scholarly journals Prevalence of Multiple Antibiotic Resistant Infections in Diabetic versus Nondiabetic Wounds

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Urvish Trivedi ◽  
Shamini Parameswaran ◽  
Andrew Armstrong ◽  
Diana Burgueno-Vega ◽  
John Griswold ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Antibiotic Resistant ◽  
Foot Ulceration ◽  
Multidrug Resistant Organisms ◽  
Initial Hypothesis ◽  
The Usa

Diabetes mellitus (DM) affects 23.6 million people in the USA and approximately 20–25% of diabetic patients will develop foot ulceration during the course of their disease. Up to a quarter of these patients will develop infections that will necessitate amputation. Although many studies report that the rates of antibiotic resistant infections have increased dramatically in the DM population over the last decade, to our knowledge there have been no reports directly comparing the rates of antibiotic resistant infections in DM versus non-DM wounds. We performed a retrospective study comparing the wound infections of 41 DM patients to those of 74 non-DM patients to test the hypothesis that infections with multidrug resistant organisms (MDRO) were more prevalent in the DM population. We found that 63.4% of DM and 50% of non-DM patients had MDRO infections, which was not statistically different. However, 61% of the DM patients hadPseudomonasinfections compared to only 18.9% of non-DM patients. Furthermore, DM patients had significantly more coinfections with bothPseudomonasandStaphylococcus aureus. Though our initial hypothesis was incorrect, we demonstrated a significant correlation betweenPseudomonasandPseudomonas/S. aureuscoinfections within DM wounds.

scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

scholarly journals Methicillin-Resistant Staphylococcus aureus Diabetic Foot Crossed Infection: A Case Report

Pathogens ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 549 ◽  
Author(s):  
María Reina-Bueno ◽  
Inmaculada C. Palomo-Toucedo ◽  
Aurora Castro-Méndez ◽  
Gabriel Domínguez-Maldonado ◽  
María del Carmen Vázquez-Bautista
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Immunological Response ◽  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
Diabetic Patients ◽  
Methicillin Resistant ◽  
Specific Protocol ◽  
Hygiene Measures ◽  
Patients With Diabetes

This work presents a protocol to prevent the transmission of multidrug-resistant infections. We focus on the Diabetic Foot Unit Podiatry Clinic Area attached to the University of Seville in particular. The most common complication for patients with diabetes is leg ulcers. Together with neuropathy, vasculopathy, and immunological response disorder, these individuals have a high predisposition to developing infections. Staphylococcus aureus is a highly prevalent microorganism in humans which, at times, may act as a pathogen. Due mainly to indiscriminate abuse of antibiotics, the methicillin-resistant strain known by its initials as MRSA is the most extended nosocomial infection globally and is a severe community and hospital healthcare problem. This paper describes compliance with new general recommendations on cleaning, hygiene, and decontamination, in addition to implementation of this specific protocol, after detection of cross infection (healthcare-related infection) in the studied unit in two patients with MRSA-infected ulcers. After an in-depth bibliographical review, strict hand hygiene measures and use of non-sterile gloves were used when treating all patients with a diabetic foot. Finally, we reflect on the need to educate healthcare personnel to guarantee correct prescription of selected antibiotics. The role of the podiatrist in the multidisciplinary team is highlighted not only in terms of management and treatment of lesions in diabetic patients, but also as a healthcare agent for the detection and prevention of MRSA together with other multidrug-resistant infections.

Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital–bound palliative care unit: A prospective cohort analysis

2020 ◽  
Vol 34 (6) ◽  
pp. 776-783 ◽  
Author(s):  
Tobias Georg Strapatsas ◽  
Viola Simons ◽  
Beniam Ghebremedhin ◽  
Parviz Ahmad-Nejad ◽  
Oliver Schmalz
Keyword(s):  
Staphylococcus Aureus ◽  
Palliative Care ◽  
Confidence Interval ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Cohort Analysis ◽  
Multidrug Resistant ◽  
Interquartile Range ◽  
University Hospital ◽  
Methicillin Resistant ◽  
Multidrug Resistant Organisms

Background: Multidrug-resistant organisms are a growing challenge and burden to patient care. To date, there are only data concerning the prevalence of methicillin-resistant Staphylococcus aureus infections. Thus, numbers of other multidrug-resistant organisms can only be extrapolated and inferred from more or less comparable cohorts. Aim: To evaluate the prevalence of multidrug-resistant organisms on palliative care in-patients. Design: A prospective cohort analysis Setting/participants: A University Hospital–bound palliative care unit, in which all patients admitted to the unit were screened for inclusion. Results: In total, 304 patients were included in this study. The prevalence for methicillin-resistant Staphylococcus aureus of 5.2% (95% confidence interval: 2.9%–8.4%), for vancomycin-resistant Enterococcus faecium of 10.5% (95% confidence interval: 7.2%–14.8%), for Ciprofloxacin-resistant-extended spectrum beta-lactamases isolates of 5.8% (95% confidence interval: 3.4%–9.3%) and Ciprofloxacin-resistant Carbapenem-resistant Gram-negative bacteria of 0.3% (95% confidence interval: 0%–1.3%) was calculated. Except for methicillin-resistant Staphylococcus aureus, patients carrying a multidrug-resistant organism had a significant longer duration of hospitalization. Median length of stay was 12 days (interquartile range: 14.5, no multidrug-resistant organisms), 14.5 days (interquartile range: 15, methicillin-resistant Staphylococcus aureus), 21 days (interquartile range: 16.5, vancomycin-resistant enterococci), 22 days (interquartile range: 20.75, Ciprofloxacin-resistant-extended spectrum beta-lactamases) and 32 days (interquartile range: 22.00) for patients carrying two organisms. Conclusion: There is a high prevalence of all multidrug-resistant organisms within the hospitalized palliative care patients. However, the multidrug-resistant organisms do not seem to impact the survival within this cohort. Further studies should evaluate additional end-points, for example, quality of life, which are of special interest in this cohort.

scholarly journals Classification of Epidemic Community-Acquired Methicillin-ResistantStaphylococcus aureusby Anatomical Site of Isolation

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Jill C. Roberts
Keyword(s):  
Infectious Disease ◽  
Staphylococcus Aureus ◽  
Invasive Disease ◽  
Anatomical Site ◽  
Wound Infections ◽  
Nasal Swabs ◽  
The Usa ◽  
Clinically Significant ◽  
Serious Disease

Methicillin-resistantStaphylococcus aureuscontributes significantly to cost, morbidity, and mortality due to infectious disease. We surveyed community-associated MRSA isolates to determine which strains were present within anatomical sites of interest. The most likely sources of MRSA among anatomic sites swabbed were wounds followed by the nasal cavity. The USA 300 MRSA strain was most commonly isolated among wound infections while nasal swabs largely yielded USA 100 MRSA. The frequency of isolation of USA 100 amongst community-associated strains is clinically significant as this strain is often correlated with invasive disease, exhibits broad antibiotic resistance, and has been considered to be hospital associated. The potential of USA 100 to cause serious disease and the frequency of its isolation suggest an important reservoir for opportunistic infection. These data demonstrate that MRSA epidemic clones are widespread among the community.

scholarly journals Differences in Hospital-Associated Multidrug-Resistant Organisms and Clostridium difficile Rates Using 2-Day versus 3-Day Definitions

2014 ◽  
Vol 35 (11) ◽  
pp. 1417-1420 ◽  
Author(s):  
Adrijana Gombosev ◽  
Salah E. Fouad ◽  
Eric Cui ◽  
Chenghua Cao ◽  
Leah Terpstra ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Infection Prevention ◽  
Prevention Programs ◽  
Multidrug Resistant ◽  
Infect Control Hosp ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Multidrug Resistant Organisms ◽  
Vancomycin Resistant

We surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, extended-spectrum β-lactamase, and multidrug-resistant Acinetobacter acquisition, as well as hospital-associated MRSA bacteremia and Clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. The former resulted in significantly higher median rates, ranging from 6.76% to 45.07% higherInfect Control Hosp Epidemiol 2014;35(11):1417–1420

scholarly journals Efficacy of Phage Cocktail AB-SA01 Therapy in Diabetic Mouse Wound Infections Caused by Multidrug-Resistant Staphylococcus aureus

2020 ◽  
Author(s):  
Legesse Garedew Kifelew ◽  
Morgyn S. Warner ◽  
Sandra Morales ◽  
Lewis Vaughan ◽  
Richard Woodman ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Bacterial Load ◽  
Foot Ulcer ◽  
Diabetic Mouse ◽  
Multidrug Resistant ◽  
Two Phase ◽  
Antibiotic Resistant ◽  
Phage Cocktail ◽  
Vancomycin Treatment

Abstract Background: Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus. Antibiotic-resistant Staphylococcus aureus is frequently isolated from DFU infections. Bacteriophages (“phages”) represent an alternative or adjunct treatment to antibiotic therapy. Here we describe the efficacy of AB-SA01, a cocktail of three S. aureus Myoviridae phages, made to current good manufacturing practice (cGMP) standards, and which has undergone two phase I trials, in treatment of multidrug-resistant (MDR) S. aureus infections.Methods: Using a diabetic mouse model, bilateral six-millimetre excisional deep skin wounds inflicted on the dorsum of Balb/c mice were infected with 6.7 log10 colony-forming units (CFU) of clinical MDR S. aureus. Infections were treated topically with AB-SA01, or controls: saline, or saline plus intraperitoneal (IP) vancomycin. Bacterial load and wound healing parameters were used to assess treatment efficacy.Results: Wounds of saline-treated mice showed no healing, but expanded and became inflamed, ulcerated, and suppurating. In contrast, AB-SA01 treatment decreased the bacterial load with efficacy similar or superior to vancomycin treatment. In phage-treated mice, wound healing was seen similar to vancomycin treatment. No adverse effects related to the application of phages were observed.Conclusion: Our results suggest that topical phage cocktail treatment may be effective in treating antibiotic-resistant S. aureus DFU infections.

scholarly journals Photodynamic Treatment of Staphylococcus aureus Infections

2021 ◽  
Author(s):  
Christian Erick Palavecino ◽  
Camila Pérez ◽  
Tania Zuñiga
Keyword(s):  
Staphylococcus Aureus ◽  
Photodynamic Therapy ◽  
Large Body ◽  
Multidrug Resistant ◽  
Photodynamic Treatment ◽  
Antibiotic Resistant ◽  
Bibliographic Search ◽  
Life Threatening ◽  
Major Producer ◽  
Healthcare Associated

Introduction: Staphylococcus aureus is a Gram-positive coconut that causes various life-threatening infections and, in turn, represents a major producer of healthcare-associated infections. This pathogen is highly resistant to antibiotics, which has made it difficult to eradicate in recent decades. Photodynamic therapy is a promising approach to address the notable shortage of antibiotic options against multidrug-resistant Staphylococcus aureus. This therapy combines the use of a photosensitizing agent, light, and oxygen to eradicate pathogenic microorganisms. The purpose of this study is to provide relevant bibliographic information about the application of photodynamic therapy as an alternative antimicrobial therapy for Staphylococcus aureus infections. Methods: This review was achieved through a bibliographic search in various databases and the analysis of relevant publications on the subject. Results: A large body of evidence demonstrates the efficacy of photodynamic therapy in eliminating biofilm- or biofilm-producing strains of Staphylococcus aureus, as well as antibiotic-resistant strains. Conclusion: We conclude that photodynamic therapy against Staphylococcus aureus is a recommended antibacterial therapy that may complement antibiotic treatment.

scholarly journals Risk factors for the diabetic foot infection with multidrug-resistant microorganisms in South India

2018 ◽  
Vol 5 (2) ◽  
pp. 675 ◽  
Author(s):  
Manikandan Kathirvel ◽  
Viswakumar Prabakaran ◽  
Jayalakshmi Jayarajan ◽  
Ajay Sivakumar ◽  
Vimalkumar Govindan
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
Univariate Analysis ◽  
Previous History ◽  
Multidrug Resistant ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Recurrent Ulcer ◽  
Multidrug Resistant Organisms ◽  
Recurrent Ulcers

Background: To analyse the risk-factors contributing to infection with multidrug-resistant organisms.Methods: 150 diabetic patients with foot ulcer were prospectively studied. Detailed clinical history and clinical examination of the ulcer were done for all patients. The microbiological profile was analyzed for each patient. Using internationally accepted criteria, the multidrug-resistant organisms were identified. Risk factors for acquiring MDRO infection were identified using appropriate statistical tools.Results: MDRO were isolated from 99 patients of 150 (66%). 54.8% (153 out of 279) of isolated organisms were multidrug-resistant organisms. By univariate analysis poor glycaemic control, previous hospitalisation, previous history of amputation, previous antibiotic usage, size of the ulcer, necrotic ulcer, recurrent ulcers, higher grade of ulcer, the presence of osteomyelitis, the presence of retinopathy, peripheral vascular disease, neuropathy and polymicrobial culture, were significantly associated with MDRO infected foot ulcers. Analysis by logistic regression indicated that only two factors significantly increased the risk of acquiring MDRO infection. They are recurrent ulcer (OR = 3.39, p <0.05, 95% CI = 1.081-10.664) and higher grade of ulcer (OR = 13.44, p <0.001, 95 % CI =3.595-50.278).Conclusions: The prevalence of MDRO is alarmingly high in infected diabetic foot ulcers. Recurrent ulcers and higher grade of ulcers are more prone to acquire MDROs.

scholarly journals Comparison of Transcriptional Responses and Metabolic Alterations in Three Multidrug-Resistant Model Microorganisms, Staphylococcus aureus ATCC BAA-39, Escherichia coli ATCC BAA-196, and Acinetobacter baumannii ATCC BAA-1790, on Exposure to Iodine-Containing Nano-micelle Drug FS-1

mSystems ◽  
2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Ilya S. Korotetskiy ◽  
Sergey V. Shilov ◽  
Tatyana V. Kuznetsova ◽  
Aleksandr I. Ilin ◽  
Monique Joubert ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Gene Regulation ◽  
Growth Phase ◽  
Multidrug Resistant ◽  
Genome Sequences ◽  
Antibiotic Resistant ◽  
Content Type ◽  
Reference Strains ◽  
Sublethal Concentrations

ABSTRACT Iodine is one of the oldest antimicrobial agents. Until now, there have been no reports on acquiring resistance to iodine. Recent studies showed promising results on application of iodine-containing nano-micelles, FS-1, against antibiotic-resistant pathogens as a supplement to antibiotic therapy. The mechanisms of the action, however, remain unclear. The aim of this study was to perform a holistic analysis and comparison of gene regulation in three phylogenetically distant multidrug-resistant reference strains representing pathogens associated with nosocomial infections from the ATCC culture collection: Escherichia coli BAA-196, Staphylococcus aureus BAA-39, and Acinetobacter baumannii BAA-1790. These cultures were treated by a 5-min exposure to sublethal concentrations of the iodine-containing drug FS-1 applied in the late lagging phase and the middle of the logarithmic growth phase. Complete genome sequences of these strains were obtained in the previous studies. Gene regulation was studied by total RNA extraction and Ion Torrent sequencing followed by mapping the RNA reads against the reference genome sequences and statistical processing of read counts using the DESeq2 algorithm. It was found that the treatment of bacteria with FS-1 profoundly affected the expression of many genes involved in the central metabolic pathways; however, alterations of the gene expression profiles were species specific and depended on the growth phase. Disruption of respiratory electron transfer membrane complexes, increased penetrability of bacterial cell walls, and osmotic and oxidative stresses leading to DNA damage were the major factors influencing the treated bacteria. IMPORTANCE Infections caused by antibiotic-resistant bacteria threaten public health worldwide. Combinatorial therapy in which antibiotics are administered together with supplementary drugs improving susceptibility of pathogens to the regular antibiotics is considered a promising way to overcome this problem. An induction of antibiotic resistance reversion by the iodine-containing nano-micelle drug FS-1 has been reported recently. This drug is currently under clinical trials in Kazakhstan against multidrug-resistant tuberculosis. The effects of released iodine on metabolic and regulatory processes in bacterial cells remain unexplored. The current work provides an insight into gene regulation in the antibiotic-resistant nosocomial reference strains treated with iodine-containing nanoparticles. This study sheds light on unexplored bioactivities of iodine and the mechanisms of its antibacterial effect when applied in sublethal concentrations. This knowledge will aid in the future design of new drugs against antibiotic-resistant infections.

scholarly journals The Neutrally Charged Diarylurea Compound PQ401 Kills Antibiotic-Resistant and Antibiotic-Tolerant Staphylococcus aureus

mBio ◽  
2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Wooseong Kim ◽  
Guijin Zou ◽  
Wen Pan ◽  
Nico Fricke ◽  
Hammad A. Faizi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Lipid Bilayers ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Cross Resistance ◽  
Lead Compound ◽  
Neutral Form ◽  
Cationic Form ◽  
Antibiotic Resistant ◽  
Content Type

ABSTRACT Resistance or tolerance to traditional antibiotics is a challenging issue in antimicrobial chemotherapy. Moreover, traditional bactericidal antibiotics kill only actively growing bacterial cells, whereas nongrowing metabolically inactive cells are tolerant to and therefore “persist” in the presence of legacy antibiotics. Here, we report that the diarylurea derivative PQ401, previously characterized as an inhibitor of the insulin-like growth factor I receptor, kills both antibiotic-resistant and nongrowing antibiotic-tolerant methicillin-resistant Staphylococcus aureus (MRSA) by lipid bilayer disruption. PQ401 showed several beneficial properties as an antimicrobial lead compound, including rapid killing kinetics, low probability for resistance development, high selectivity to bacterial membranes compared to mammalian membranes, and synergism with gentamicin. In contrast to well-studied membrane-disrupting cationic antimicrobial low-molecular-weight compounds and peptides, molecular dynamic simulations supported by efficacy data demonstrate that the neutral form of PQ401 penetrates and subsequently embeds into bacterial lipid bilayers more effectively than the cationic form. Lastly, PQ401 showed efficacy in both the Caenorhabditis elegans and Galleria mellonella models of MRSA infection. These data suggest that PQ401 may be a lead candidate for repurposing as a membrane-active antimicrobial and has potential for further development as a human antibacterial therapeutic for difficult-to-treat infections caused by both drug-resistant and -tolerant S. aureus. IMPORTANCE Membrane-damaging antimicrobial agents have great potential to treat multidrug-resistant or multidrug-tolerant bacteria against which conventional antibiotics are not effective. However, their therapeutic applications are often hampered due to their low selectivity to bacterial over mammalian membranes or their potential for cross-resistance to a broad spectrum of cationic membrane-active antimicrobial agents. We discovered that the diarylurea derivative compound PQ401 has antimicrobial potency against multidrug-resistant and multidrug-tolerant Staphylococcus aureus. PQ401 selectively disrupts bacterial membrane lipid bilayers in comparison to mammalian membranes. Unlike cationic membrane-active antimicrobials, the neutral form of PQ401 rather than its cationic form exhibits maximum membrane activity. Overall, our results demonstrate that PQ401 could be a promising lead compound that overcomes the current limitations of membrane selectivity and cross-resistance. Also, this work provides deeper insight into the design and development of new noncharged membrane-targeting therapeutics to combat hard-to-cure bacterial infections.

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