Objective: To investigate the molecular epidemiology and antimicrobial resistance patterns of methicillin-resistant Staphylococcus aureus(MRSA) among healthcare workers and patients.Methods: MRSA isolates were recover...Objective: To investigate the molecular epidemiology and antimicrobial resistance patterns of methicillin-resistant Staphylococcus aureus(MRSA) among healthcare workers and patients.Methods: MRSA isolates were recovered from nasal swabs collected at a tertiary care hospital of Nepal and confirmed on the basis of Gram staining, conventional biochemical tests, and PCR amplification of mec A gene. PCRs were also used for detection of the different resistance genes and staphylococcal cassette chromosome(SCC) mec types.Antibiotic susceptibility patterns of isolates were assessed by disc diffusion method and minimum inhibitory concentrations were determined by E-test.Results: A total of 29 MRSA were isolated from 536 nasal swabs(5.4%) of health care workers and patients at a tertiary care hospital in Nepal. All isolates were susceptible to amikacin, gentamicin, vancomycin(minimal inhibitory concentrations < 2 mg/m L), tigecycline, tetracycline, nitrofurantoin, rifampicin, quinupristin-dalfopristin, and linezolid. Among the 29 MRSA isolates, resistance to erythromycin(72%), ciprofloxacin(75%), co-trimoxazole(62%), clindamycin(10%), and chloramphenicol(10%) was found, and fifteen isolates(51%)exhibited high-level mupirocin resistance(minimal inhibitory concentrations > 1 024 mg/m L).Fourteen isolates were found harboring the mup A gene and one isolate was found carrying the novel mup B gene. High prevalence(68%) of SCCmec I type was found, followed by SCCmec V(13%) and SCCmec III(3%) among all the MRSA isolates.Conclusions: We found the emergence of SCCmec type I with high-level mupirocin resistance among MRSA in Nepal. Data also suggest that MRSA SCCmec type V strain has spread from the community to the hospital.展开更多
Introduction: In 2013, the Center for Disease Control (CDC) designated methicillin-resistant Staphylococcus aureus (MRSA) as a serious threat. In addition to its intrinsic virulence, MRSA has become resistant to numer...Introduction: In 2013, the Center for Disease Control (CDC) designated methicillin-resistant Staphylococcus aureus (MRSA) as a serious threat. In addition to its intrinsic virulence, MRSA has become resistant to numerous antibacterial agents. In many instances, mupirocin is used empirically to decolonize patients harboring MRSA to decrease the possibility of progression to disease. In vitro susceptibility information is critical to identify patients who would benefit from use of mupirocin for decolonization and treatment of infections caused by MRSA. Methods: One-hundred and sixty-three recent MRSA single patient clinical isolates were collected from the Clinical Microbiology Laboratory. In-vitro susceptibility testing was performed using E-test methodology for tigecycline, ceftaroline, daptomycin, vancomycin, linezolid, and mupirocin. Results: Of the 163 MRSA isolates tested, >99% demonstrated susceptibility to tigecycline, ceftaroline, daptomycin, vancomycin, and linezolid. Seventy (43%) had vancomycin MICs ≥ 1.5 μg/ml, twenty-four isolates (15%) were resistant to mupirocin, and three appeared to express mupirocin hetero-resistance. Conclusion: While antibiotic susceptibility to mupirocin is not routinely performed in clinical microbiology laboratories, the level of resistance to mupirocin identified in this surveillance study suggests that susceptibility testing should be added to routine MRSA panels.展开更多
Surgical Site Infections (SSIs) remain a prevalent issue in healthcare. An average of 2% to 4% of all Total Knee Arthroplasties (TKA/TKR) result in a Prosthetic Joint Infection (PJI) (Ashraf et al. , 2018). These surg...Surgical Site Infections (SSIs) remain a prevalent issue in healthcare. An average of 2% to 4% of all Total Knee Arthroplasties (TKA/TKR) result in a Prosthetic Joint Infection (PJI) (Ashraf et al. , 2018). These surgical site infections cause significant distress to the patient and require extended courses of antibiotic treatment and revision surgery of the infected joint. SSIs also reduce financial reimbursement to the surgery facility and affect the performing surgeon’s performance scores. To prevent surgical infection, healthcare facilities have implemented various screening or decolonization methods to prevent surgical infection to may cause infection. Various treatment methods exist for managing MRSA preoperatively which include Povidone Iodine (PI) application as a universal decolonization method and/or screening every patient pre-operatively for MRSA and treating MRSA-positive patients with Mupirocin ointment. Both interventions are well-established in the literature. At the author’s facility, the elective TKR populations were analyzed while each intervention was implemented. In 2019 TKR patients underwent MRSA swabbing and testing and in 2021 PI decolonization was the decolonization method of choice. The study revealed that MRSA testing and swabbing were better at reducing SSI related to MRSA than Povidone Iodine decolonization.展开更多
Objective:To evaluate the efficacy and safety of sodium fusidate ointment and mupirocin ointment in the treatment of bacteria-infected skin disease.Methods:The search terms“sodium fusidate ointment”,“mupirocin oint...Objective:To evaluate the efficacy and safety of sodium fusidate ointment and mupirocin ointment in the treatment of bacteria-infected skin disease.Methods:The search terms“sodium fusidate ointment”,“mupirocin ointment”,“bacterial infection”,etc.were searched in the database of PubMed,EMbase,Cochrane,Web of Science,Wanfang,VIP,and CNKI.The search time was from inception to November 2019.Randomized controlled trials of sodium fusidate ointment and mupirocin ointment for the treatment of bacteria-infected skin disease were collected.Two studies independently performed literature screening,data extraction,and literature quality evaluation.Meta analysis was performed using RevMan 5.3 software.Results:A total of 14 literature were included,involving 1,825 patients,916 in the experimental group,and 909 in the control group.Meta analysis results showed that the total clinical effective rate of the experimental group(RR=1.12,95%CI(1.06,1.19),P<0.0001),degree of improvement in pruritus score(MD=−1.21,95%CI(−1.78,−0.64),P<0.0001),degree of improvement of eczema area and severity index score(MD=−2.47,95%CI(−3.92,−1.02),P=0.0008),and sensitivity rate of drug sensitivity test(RR=1.35,95%CI(1.24,1.46),P<0.00001)were better than those of control group.The incidence of adverse reactions(RR=0.18,95%CI(0.09,0.39),P<0.00001)was significantly smaller than that of control group.But the bacterial clearance rate(RR=1.22,95%CI(0.98,1.52),P=0.08)compared with the control group,the difference was not statistically significant.Conclusion:Sodium fusidate ointment is better than mupirocin ointment in the treatment of bacteria-infected skin disease,and it helps to improve the severity of disease and itching,and has good safety,which is worthy of clinical promotion.展开更多
Nanostructured and conducting polymer polyaniline(PANI)is used in numerous applications in electrotherapy,electro-magnetic materials for monitoring health,antimicrobial clothing,data transfer in smart textiles,biosens...Nanostructured and conducting polymer polyaniline(PANI)is used in numerous applications in electrotherapy,electro-magnetic materials for monitoring health,antimicrobial clothing,data transfer in smart textiles,biosensors and for defense technology.An important criterion for all the above mentioned utilities is,producing polymeric conductive fibers.In the present study we prepared conducting PANI nanofibres combined with mupirocin,a topical antimicrobial agent,through a self-assembly process.The prepared polymer was then tested for the antibacterial properties against various Gram positive and Gram negative bacteria such as Streptococcus pyogenes,Staphylococcus epidermidis,Staphylococcus aureus and Escherichia coli.Scanning electron microscopy(SEM)and Fourier transform infrared spectroscopy(FTIR)were used to identify the chemical structure of the PANI nanofibres.The antibacterial properties were assessed by measuring the zones of inhibition.It was evident from these results that antimicrobial activity increased with increasing PANI and PANI combined with mupirocin(PANI-mupirocin)concentrations.It was also found that PANI-mupirocin has enhanced antimicrobial activity compared to PANI alone.This information might be useful to evaluate the potential use of nanostructured polyaniline in fabrics incorporated with antibacterial agents as a prophylactic use against bacterial skin infections in the near future.展开更多
基金Supported by Central Department of Microbiology,Tribhuvan University and Annapurna Neurological Institute and Allied Sciences and supported from National Research Council of Thailand 2016(R2560B064)
文摘Objective: To investigate the molecular epidemiology and antimicrobial resistance patterns of methicillin-resistant Staphylococcus aureus(MRSA) among healthcare workers and patients.Methods: MRSA isolates were recovered from nasal swabs collected at a tertiary care hospital of Nepal and confirmed on the basis of Gram staining, conventional biochemical tests, and PCR amplification of mec A gene. PCRs were also used for detection of the different resistance genes and staphylococcal cassette chromosome(SCC) mec types.Antibiotic susceptibility patterns of isolates were assessed by disc diffusion method and minimum inhibitory concentrations were determined by E-test.Results: A total of 29 MRSA were isolated from 536 nasal swabs(5.4%) of health care workers and patients at a tertiary care hospital in Nepal. All isolates were susceptible to amikacin, gentamicin, vancomycin(minimal inhibitory concentrations < 2 mg/m L), tigecycline, tetracycline, nitrofurantoin, rifampicin, quinupristin-dalfopristin, and linezolid. Among the 29 MRSA isolates, resistance to erythromycin(72%), ciprofloxacin(75%), co-trimoxazole(62%), clindamycin(10%), and chloramphenicol(10%) was found, and fifteen isolates(51%)exhibited high-level mupirocin resistance(minimal inhibitory concentrations > 1 024 mg/m L).Fourteen isolates were found harboring the mup A gene and one isolate was found carrying the novel mup B gene. High prevalence(68%) of SCCmec I type was found, followed by SCCmec V(13%) and SCCmec III(3%) among all the MRSA isolates.Conclusions: We found the emergence of SCCmec type I with high-level mupirocin resistance among MRSA in Nepal. Data also suggest that MRSA SCCmec type V strain has spread from the community to the hospital.
文摘Introduction: In 2013, the Center for Disease Control (CDC) designated methicillin-resistant Staphylococcus aureus (MRSA) as a serious threat. In addition to its intrinsic virulence, MRSA has become resistant to numerous antibacterial agents. In many instances, mupirocin is used empirically to decolonize patients harboring MRSA to decrease the possibility of progression to disease. In vitro susceptibility information is critical to identify patients who would benefit from use of mupirocin for decolonization and treatment of infections caused by MRSA. Methods: One-hundred and sixty-three recent MRSA single patient clinical isolates were collected from the Clinical Microbiology Laboratory. In-vitro susceptibility testing was performed using E-test methodology for tigecycline, ceftaroline, daptomycin, vancomycin, linezolid, and mupirocin. Results: Of the 163 MRSA isolates tested, >99% demonstrated susceptibility to tigecycline, ceftaroline, daptomycin, vancomycin, and linezolid. Seventy (43%) had vancomycin MICs ≥ 1.5 μg/ml, twenty-four isolates (15%) were resistant to mupirocin, and three appeared to express mupirocin hetero-resistance. Conclusion: While antibiotic susceptibility to mupirocin is not routinely performed in clinical microbiology laboratories, the level of resistance to mupirocin identified in this surveillance study suggests that susceptibility testing should be added to routine MRSA panels.
文摘Surgical Site Infections (SSIs) remain a prevalent issue in healthcare. An average of 2% to 4% of all Total Knee Arthroplasties (TKA/TKR) result in a Prosthetic Joint Infection (PJI) (Ashraf et al. , 2018). These surgical site infections cause significant distress to the patient and require extended courses of antibiotic treatment and revision surgery of the infected joint. SSIs also reduce financial reimbursement to the surgery facility and affect the performing surgeon’s performance scores. To prevent surgical infection, healthcare facilities have implemented various screening or decolonization methods to prevent surgical infection to may cause infection. Various treatment methods exist for managing MRSA preoperatively which include Povidone Iodine (PI) application as a universal decolonization method and/or screening every patient pre-operatively for MRSA and treating MRSA-positive patients with Mupirocin ointment. Both interventions are well-established in the literature. At the author’s facility, the elective TKR populations were analyzed while each intervention was implemented. In 2019 TKR patients underwent MRSA swabbing and testing and in 2021 PI decolonization was the decolonization method of choice. The study revealed that MRSA testing and swabbing were better at reducing SSI related to MRSA than Povidone Iodine decolonization.
文摘Objective:To evaluate the efficacy and safety of sodium fusidate ointment and mupirocin ointment in the treatment of bacteria-infected skin disease.Methods:The search terms“sodium fusidate ointment”,“mupirocin ointment”,“bacterial infection”,etc.were searched in the database of PubMed,EMbase,Cochrane,Web of Science,Wanfang,VIP,and CNKI.The search time was from inception to November 2019.Randomized controlled trials of sodium fusidate ointment and mupirocin ointment for the treatment of bacteria-infected skin disease were collected.Two studies independently performed literature screening,data extraction,and literature quality evaluation.Meta analysis was performed using RevMan 5.3 software.Results:A total of 14 literature were included,involving 1,825 patients,916 in the experimental group,and 909 in the control group.Meta analysis results showed that the total clinical effective rate of the experimental group(RR=1.12,95%CI(1.06,1.19),P<0.0001),degree of improvement in pruritus score(MD=−1.21,95%CI(−1.78,−0.64),P<0.0001),degree of improvement of eczema area and severity index score(MD=−2.47,95%CI(−3.92,−1.02),P=0.0008),and sensitivity rate of drug sensitivity test(RR=1.35,95%CI(1.24,1.46),P<0.00001)were better than those of control group.The incidence of adverse reactions(RR=0.18,95%CI(0.09,0.39),P<0.00001)was significantly smaller than that of control group.But the bacterial clearance rate(RR=1.22,95%CI(0.98,1.52),P=0.08)compared with the control group,the difference was not statistically significant.Conclusion:Sodium fusidate ointment is better than mupirocin ointment in the treatment of bacteria-infected skin disease,and it helps to improve the severity of disease and itching,and has good safety,which is worthy of clinical promotion.
基金The authors are grateful to the management of the Masterskill university of health science,Malaysia for promoting research and providing financial support in carrying out this investigation and Nano-RAM Technologies,Bangalore,Karnataka State,India for their technical support.
文摘Nanostructured and conducting polymer polyaniline(PANI)is used in numerous applications in electrotherapy,electro-magnetic materials for monitoring health,antimicrobial clothing,data transfer in smart textiles,biosensors and for defense technology.An important criterion for all the above mentioned utilities is,producing polymeric conductive fibers.In the present study we prepared conducting PANI nanofibres combined with mupirocin,a topical antimicrobial agent,through a self-assembly process.The prepared polymer was then tested for the antibacterial properties against various Gram positive and Gram negative bacteria such as Streptococcus pyogenes,Staphylococcus epidermidis,Staphylococcus aureus and Escherichia coli.Scanning electron microscopy(SEM)and Fourier transform infrared spectroscopy(FTIR)were used to identify the chemical structure of the PANI nanofibres.The antibacterial properties were assessed by measuring the zones of inhibition.It was evident from these results that antimicrobial activity increased with increasing PANI and PANI combined with mupirocin(PANI-mupirocin)concentrations.It was also found that PANI-mupirocin has enhanced antimicrobial activity compared to PANI alone.This information might be useful to evaluate the potential use of nanostructured polyaniline in fabrics incorporated with antibacterial agents as a prophylactic use against bacterial skin infections in the near future.
