scholarly journals Update on Coagulase-Negative Staphylococci—What the Clinician Should Know

2021 ◽  
Vol 9 (4) ◽  
pp. 830
Author(s):  
Ricarda Michels ◽  
Katharina Last ◽  
Sören L. Becker ◽  
Cihan Papan
Keyword(s):  
Clinical Care ◽  
Clinical Information ◽  
Preterm Neonates ◽  
Coagulase Negative Staphylococci ◽  
Antimicrobial Drugs ◽  
The Past ◽  
Healthcare Settings ◽  
Skin Contamination ◽  
Implanted Medical Devices ◽  
Causative Agents

Coagulase-negative staphylococci (CoNS) are among the most frequently recovered bacteria in routine clinical care. Their incidence has steadily increased over the past decades in parallel to the advancement in medicine, especially in regard to the utilization of foreign body devices. Many new species have been described within the past years, while clinical information to most of those species is still sparse. In addition, interspecies differences that render some species more virulent than others have to be taken into account. The distinct populations in which CoNS infections play a prominent role are preterm neonates, patients with implanted medical devices, immunodeficient patients, and those with other relevant comorbidities. Due to the property of CoNS to colonize the human skin, contamination of blood cultures or other samples occurs frequently. Hence, the main diagnostic hurdle is to correctly identify the cases in which CoNS are causative agents rather than contaminants. However, neither phenotypic nor genetic tools have been able to provide a satisfying solution to this problem. Another dilemma of CoNS in clinical practice pertains to their extensive antimicrobial resistance profile, especially in healthcare settings. Therefore, true infections caused by CoNS most often necessitate the use of second-line antimicrobial drugs.

ANTIBIOTIC THERAPY FOR COW MASTITIS

2021 ◽  
Vol 1 (2) ◽  
pp. 162-168
Author(s):  
N.N. Avduevskyа ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Dairy Farms ◽  
Pathogenic Microorganisms ◽  
Streptococcus Dysgalactiae ◽  
Antimicrobial Drugs ◽  
Milk Samples ◽  
The Past ◽  
The Family ◽  
Causative Agents

Over the past two years (2019, 2020), we have studied 660 milk samples from cows with various forms of mastitis, delivered from 50 dairy farms and complexes. At the same time, 1240 microbiological studies were performed, as a result of which 248 cultures of pathogenic and conditionally pathogenic microorganisms were isolated, namely: 146 (58,8%) cultures of Staphylococcus aureus, 33 – (13,3%) conditionally pathogenic staphylococci, 31 – (12,5%) Streptococcus agalactiae, 13 – (5,2%) Streptococcus dysgalactiae, 25 – (10%) of the family of Enterobacteriaceae. For 2019 and 2020 the allocation percentage of Staphylococcus aureus was 58,8%, which exceeds the allocation percentage of conditional pathogenic staphylococci 4,4 times, agalactiae 4,7 times and dysgalactiae Streptococcus 11,3%, enterobacteria, 5,9 times, respectively. After examining the areas of growth retardation of Staphylococcus aureus to antimicrobial agents, both intracisternal and intramuscular, on the example of nine dairy farms in 2019 and 2020, we revealed different resistance of the pathogen in each of the farms we examined. When analyzing the sensitivity of Staphylococcus aureus to antimicrobial drugs, including complex ones, their active substance was taken into account. As a result of the conducted studies, it was found that in all farms, the greatest sensitivity of Staphylococcus aureus was noted to norfloxacin (35,3 mm), neomycin (33,2 mm), amoxicillin (34,5 mm), benzylpenicillin-procaine (33,6 mm), marbofloxacin (34,5 mm). The lowest sensitivity of the microbe was found to cloxacillin (26,6 mm), dioxidin (22,5 mm), and spiramycin (25,5 mm). Thus, Staphylococcus aureus has different resistance to antibiotics, and the use of antimicrobial agents with low effectiveness can lead to a chronic form of mastitis. In this regard, and to achieve effective treatment, it is necessary to identify the causative agents of inflammation of the mammary gland of cows, as well as to analyze their sensitivity to the antibacterial drugs used in the farm. The article was completed in accordance with state task N 0578-2019-0003.

Novel Drugs and Biologics of 2016: A Boom for Neurodrugs in the Pipelin

2017 ◽  
Vol 10 (5) ◽  
pp. 3809-3814
Author(s):  
D Samba Reddy
Keyword(s):  
Muscular Atrophy ◽  
Clinical Care ◽  
New Drugs ◽  
Essential Medicines ◽  
High Demand ◽  
The Past ◽  
Novel Drugs ◽  
Innovative Products ◽  
Cns Drugs ◽  
The U.S

This article provides a brief overview of novel drugs approved by the U.S. FDA in 2016.  It also focuses on the emerging boom in the development of neurodrugs for central nervous system (CNS) disorders. These new drugs are innovative products that often help advance clinical care worldwide, and in 2016, twenty-two such drugs were approved by the FDA. The list includes the first new drug for disorders such as spinal muscular atrophy, Duchenne muscular dystrophy or hallucinations and delusions of Parkinson’s disease, among several others. Notably, nine of twenty-two (40%) were novel CNS drugs, indicating the industry shifting to neurodrugs. Neurodrugs are the top selling pharmaceuticals worldwide, especially in America and Europe. Therapeutic neurodrugs have proven their significance many times in the past few decades, and the CNS drug portfolio represents some of the most valuable agents in the current pipeline. Many neuroproducts are vital or essential medicines in the current therapeutic armamentarium, including dozens of “blockbuster drugs” (drugs with $1 billion sales potential).  These drugs include antidepressants, antimigraine medications, and anti-epilepsy medications. The rise in neurodrugs’ sales is predominantly due to increased diagnoses of CNS conditions. The boom for neuromedicines is evident from the recent rise in investment, production, and introduction of new CNS drugs.  There are many promising neurodrugs still in the pipeline, which are developed based on the validated “mechanism-based” strategy. Overall, disease-modifying neurodrugs that can prevent or cure serious diseases, such as multiple sclerosis, epilepsy, and Alzheimer’s disease, are in high demand. 

It’s Time to Talk to Prehospital Providers: Feedback Disparities among Ground-Based Emergency Medical Services Providers and its Impact on Job Satisfaction

2021 ◽  
pp. 1-9
Author(s):  
Sarayna S. McGuire ◽  
Anuradha Luke ◽  
Aaron B. Klassen ◽  
Lucas A. Myers ◽  
Aidan F. Mullan ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Patient Care ◽  
Emergency Medical Services ◽  
Performance Feedback ◽  
Life Support ◽  
Clinical Care ◽  
Medical Services ◽  
The Past ◽  
Emergency Medical ◽  
Overall Job Satisfaction

Abstract Objective: Performance feedback on clinical care and patient outcomes is a cornerstone of medical education, yet it remains lacking in the prehospital environment. Research seeking to establish the quantity of feedback provided to Emergency Medical Services (EMS) has been limited and studies focused on complimentary feedback or how feedback relates to EMS job satisfaction are lacking. The objectives of this study were to measure the frequency and nature of feedback received by EMS agencies and to identify the importance of receiving feedback as it relates to EMS job satisfaction. Methods: This was an anonymous, survey-based study of twenty-nine Basic Life Support (BLS) and fifteen Advanced Life Support (ALS) agencies located in Southeastern Minnesota (USA). Descriptive statistics and Fisher exact tests were used. The study was deemed exempt by the Mayo Clinic Institutional Review Board. Results: Ninety-four responses were included from nineteen different EMS agencies, including sixty-one (64.9%) paramedics and thirty-three (35.1%) emergency medical technicians (EMTs). One-half of all respondents reported that they had not received any type of feedback in the past 30 days, while another 43.6% of respondents indicated that they had only received feedback one to three times in the same time period. Twenty (60.6%) EMTs reported receiving no feedback in the past 30 days, compared with twenty-seven (44.3%) paramedics (P = .123). Of respondents receiving feedback, 65.9% reported never or rarely receiving positive reinforcing feedback and 60.6% reported never or rarely receiving constructive criticism or feedback regarding something that did not go well with patient care or transport. The majority of respondents were dissatisfied with the quantity (86.1%) and quality (73.4%) of feedback received. An overwhelming majority (93.6%) indicated that feedback on patient care or outcomes was important in influencing their overall job satisfaction. This high importance was maintained across all demographic groups. Conclusion: Within the cohort of survey respondents, a paucity of feedback received by EMS personnel is a source of dissatisfaction for EMS providers. Feedback on patient care strongly relates to overall job satisfaction. These findings suggest system-wide opportunities for structured feedback processes, focusing upon both quality and quantity of delivered feedback, to improve both patient care and staff satisfaction.

scholarly journals Who are we missing with EHR-based smoking cessation treatments? A descriptive study of patients who smoke and do not regularly visit primary care clinics

2020 ◽  
Vol 15 (4) ◽  
pp. 175-180
Author(s):  
Margaret Nolan ◽  
Deejay Zwaga ◽  
Danielle McCarthy ◽  
Christian Kastman ◽  
Timothy Baker ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider ◽  
The United States ◽  
Primary Care Visit ◽  
Patient Portal ◽  
The Past ◽  
Healthcare Settings ◽  
Care Visit ◽  
Tobacco Treatment

AbstractIntroductionMost tobacco treatment efforts target healthcare settings, because about 75% of smokers in the United States visit a primary care provider annually. Yet, 25% of patients may be missed by such targeting.AimsTo describe patients who smoke but infrequently visit primary care – their characteristics, rates of successful telephone contact, and acceptance of tobacco treatment.MethodsTobacco Cessation Outreach Specialists ‘cold-called’ those without a primary care visit in the past year, offering tobacco dependence treatment. Age, sex, insurance status, race, ethnicity, electronic health record (EHR) patient-portal status and outreach outcomes were reported.ResultsOf 3,407 patients identified as smokers in a health system registry, 565 (16.6%) had not seen any primary care provider in the past year. Among 271 of those called, 143 (53%) were successfully reached and 33 (23%) set a quit date. Those without visits tended to be younger, male, some-day versus every-day smokers (42 vs. 44 years, P = 0.004; 48% vs. 40% female, P = 0.0002, and 21% vs. 27% some-day, P = 0.003), and less active on the EHR patient portal (33% vs. 40%, P = 0.001).ConclusionsA substantial proportion of patients who smoke are missed by traditional tobacco treatment interventions that require a primary care visit, yet many are receptive to quit smoking treatment offers.

Small-colony Variants (SCVs) of Staphylococci: A Role in Foreign Body-associated Infections

2007 ◽  
Vol 30 (9) ◽  
pp. 778-785 ◽  
Author(s):  
C. Von Eiff ◽  
K. Becker
Keyword(s):  
Foreign Body ◽  
Defense Mechanisms ◽  
Susceptibility Testing ◽  
Slow Growth ◽  
Clinical Laboratory ◽  
Coagulase Negative Staphylococci ◽  
Small Colony Variants ◽  
The Past ◽  
Small Colony ◽  
Antibacterial Chemotherapy

Staphylococci have various strategies for resisting therapy that extend beyond classic mechanisms. Clinical experience with device-associated infections as well as with infections due to small-colony variants (SCVs) clearly shows that both antibacterial chemotherapy and host defense mechanisms are often unable to eliminate the pathogens and cure these infections. Of particular interest is the fact that in the past few years an increasing number of various foreign body-related infections due to staphylococcal SCVs have been reported. In this overview, the characteristics of SCVs recovered from clinical specimens and of defined mutants displaying the SCV phenotype are described. Their slow growth and changing biochemical and physiological features represent a challenge to clinical laboratory personnel, because recovery, identification, as well as susceptibility testing of these variants need particular efforts. In addition, the reduced susceptibility to aminoglycosides and the ability of SCVs to persist intracellularly require specific attention for the treatment of these infections. Thus, special efforts to search for these variants formed by Staphylococcus aureus or by coagulase-negative staphylococci should be considered when an infection is particularly resistant to therapy, persists for a long period or fails to respond to apparently adequate therapy with antimicrobial compounds.

Distinguishing Sepsis From Blood Culture Contamination in Young Infants With Blood Cultures Growing Coagulase-Negative Staphylococci

PEDIATRICS ◽  
1990 ◽  
Vol 86 (2) ◽  
pp. 157-162
Author(s):  
Joseph W. St Geme ◽  
Louis M. Bell ◽  
Stephen Baumgart ◽  
Carl T. D'Angio ◽  
Mary Catherine Harris
Keyword(s):  
Blood Culture ◽  
Peripheral Blood ◽  
Clinical Information ◽  
Study Groups ◽  
Blood Cultures ◽  
High Risk Population ◽  
Coagulase Negative Staphylococci ◽  
Peripheral Blood Culture ◽  
Young Infants ◽  
Initial Culture

Coagulase-negative staphylococci represent the most common cause of serious nosocomial infection in many intensive care nurseries. However, these organisms are also common blood culture contaminants. To determine the value of quantitative blood cultures in distinguishing sepsis from culture contamination, we reviewed records of all infants in our nurseries who had peripheral blood isolates of coagulase-negative staphylococci during a 3-year period. Twenty-three episodes of sepsis were identified in 21 infants, and 10 infants had blood culture contamination. Colony counts from the initial peripheral blood culture were significantly different for the two study groups (P < .001). In 9 of 23 episodes of sepsis, the initial peripheral blood culture grew >100 colony-forming units (cfu) per mL. In the other 14 episodes, the initial culture yielded ≤50 cfu/mL. All 10 infants with culture contamination had colony counts of <50 cfu/mL, and in 9 the initial peripheral blood culture grew <20 cfu/mL. Infants with sepsis, including those with colony counts of ≤50 cfu/mL, were significantly more likely to have a central catheter or an abnormal hematologic value or both (P < .05). Infants who lacked these clinical features were more likely to have contamination. We conclude that quantitative blood cultures in conjunction with specific clinical information may distinguish sepsis from culture contamination with coagluase-negative staphylococci in young infants. In addition, low colony-count growth should not be ignored as contamination in this high-risk population.

Sex Offenders and Cyproterone Acetate—A Review of Clinical Care

1986 ◽  
Vol 26 (4) ◽  
pp. 279-282 ◽  
Author(s):  
David Torpy ◽  
Arden Tomison
Keyword(s):  
Sex Offenders ◽  
Cyproterone Acetate ◽  
Clinical Care ◽  
The Past

The literature on the use of cyproterone acetate in the treatment of sex offenders is examined. Seven patients who had received this treatment in the past five years are reviewed in the light of these publications.

scholarly journals Finding of coagulase negative staphylococci in the herd with an increased number of somatic cells in milk and their antimicrobial susceptibility

2013 ◽  
Vol 67 (3-4) ◽  
pp. 175-185
Author(s):  
Vera Katic ◽  
Natasa Rajic-Savic
Keyword(s):  
Clavulanic Acid ◽  
Somatic Cells ◽  
Inhibition Zone ◽  
Subclinical Mastitis ◽  
Blood Agar ◽  
Penicillin G ◽  
Coagulase Negative Staphylococci ◽  
Milk Samples ◽  
Causative Agents ◽  
Amoxicillin Clavulanic Acid

Coagulase-negative staphylococci (CNS) are generally considered to be opportunistic pathogens. Controlling CNS mastitis is difficult because the epidemiology is not clear, and the CNS group consists of about 40 different Staphylococcus species. Therefore, the aim of this study was to determine the prevalence of coagulasenegative staphylococci in milk of the cows with subclinical mastitis, as well as to determine different CNS species isolated from quarter milk samples for their susceptibility to antimicrobials used commonly for mastitis therapy. On the farm where there was found an increase of somatic cells in bulk milk, 112 dairy cows were examined by mastitis test. From 52 udder quarters where mastitis test showed an increase of somatic cells, milk samples were taken for bacteriological examination. For isolating the causes of mastitis there was used blood agar. Identification of the causative agents of mastitis was carried out on the basis of colony appearance on blood agar and their physiological characteristics. Coagulasepositive staphylococci sensitivity which cause mastitis was tested by Kirby Bauer method. For susceptibility testing there were used commercially produced discs containing: 10 IU penicillin, amoxicillin/clavulanic acid (20 +10 ?g), cloxacillin 25 ?g, 30 ?g amoxicillin, cephalexin 30 ?g, ceftiofur 30 ?g, 15 ?g lincomycin, gentamicin and tetracycline 30 ?g. The sensitivity of microorganisms was evaluated on the basis of inhibition zone diameter recommended by the manufacturer and was labeled as sensitive (S) moderately sensitive (I) or resistant (R). Coagulase-negative staphylococci were isolated from 61.53% of samples from cows with subclinical mastitis, making them the most common cause of subclinical mastitis. The highest resistance of coagulase-negative staphylococci was found to penicillin G (58.33% of isolates). Full sensitivity of coagulase-negative staphylococci was found to amoxicillin / clavulanic acid (100% of isolates), a good sensitivity to ceftiofur (83.33% of isolates), cefalexin (70.83% of isolates) and ceftriaxone (41.66% of isolates).

scholarly journals Nosocomial blood stream infections in Imam Khomeini Hospital, Urmia, Islamic Republic of Iran, 1999-2001

2005 ◽  
Vol 11 (3) ◽  
pp. 478-484
Author(s):  
M. Rahbar
Keyword(s):  
Blood Stream ◽  
Blood Cultures ◽  
Microbiology Laboratory ◽  
Islamic Republic ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Blood Stream Infections ◽  
Skin Contamination ◽  
Islamic Republic Of Iran ◽  
Gram Positive Cocci

Ina 2-year retrospective study, the database of the microbiology laboratory of the Imam Khomeini Hospital was reviewed to identify patients who had nosocomial bacteraemia between 1 May 1999 and 31 May 2001 and identify the pathogen responsible and its resisitance to antibiotics. Of 6492 patients in various wards, 593 [9.1%] had positive blood cultures; 85 of those [14.3%] had signs of potential skin contamination. Gram-positive cocci, including coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus pneumoniae and other Gram-positive cocci, accounted for 42.3% of isolates. Gram-negative bacilli were responsible for another 42.3% of isolates; Pseudomonas aeruginosa was the predominant isolate. Patterns of drug resistance varied according to species of bacteria but were generally quite high

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