidermis Have Eczema, Hair Hypopigmentation, and Hair Loss

    Microsoft Academic Search

    Joseph M. Carroll; Tessa Crornpton; John P. Seery; Fiona M. Watt

    1997-01-01

    To study the role of IFN-? in the pathogenesis of inflammatory skin diseases, we used the involucrin promoter to overexpress IFN-? in the suprabasal layers of transgenic mouse epidermis. IFN-? mRNA and protein were readily detectable in the skin but not in the blood. Mice exhibited striking hypopigmentation of the hair due to a reduced abundance of DOPA-positive melanocytes. Severely

  5. Update on the management of chronic eczema: new approaches and emerging treatment options

    PubMed Central

    Walling, Hobart W; Swick, Brian L

    2010-01-01

    Atopic dermatitis (AD) is a common disease with worldwide prevalence, affecting up to 20% of children and 3% of adults. Recent evidence regarding pathogenesis has implicated epidermal barrier defects deriving from filagrin mutations with resulting secondary inflammation. In this report, the authors comprehensively review the literature on atopic dermatitis therapy, including topical and systemic options. Most cases of AD will benefit from emollients to enhance the barrier function of skin. Topical corticosteroids are first-line therapy for most cases of AD. Topical calcineurin inhibitors (tacrolimus ointment, pimecrolimus cream) are considered second line therapy. Several novel barrier-enhancing prescription creams are also available. Moderate to severe cases inadequately controlled with topical therapy may require phototherapy or systemic therapy. The most commonly employed phototherapy modalites are narrow-band UVB, broadband UVB, and UVA1. Traditional systemic therapies include short-term corticosteroids, cyclosporine (considered to be the gold standard), methotrexate, azathioprine, mycophenolate mofetil, and most recently leflunamide. Biologic therapies include recombinant monoclonal antibodies acting on the immunoglobulin E / interleukin-5 pathway (omalizumab, mepolizumab), acting as tumor necrosis factor-? inhibitors (infliximab, etanercept, adalimumab), and acting as T-cell (alefacept) and B-cell (rituxumab) inhibitors, as well as interferon ? and intravenous immunoglobulin. Efficacy, safety, and tolerability are reviewed for each medication. PMID:21437065

  6. Increase in NGF content and nerve fiber sprouting in human allergic contact eczema

    Microsoft Academic Search

    Ilka Kinkelin; Sandra Mötzing; Martin Koltzenburg; Eva-Bettina Bröcker

    2000-01-01

    There is increasing evidence for an intimate interaction of the skin and the nervous system. As known from animal studies, nerve growth factor (NGF) is essential for the innervation density and functional properties of sensory neurons of the skin during embryogenesis and in adulthood, and possibly during cutaneous inflammation. This study examined NGF content and sprouting of nerves during the

  7. Old King Coal — molecular mechanisms underlying an ancient treatment for atopic eczema

    PubMed Central

    McLean, W.H. Irwin; Irvine, Alan D.

    2013-01-01

    Traditional remedies for common disorders have been known for centuries, but insight into their mechanism of action is often limited. In this issue of the JCI, Joost Schalkwijk’s research group at the Radboud University Nijmegen Medical Centre in The Netherlands advances our understanding of why topical coal tar is an effective treatment for atopic dermatitis (AD), both rationalizing the use of this traditional medicine, and providing the scientific basis for new therapeutic approaches. PMID:23348733

  8. Specificity Protein 1 is Pivotal in the Skin’s Anti-viral Response

    PubMed Central

    Bin, Lianghua; Howell, Michael D; Kim, Byung Eui; Streib, Joanne E; Hall, Clifton F; Leung, Donald YM

    2013-01-01

    Background Previous studies have found Sp1 transcription factor in the viral replication machinery and postulated that Sp1 was required for viral replication in host cells. Objectives We investigated the role of Sp1 in the skin’s anti-viral responses from the perspective of host defense and its biological relevance in patients with atopic dermatitis and a history of eczema herpeticum (ADEH+). Methods Small interfering RNA duplexes were used to knock-down Sp1 in keratinocytes. The expression of vaccinia virus (VV), herpes simplex virus-1 (HSV-1) and other genes were evaluated by real-time PCR, or combined with western blot and immunohistofluorescence staining. A total of 106 human subjects participated in this study. Results Both VV and HSV-1 replication were enhanced in Sp1 knocked-down keratinocytes. Sp1 gene expression was significantly decreased in ADEH+ subjects, as compared to ADEH? and non-atopic subjects (P<0.0001); and inversely correlated with VV DNA copy number in human skin explants incubated with VV in vitro (partial correlation r = ?0.256, P = 0.009). Gene profiling revealed that the anti-viral genes, PKR and OAS2, were significantly downregulated in Sp1 silenced keratinocytes. Gene expression of PKR and OAS2 were also significantly decreased in skin biopsies from ADEH+, as compared to ADEH- and non-atopic subjects. IFN-? augmented the anti-viral capacity of Sp1 silenced keratinocytes. Conclusions Sp1 knockdown enhances viral replication in keratinocytes by downregulating gene expression of PKR and OAS2. Sp1 deficiency in ADEH+ patients may contribute to their increased propensity to disseminated skin viral infections. IFN? augmentation may be a potential treatment for ADEH+ patients. PMID:21208652

  9. Staphylococcus aureus ?-toxin modulates skin host response to viral infection

    PubMed Central

    Bin, Lianghua; Kim, Byung Eui; Brauweiler, Anne; Goleva, Elena; Streib, Joanne; Ji, Yinduo; Schlievert, Patrick M.; Leung, Donald Y. M.

    2012-01-01

    Background Patients with atopic dermatitis (AD) with a history of eczema herpeticum have increased staphylococcal colonization and infections. However, whether Staphylococcus aureus alters the outcome of skin viral infection has not been determined. Objective We investigated whether S aureus toxins modulated host response to herpes simplex virus (HSV) 1 and vaccinia virus (VV) infections in normal human keratinocytes (NHKs) and in murine infection models. Methods NHKs were treated with S aureus toxins before incubation of viruses. BALB/c mice were inoculated with S aureus 2 days before VV scarification. Viral loads of HSV-1 and VV were evaluated by using real-time PCR, a viral plaque-forming assay, and immunofluorescence staining. Small interfering RNA duplexes were used to knockdown the gene expression of the cellular receptor of ?-toxin, a disintegrin and metalloprotease 10 (ADAM10). ADAM10 protein and ?-toxin heptamers were detected by using Western blot assays. Results We demonstrate that sublytic staphylococcal ?-toxin increases viral loads of HSV-1 and VV in NHKs. Furthermore, we demonstrate in vivo that the VV load is significantly greater (P < .05) in murine skin inoculated with an ?-toxin–producing S aureus strain compared with murine skin inoculated with the isogenic ?-toxin–deleted strain. The viral enhancing effect of ?-toxin is mediated by ADAM10 and is associated with its poreforming property. Moreover, we demonstrate that ?-toxin promotes viral entry in NHKs. Conclusion The current study introduces the novel concept that staphylococcal ?-toxin promotes viral skin infection and provides a mechanism by which S aureus infection might predispose the host toward disseminated viral infections. PMID:22840852

  10. Plasmacytoid dendritic cells: a new cutaneous dendritic cell subset with distinct role in inflammatory skin diseases.

    PubMed

    Wollenberg, Andreas; Wagner, Moritz; Günther, Sandra; Towarowski, Andreas; Tuma, Evelyn; Moderer, Martina; Rothenfusser, Simon; Wetzel, Stefanie; Endres, Stefan; Hartmann, Gunther

    2002-11-01

    Epidermal dendritic cells found in inflamed skin include Langerhans cells and the recently identified population of inflammatory dendritic epidermal cells. Another subset of dendritic cells in humans is the plasmacytoid dendritic cell in peripheral blood, which is characterized by the production of large amounts of type I interferon (interferon-alpha and interferon-beta) upon viral infection. We hypothesized that plasmacytoid dendritic cells might be involved in anti-viral defense mechanisms of the skin. Here we investigated plasmacytoid dendritic cells, inflammatory dendritic epidermal cells, and Langerhans cells in epidermal single cell suspensions of normal looking skin from healthy volunteers and of lesional skin from patients with different inflammatory skin diseases. Langerhans cells were found in normal and in inflamed skin samples. In normal skin, plasmacytoid dendritic cells and inflammatory dendritic epidermal cells were low or absent. Lesional skin samples from patients with psoriasis vulgaris and contact dermatitis contained relatively high numbers of both inflammatory dendritic epidermal cells and plasmacytoid dendritic cells. In contrast, many inflammatory dendritic epidermal cells but only very few plasmacytoid dendritic cells could be detected in atopic dermatitis lesions. Lupus erythematosus was characterized by high numbers of plasmacytoid dendritic cells but low numbers of inflammatory dendritic epidermal cells. These results demonstrate that in addition to resident Langerhans cells, plasmacytoid dendritic cells and inflammatory dendritic epidermal cells are selectively recruited to the skin lesions depending on the type of skin disease. The lack of plasmacytoid dendritic cells in atopic dermatitis may predispose atopic dermatitis patients to viral infections such as eczema herpeticum, a secondary infection of atopic dermatitis lesions with herpes simplex virus. The composition of dendritic cell subsets may help to clarify the etiology of inflammatory skin diseases and forms the basis for therapeutic intervention with selective microbial molecules such as immunostimulatory CpG oligonucleotides. PMID:12445198

  11. Herpesviruses and the microbiome.

    PubMed

    Dreyfus, David H

    2013-12-01

    The focus of this article will be to examine the role of common herpesviruses as a component of the microbiome of atopic patients and to review clinical observations suggesting that atopic patients might be predisposed to more severe and atypical herpes-related illness because their immune response is biased toward a TH2 cytokine profile. Human populations are infected with 8 herpesviruses, including herpes simplex virus HSV1 and HSV2 (also termed HHV1 and HHV2), varicella zoster virus (VZV or HHV3), EBV (HHV4), cytomegalovirus (HHV5), HHV6, HHV7, and Kaposi sarcoma-associated herpesvirus (termed KSV or HHV8). Herpesviruses are highly adapted to lifelong infection of their human hosts and thus can be considered a component of the human "microbiome" in addition to their role in illness triggered by primary infection. HSV1 and HSV2 infection and reactivation can present with more severe cutaneous symptoms termed eczema herpeticum in the atopic population, similar to the more severe eczema vaccinatum, and drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) is associated with reactivation of HSV6 and possibly other herpesviruses in both atopic and nonatopic patients. In this review evidence is reviewed that primary infection with herpesviruses may have an atypical presentation in the atopic patient and conversely that childhood infection might alter the atopic phenotype. Reactivation of latent herpesviruses can directly alter host cytokine profiles through viral expression of cytokine-like proteins, such as IL-10 (EBV) or IL-6 (cytomegalovirus and HHV8), viral encoded and secreted siRNA and microRNAs, and modulation of expression of host transcription pathways, such as nuclear factor ?B. Physicians caring for allergic and atopic populations should be aware of common and uncommon presentations of herpes-related disease in atopic patients to provide accurate diagnosis and avoid unnecessary laboratory testing or incorrect diagnosis of other conditions, such as drug allergy or autoimmune disease. Antiviral therapy and vaccines should be administered promptly when indicated clinically. PMID:23611298

  12. Minimal dose requirements for nasal mupirocin and its role in the control of epidemic MRSA

    Microsoft Academic Search

    Casewell W. M; R. L. R. Hill

    1991-01-01

    Staphylococci are still a leading cause of hospital infection. The success of nasal mupirocin for the control of epidemic methicillin- resistant Staphylococcus aureus (EMRSA), the prevention of colonization of central venous cannulae, and the prevention of septicaemia in haemodialysis patients should encourage the use of minimal dose regimens to minimize the emergence of mupirocin resistance. Mupirocin applied to the anterior

  13. Evolutionarily distinct bacteriophage endolysins featuring conserved peptidoglycan cleavage sites protect mice from MRSA infection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Staphylococcus aureus is a Gram-positive pathogen relevant for both human and animal health. With multi-drug resistant S. aureus strains becoming increasingly prevalent, alternative therapeutics are urgently needed. Bacteriophage endolysins (peptidoglycan hydrolases, PGH) are capable of killing Gra...

  14. Mobile Genetic Element-Encoded Cytolysin Connects Virulence to Methicillin Resistance in MRSA

    Microsoft Academic Search

    Shu Y. Queck; Burhan A. Khan; Rong Wang; Thanh-Huy L. Bach; Dorothee Kretschmer; Liang Chen; Barry N. Kreiswirth; Andreas Peschel; Frank R. DeLeo; Michael Otto

    2009-01-01

    Bacterial virulence and antibiotic resistance have a significant influence on disease severity and treatment options during bacterial infections. Frequently, the underlying genetic determinants are encoded on mobile genetic elements (MGEs). In the leading human pathogen Staphylococcus aureus, MGEs that contain antibiotic resistance genes commonly do not contain genes for virulence determinants. The phenol-soluble modulins (PSMs) are staphylococcal cytolytic toxins with

  15. Evidence of staphylococcal toxic shock syndrome caused by MRSA in a mother-newborn pair.

    PubMed

    Rostad, Christina A; Philipsborn, Rebecca Pass; Berkowitz, Frank E

    2015-04-01

    A neonate and his mother presented with fever and erythroderma. The mother met full diagnostic criteria for staphylococcal toxic shock syndrome, whereas the neonate lacked hypotension and multiorgan dysfunction. A wound culture from the neonate's circumcision site grew methicillin-resistant Staphylococcus aureus containing the tst gene. This provides evidence of the first reported case of toxic shock syndrome caused by methicillin-resistant Staphylococcus aureus in a mother-newborn pair. PMID:25260039

  16. Flavonoids from Sophora moorcroftiana and their synergistic antibacterial effects on MRSA.

    PubMed

    Wang, Shuang-Ying; Sun, Zhong-Lin; Liu, Tao; Gibbons, Simon; Zhang, Wen-Ju; Qing, Mu

    2014-07-01

    Synergy is now a widely recognized approach that has direct applicability for new pharmaceuticals. The ethanolic extract of the aerial parts of the herb Sophora moorcroftiana showed significant antibacterial activity against drug-resistant Staphylococcus aureus, and its minimum inhibitory concentration (MIC) was 8 µg/mL. In a phytochemical study of the extract, five flavonoids were obtained. However, the isolates exhibited antibacterial activity in the range of 32-128 µg/mL, which was weaker than the extract. In combination with antibiotics, the antibacterially inactive compound genistein (1) and diosmetin (4) showed significant synergistic activity against drug-resistant S. aureus. In combination with norfloxacin, genistein (1) reduced the MIC to 16 µg/mL and showed synergy against strain SA1199B with a fractional inhibitory concentration index (FICI) of 0.38. With the antibiotics norfloxacin, streptomycin and ciprofloxacin, diosmetin (4) showed synergy against SA1199B, RN4220 and EMRSA-15, with FICI values of 0.38, 0.38 and 0.09, respectively. In an efflux experiment to elucidate a plausible mechanism for the observed synergy, genistein showed marginal inhibition of the NorA efflux protein. PMID:24338874

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

    E-print Network

    Suh, Young-Ger

    . In particular, the 6-n-butylmansonone F showed fourfold higher antibacterial activities compared of the common antibacterial agents (see Fig. 1). Our preliminary SAR studies on mansonone F have re- vealed antibacterial activities, (3) the polar substituents at C-3 eliminate the antibacterial activities, and 4) the C

  18. Defective neutrophil chemotaxis and raised serum ige levels in a child with recurrent bacterial infections and eczema. Influence of levamisole.

    PubMed

    De Cree, J; Emmery, L; Timmermans, J; Eeckels, R; De Cock, W; Verhaegen, H

    1978-02-01

    A 5 1/2-year-old girl, with a life-long history of recurrent staphylococcal infections and eczematous dermatitis had a defect in polymorphonuclear leucocyte chemotaxis and phagocytosis in autologous serum, a high serum IgE level, and a disturbed T cell function. Levamisole improved all the immunological abnormalities and there was a dramatic clinical improvement. Discontinuation of therapy with levamisole resulted in gradual deterioration. PMID:306223

  19. Defective neutrophil chemotaxis and raised serum ige levels in a child with recurrent bacterial infections and eczema. Influence of levamisole

    Microsoft Academic Search

    J De Cree; L Emmery; J Timmermans; R Eeckels; W De Cock; H Verhaegen

    1978-01-01

    A 5 1\\/2-year-old girl, with a life-long history of recurrent staphylococcal infections and eczematous dermatitis had a defect in polymorphonuclear leucocyte chemotaxis and phagocytosis in autologous serum, a high serum IgE level, and a disturbed T cell function. Levamisole improved all the immunological abnormalities and there was a dramatic clinical improvement. Discontinuation of therapy with levamisole resulted in gradual deterioration.

  20. Lymphocyte transformation, IgE and T-cells in eczema vaccinatum treated with transfer factor. A case report.

    PubMed

    Dahl, B; Thestrup-Pedersen, K; Ellegaard, J; Zachariae, H

    1975-01-01

    Transfer factor (TF) was given to intensify the cell-mediated immune reactions in an atopic patient with generalized vaccinia. The patient showed marked reactivity of peripheral blood lymphocytes to stimulation with phytohaemagglutinin and pokeweed mitogen, but also in nonstimulated cultures. However, later tests with mitogen stimulation of lymphocytes indicated a defective cellular defence mechanism. The addition of autologous plasma to lymphocyte cultures depressed the reactivity of PHA-stimulation considerably. Initially, the patient also showed a normal T-lymphocyte count in peripheral blood, but six months after her vaccinia, extremely high serum IgE levels and a decreased percentage of T-lymphocytes was observed. Although an evaluation of the clinical effect of transfer factor injection is difficult, it should be noted that the patient's temperature immediately fell to normal, and her general health improved following treatment. PMID:50689

  1. Sorocenols G and H, Anti-MRSA Oxygen Heterocyclic Diels-Alder-type Adducts from Sorocea muriculata Roots

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Bioassay-guided fractionation of a root extract of Sorocea muriculata led to the isolation and identification of two new oxygen heterocyclic Diels-Alder-type adducts, sorocenols G (1) and H (2), along with lupeol-3-(3'R-hydroxytetradecanoate) and oxyresveratrol. The structures of 1 and 2 were eluci...

  2. University of Minnesota study of exposure of animal manure applicators to bacteria (S. aureus, MRSA) of swine origin

    E-print Network

    Netoff, Theoden

    demonstrated). 2) Recently, studies in Pennsylvania reported associations between application of livestock. Only summary information will be provide at the end of this study. Participation in this study will receive $100 at the end of the study upon completion of the sampling. Contacts: Please feel free

  3. Quantifying Cost-Effectiveness of Controlling Nosocomial Spread of Antibiotic-Resistant Bacteria: The Case of MRSA

    Microsoft Academic Search

    Marjan W. M. Wassenberg; G. Ardine de Wit; Ben A. van Hout; Marc J. M. Bonten

    2010-01-01

    BackgroundThe costs and benefits of controlling nosocomial spread of antibiotic-resistant bacteria are unknown.MethodsWe developed a mathematical algorithm to determine cost-effectiveness of infection control programs and explored the dynamical interactions between different epidemiological variables and cost-effectiveness. The algorithm includes occurrence of nosocomial infections, attributable mortality, costs and efficacy of infection control and how antibiotic-resistant bacteria affect total number of infections: do

  4. Evaluation of the Protective Immunity of a Novel Subunit Fusion Vaccine in a Murine Model of Systemic MRSA Infection

    PubMed Central

    Zuo, Qian-Fei; Yang, Liu-Yang; Feng, Qiang; Lu, Dong-Shui; Dong, Yan-Dong; Cai, Chang-Zhi; Wu, Yi; Guo, Ying; Gu, Jiang; Zeng, Hao; Zou, Quan-Ming

    2013-01-01

    Staphylococcus aureus is a common commensal organism in humans and a major cause of bacteremia and hospital acquired infection. Because of the spread of strains resistant to antibiotics, these infections are becoming more difficult to treat. Therefore, exploration of anti-staphylococcal vaccines is currently a high priority. Iron surface determinant B (IsdB) is an iron-regulated cell wall-anchored surface protein of S. aureus. Alpha-toxin (Hla) is a secreted cytolytic pore-forming toxin. Previous studies reported that immunization with IsdB or Hla protected animals against S. aureus infection. To develop a broadly protective vaccine, we constructed chimeric vaccines based on IsdB and Hla. Immunization with the chimeric bivalent vaccine induced strong antibody and T cell responses. When the protective efficacy of the chimeric bivalent vaccine was compared to that of individual proteins in a murine model of systemic S. aureus infection, the bivalent vaccine showed a stronger protective immune response than the individual proteins (IsdB or Hla). Based on the results presented here, the chimeric bivalent vaccine affords higher levels of protection against S. aureus and has potential as a more effective candidate vaccine. PMID:24324681

  5. Crystal structure of a Baeyer-Villiger flavin-containing monooxygenase from Staphylococcus aureus MRSA strain MU50.

    PubMed

    Hwang, William C; Xu, Qingping; Wu, Bainan; Godzik, Adam

    2014-08-01

    Flavin-containing Monooxygenase (FMO) catalyzed the oxygenation of broad spectrum of substrates. FMO can also serve as biocatalysts in the Baeyer-Villiger reaction in organic synthesis. Here, we report the high-resolution crystal structure of a Baeyer-Villiger Flavin-containing Monooxygenase (BVFMO) from methicillin- and vancomycin-resistant Staphylococcus aureus strain MU50. The structure of S. aureus FMO should facilitate further development of BVFMO as biocatalysts. A possible role of S. aureus FMO in methicillin and vancomycin resistance is discussed. Proteins 2014. © 2014 Wiley Periodicals, Inc. PMID:25092800

  6. Work-related allergy in medical doctors: atopy, exposure to domestic animals, eczema induced by common chemicals and membership of the surgical profession as potential risk factors

    Microsoft Academic Search

    Hitomi Kanayama; Kazuhiro Sato; Tomio Mori; Takayoshi Hirai; Tomohiro Umemura; Tarou Tamura; Toshiko Ido; Masanobu Kumakiri; Yukinori Kusaka

    Purpose  To investigate the risk factors associated with work-related allergy-like symptoms in medical doctors.\\u000a \\u000a \\u000a \\u000a Methods  Self-administered questionnaire survey and CAP test were conducted among medical school students in the 4th grade of their\\u000a 6-year medical course in 1993–1996 and 1999–2001. Follow-up questionnaires were sent in 2004 to the graduates. These questionnaires\\u000a enquired into personal and family history of allergic diseases, lifestyle, history

  7. IL-10 suppresses IL-17-mediated dermal inflammation and reduces the systemic burden of vaccinia virus in a mouse model of eczema vaccinatum

    PubMed Central

    Darling, Alanna R.; Freyschmidt, Eva-Jasmin; Burton, Oliver T.; Koleoglou, Kyle; Oyoshi, Michiko K.; Oettgen, Hans C.

    2014-01-01

    Individuals with atopic dermatitis (AD) are susceptible to a severe, potentially fatal, systemic infection and inflammatory response following exposure to vaccina virus (VV). IL-10 acts both as an inducer of Th2 responses and as a regulator of T cell activation. It has been shown to limit skin inflammation elicited by contact sensitizers. AD exacerbations have been associated with decreased IL-10 function. We used IL-10?/? mice to test the role of the cytokine in VV immunity. They exhibited larger primary lesions and increased cutaneous neutrophil infiltration compared to wild-type (WT) counterparts. This was associated with enhanced production of IL-17A, IL-17F and CXCL2. Paradoxically, despite intact adaptive immune responses, tissue viral burdens were increased in IL-10?/? mice. These findings suggest that IL-10 is important in limiting skin inflammation induced by VV and that abnormal IL-17-driven neutrophil recruitment at the primary infection site in the skin results in increased systemic viral dissemination. PMID:24412909

  8. IL-10 suppresses IL-17-mediated dermal inflammation and reduces the systemic burden of Vaccinia virus in a mouse model of eczema vaccinatum.

    PubMed

    Darling, Alanna R; Freyschmidt, Eva-Jasmin; Burton, Oliver T; Koleoglou, Kyle J; Oyoshi, Michiko K; Oettgen, Hans C

    2014-02-01

    Individuals with atopic dermatitis (AD) are susceptible to a severe, potentially fatal, systemic infection and inflammatory response following exposure to Vaccinia virus (VV). IL-10 acts both as an inducer of Th2 responses and as a regulator of T cell activation. It has been shown to limit skin inflammation elicited by contact sensitizers. AD exacerbations have been associated with decreased IL-10 function. We used IL-10(-/-) mice to test the role of the cytokine in VV immunity. They exhibited larger primary lesions and increased cutaneous neutrophil infiltration compared to wild-type (WT) counterparts. This was associated with enhanced production of IL-17A, IL-17F and CXCL2. Paradoxically, despite intact adaptive immune responses, tissue viral burdens were increased in IL-10(-/-) mice. These findings suggest that IL-10 is important in limiting skin inflammation induced by VV and that abnormal IL-17-driven neutrophil recruitment at the primary infection site in the skin results in increased systemic viral dissemination. PMID:24412909

  9. ENN http://ehs.stanford.edu/aboutus/news.htmlEH&S News & Notes Edition: January 2008

    E-print Network

    and MRSA infections treatable? Yes. Most staph and MRSA infections are treatable with antibiotics. However prevent staph or MRSA skin infec- tions? Factors that have been associated with the spread of MRSA skin://www.cdc. gov/ncidod/dhqp/ar_mrsa.html This article is for information only and is not meant to be used for self

  10. This Just In… The Latest Research Findings

    MedlinePLUS

    ... page please turn Javascript on. Understanding and Controlling MRSA MRSA (pron. MUHR-suh) is a type of "staph" ... are difficult to treat with several common antibiotics. MRSA stands for Methicillin-resistant Staphylococcus aureus. It's sometimes ...

  11. Methicillin-Resistant Staphylococcus aureus, Samoa, 2007–2008

    PubMed Central

    Alesana-Slater, James; Heffernan, Helen; Camp, Tracy; Richardson, Alice; Herbison, Peter; Norris, Pauline

    2011-01-01

    Little is known about the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in most Pacific Island nations. Relatively high rates of MRSA have been reported in Polynesian people living outside the Pacific Islands. To determine the prevalence and characteristics of MRSA, we assessed wound swabs from 399 persons with skin and soft tissue infection living in Samoa. MRSA was isolated from 9% of study participants; 34 of the 196 S. aureus isolates were MRSA. Five MRSA genotypes were identified; the 3 most common were USA300, the Queensland clone, and a sequence type 1 MRSA strain that shares <85% homology with the sequence type 1 MRSA strain common in the region (WA MRSA-1). The Southwest Pacific MRSA clone was identified but accounted for only 12% of MRSA isolates. The high prevalence of MRSA in Samoa provides impetus for initiatives to improve antimicrobial drug resistance surveillance, infection control, and antimicrobial drug use in Pacific Island nations. PMID:21749763

  12. Community Acquisition of Gentamicin-Sensitive Methicillin-Resistant Staphylococcus aureus in Southeast Queensland, Australia

    Microsoft Academic Search

    GRAEME R. NIMMO; JACQUELINE SCHOONEVELDT; BRAD MCCALL; ALISON VICKERY; Brisbane Southside

    2000-01-01

    Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) susceptible to gentamicin has been reported in a number of countries in the 1990s. To study the acquisition of gentamicin-sensitive MRSA (GS-MRSA) in southeast Queensland and the relatedness of GS-MRSA to other strains of MRSA, 35 cases of infection due to GS-MRSA from October 1997 through September 1998 were examined retrospectively to determine the mode

  13. Dissemination of methicillin-resistant Staphylococcus aureus SCCmec type IV and SCCmec type V epidemic clones in a tertiary hospital: challenge to infection control.

    PubMed

    Dhawan, B; Rao, C; Udo, E E; Gadepalli, R; Vishnubhatla, S; Kapil, A

    2015-01-01

    Two-hundred MRSA strains from inpatients with healthcare-associated (HA) and 100 MRSA strains from outpatients with community-associated (CA) skin and soft tissue infections (SSTIs) were tested for antimicrobial susceptibility, staphylococcal cassette chromosome mec (SCCmec) typing, Panton-Valentine leucocidin (PVL) toxin, seh and arcA genes. Based on SCCmec typing, HA-MRSA isolates were further divided into HA-SCCmec I/II/III MRSA and HA-SCCmec IV/V MRSA, and CA-MRSA isolates into CA-SCCmec I/II/III MRSA and CA-SCCmec IV/V MRSA. SCCmec types were further characterized by pulsed-field gel electrophoresis, spa typing and multi-locus sequence typing. Seventy-five (37·5%) HA-MRSA isolates and 83/100 CA-MRSA isolates were SCCmec IV/V genotype. HA-SCCmec IV/V MRSA was associated with malignancy (P = 0·03) and bone fractures (P = 0·02) compared to CA-SCCmec IV/V MRSA. HA-SCCmec IV/V MRSA was associated with PVL gene carriage compared to HA-SCCmec I/II/III MRSA (P < 0·001). ST22-MRSA-IV (EMRSA-15), ST772-MRSA-V, and ST36-MRSA-IV and ST239:EMRSA-I:III were the major clones identified. Our study documents the emergence of SCCmec IV and SCCmec V MRSA clones in an Indian hospital. PMID:24690229

  14. Efficacy of short novel antimicrobial and anti-inflammatory peptides in a mouse model of methicillin-resistant Staphylococcus aureus (MRSA) skin infection

    PubMed Central

    Mohamed, Mohamed F; Seleem, Mohamed N

    2014-01-01

    The therapeutic efficacy of two novel short antimicrobial and anti-inflammatory peptides (RR and RRIKA) was evaluated in a mouse model of staphylococcal skin infection. RR (2%) and RRIKA (2%) significantly reduced the bacterial counts and the levels of proinflammatory cytokines, tumor necrosis factor (TNF)-?, and interleukin (IL)-6, in methicillin-resistant Staphylococcus aureus USA 300-0114 skin lesions. Furthermore, the combined therapy of RRIKA (1%) and lysostaphin (0.5%) had significantly higher antistaphylococcal and anti-inflammatory activity compared to monotherapy. This study supports the potential use of these peptides for topical treatment of methicillin-resistant Staphylococcus aureus skin infections. PMID:25378910

  15. Draft Genome Sequences of Clinical Daptomycin-Nonsusceptible Methicillin-Resistant Staphylococcus aureus (MRSA) Strain APS211 and Its Daptomycin-Susceptible Progenitor APS210

    PubMed Central

    Cameron, David R.; Jiang, Jhih-Hang; Abbott, Iain J.; Spelman, Denis W.

    2015-01-01

    To assess the genetic factors contributing to daptomycin resistance in Staphylococcus aureus, the draft genome of a clinically derived daptomycin-nonsusceptible isolate APS211 was generated and compared to the draft sequence of its susceptible progenitor strain APS210. Four genetic differences were identified including a previously described mutation within the mprF gene. PMID:26067951

  16. JOURNAL OF CLINICAL MICROBIOLOGY, Oct. 2009, p. 31293137 Vol. 47, No. 10 0095-1137/09/$08.00 0 doi:10.1128/JCM.00709-09

    E-print Network

    Wysocki, Vicki H.

    aureus (MRSA) are among the most com- mon complications of health care in the United States. Klevens et al. estimate that 94,360 invasive MRSA infections occur in the United States each year, with associated deaths in 18,650 cases (26). Infections are subcategorized as health care-asso- ciated MRSA (HA-MRSA

  17. Methicillin resistant Staphylococcus aureus colonization in pigs and pig farmers

    Microsoft Academic Search

    T. Khanna; R. Friendship; C. Deweya; J. S. Weese

    2008-01-01

    Methicillin resistant Staphylococcus aureus (MRSA) colonization has recently been identified in pigs and people that work with pigs, raising concerns about the role of pigs as reservoirs of MRSA for human infection. The objectives of this study were to evaluate the prevalence of MRSA colonization in pigs and pig farmers in Ontario, Canada and to characterize MRSA strains. Nasal and

  18. Transmission and Control of Methicillin-Resistant Staphylococcus aureus in a Skilled Nursing Facility

    Microsoft Academic Search

    J. Conley Thomas; Janis Bridge; Stephen Waterman; Jacqueline Vogt; Liga Kilman; Gary Hancock

    1989-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly frequent in both acute care facilities (ACFs) and skilled nursing facilities (SNFs). Admissions to SNFs from ACFs with endemic MRSA are one likely source of infection in SNFs. The occurrence of MRSA in SNFs and the relative roles of ACFs and SNFs in MRSA transmission have not been well characterized. We conducted an epidemiologic

  19. Synthetic Mimics of Antimicrobial Peptides--A Versatile Ring-Opening Metathesis Polymerization Based Platform for the Synthesis of Selective

    E-print Network

    Tew, Gregory N.

    of methicillin-resistant S. aureus bacte- ria (MRSA) jumped from 3 to 52%.[3,4] Two million people in the US are infected annually with MRSA during hospital- ization, and the follow-up costs of these MRSA infections add of and contagion with MRSA and other multiple-resistant organisms. For example, a "first-in-man Phase I clinical

  20. 24 IEEE TRANSACTIONS ON COMPUTER-AIDED DESIGN OF INTEGRATED CIRCUITS AND SYSTEMS, VOL. 17, NO. 1, JANUARY 1998 Efficient Algorithms for the Minimum

    E-print Network

    Cong, Jason "Jingsheng"

    of the MSPSA problem is called the minimum rectilinear Steiner arborescence (MRSA) problem. Given a set be shown that an MSPSA of is an MRSA of . The MSPSA and MRSA problems have applications to performance for the MRSA problem can be cl