RESUMEN

The antibiotic resistance among coagulase - negative Staphylococcus (CoNS) species towards methicillin is rarely reported in veterinary medicine. Under the aspect/concept of One Health, those strains pose a risk to human health due to the presence in canine pets where the transfer of resistant genetic markers might occur to other staphylococci species. The aim of this study was to investigate the antimicrobial resistance pattern among Coagulase Negative Staphylococci (CoNS) isolated from asymptomatic dogs and those affected by topic infections. Swabs from 254 dogs were first seeded in Mannitol Salt Agar. Species identification was conducted by Matrix Assisted Laser Desorption ionization - time of flight (MALDI-TOF ms) as previously described. The susceptibility test was performed by disk diffusion according to CLSI standards. Detection of mecA gene was performed. CoNS could be recovered from both groups of dogs and an alarming presence of methicillin-resistant coagulase negative staphylococci (MRCoNS) was confirmed, in 10.2% (17/166) of the samples. Eight of those methicillin resistant strains were isolated from asymptomatic dogs whereas nine were present in dogs affected by pyoderma and otitis externa.

Asunto(s)

Coagulasa/deficiencia , Reservorios de Enfermedades/microbiología , Enfermedades de los Perros/microbiología , Resistencia a la Meticilina , Infecciones Estafilocócicas/veterinaria , Staphylococcus/aislamiento & purificación , Animales , Antibacterianos/farmacología , Enfermedades de los Perros/transmisión , Perros , Farmacorresistencia Bacteriana , Genes Bacterianos , Humanos , Resistencia a la Meticilina/genética , Pruebas de Sensibilidad Microbiana , Proteínas de Unión a las Penicilinas , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión , Staphylococcus/clasificación , Staphylococcus/enzimología , Staphylococcus/genética

RESUMEN

The close contact between pets and their owners is a potential source for microorganisms and genetic material exchange. Staphylococcus species considered as harmless inhabitants of animals' and humans' microbiota can act as reservoirs of antimicrobial resistance genes to more virulent species, thereby increasing their potential to resist drug therapy. This process could be inhibited by the antiplasmid immunity conferred by CRISPR systems. On the other hand, CRISPR spacer sequences can be explored as molecular clocks to track the history of genetic invasion suffered by a bacterial strain. To understand better the role of domestic dogs in human health as an antimicrobial resistance genes source, we analyzed 129 genomes of Staphylococcus strains of canine origin for the presence of CRISPR systems. Only 8% of the strains were positive for CRISPR, which is consistent with Staphylococcus role as gene reservoirs. The plasmidial origin or some spacers confirms the unsuccessful attempt of plasmid exchange in strains carrying CRISPRs. Some of these systems are within a staphylococcal cassette chromosome mec (SCCmec), sharing 98% of identity between their harboring strains. These CRISPRs' spacers reveal that this SCCmec was transferred between canine S. pseudintermedius strains, then to S. schleiferi and to Staphylococcus strains isolated from human beings. Our findings shows genetic evidence for the global spreading of pathogenic bacteria and the antimicrobial resistance genes carried by them and reinforce that, in the age of antimicrobial resistance, it is imperative that drug therapies consider the integrated nature of the relationship between pets and humans.

Asunto(s)

Repeticiones Palindrómicas Cortas Agrupadas y Regularmente Espaciadas , Farmacorresistencia Bacteriana/genética , Infecciones Estafilocócicas/veterinaria , Staphylococcus/genética , Animales , Reservorios de Enfermedades/microbiología , Perros/microbiología , Transferencia de Gen Horizontal , Genoma Bacteriano , Humanos , Resistencia a la Meticilina/genética , Pruebas de Sensibilidad Microbiana , Mascotas/microbiología , Plásmidos , Infecciones Estafilocócicas/transmisión , Staphylococcus/aislamiento & purificación

RESUMEN

BACKGROUND: The production and commercialization of tilapia (Oreochromis niloticus) is fundamentally important to the semi-arid region of northeastern Brazil. In this region, one of the main forms of commercialization occurs in street markets (fairs). A high incidence of methicillin-resistant Staphylococcus aureus (MRSA) strains was previously detected in different food-related environments in Brazil. However, limited data is available about the presence of MRSA in street markets commercializing tilapias. In this study, we identified Staphylococcus aureus from tilapia and utensils used in the commercialization of tilapia in the street markets of a semi-arid Brazilian municipality and characterized the virulence potential of the isolates by analyzing their β-lactam resistance, intercellular adhesion and enterotoxin genes. METHODS: The study used samples from the 5 main markets in the city. Phenotypic tests to determine antimicrobial resistance, exopolysaccharide (EPS) production, the potential for biofilm formation and cell surface hydrophobicity were conducted on S. aureus isolates. The presence of antimicrobial resistance genes (mecA and blaZ), potential biofilm production genes (icaA and icaD) and enterotoxin (se) genes was investigated. RESULTS: Coagulase-positive staphylococci (CoPS) were detected in samples from all markets in discordance with the legal limits in force. Twelve isolates were confirmed to be S. aureus. Ten isolates demonstrated multidrug resistance (MDR). All isolates were able to produce EPS and form biofilms. Eight isolates exhibited strong hydrophobicity and six a high potential for biofilm formation. Twelve isolates were positive for mecA, blaZ, icaD and sed. CONCLUSIONS: Tilapia marketed in unsuitable conditions may be a vehicle for staphylococcal food poisoning and for the dissemination of MRSA to consumers. Additionally, the ability of the isolates to produce biofilms is an alert to the presence and persistence of these virulent microorganisms on utensils used for the commercial distribution of tilapia.

Asunto(s)

Microbiología de Alimentos , Staphylococcus aureus/aislamiento & purificación , Staphylococcus aureus/patogenicidad , Tilapia/microbiología , Animales , Adhesión Bacteriana/genética , Biopelículas/crecimiento & desarrollo , Brasil , Comercio , Utensilios de Comida y Culinaria , ADN Bacteriano/análisis , Farmacorresistencia Bacteriana/genética , Enterotoxinas/genética , Enfermedades Transmitidas por los Alimentos/microbiología , Staphylococcus aureus Resistente a Meticilina/genética , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/patogenicidad , Pruebas de Sensibilidad Microbiana , Polisacáridos Bacterianos/biosíntesis , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión , Staphylococcus aureus/genética , Resistencia betalactámica/genética

RESUMEN

Abstract Mastitis is an inflammatory process of the udder tissue caused mainly by the bacteria Staphylococcus aureus. The indiscriminate use of antibiotics fosters conditions that favor the selection of resistant microorganisms, suppressing at the same time susceptible forms, causing a serious problem in dairy cattle. Given the importance in performing an antibiogram to select the most adequate antimicrobial therapy, the aim of this study was to identify bacteria isolated from cow's milk with mastitis, in dairy farms situated in the city of Pelotas, Rio Grande do Sul, and to determinate the susceptibility profile of these isolates against the antibiotics used to treat this illness. A total of 30 isolates of Staphylococcus spp., were selected from milk samples from the udder quarters with subclinical mastitis whose species were identified through the Vitek system. The susceptibility profile was performed by the disk diffusion assay, against: ampicillin, amoxicillin, bacitracin, cephalexin, ceftiofur, enrofloxacin, gentamicin, neomycin, norfloxacin, penicillin G, tetracycline and trimethoprim. In the antibiogram, 100.0% of the isolates were resistant to trimethoprim and 96.7% to tetracycline and neomycin, three strains of Staphylococcus spp., (10.0%) presented resistance to the 12 antibiotics tested and 24 (80.0%) to at least eight. These results showed the difficulty in treating mastitis, due to the pathogens' resistance.

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Resumo A mastite se constitui no processo inflamatório da glândula mamária causada principalmente por bactérias Staphylococcus aureus. O uso indiscriminado dos antibióticos promove condições que favorecem a seleção de micro-organismos resistentes e, ao mesmo tempo, suprime formas suscetíveis, causando um grave problema para a bovinocultura leiteira. Tendo em vista a importância da realização do antibiograma para a seleção da terapia antimicrobiana mais adequada, o objetivo deste estudo foi identificar bactérias isoladas de leite de vaca com mastite, oriundas de propriedades leiteiras localizadas na cidade de Pelotas, RS, bem como determinar o perfil de suscetibilidade desses isolados frente a antibióticos usados para o tratamento desta doença. Foram selecionados 30 isolados de Staphylococcus spp. de amostras de leite provenientes de quartos mamários com mastite subclínica, cujas espécies foram identificadas através do sistema Vitek. O perfil de suscetibilidade foi realizado pela técnica de difusão em disco, frente a: ampicilina, amoxicilina, bacitracina, cefalexina, ceftiofur, enrofloxacina, gentamicina, neomicina, norfloxacina, penicilina G, tetraciclina e trimetoprima. No antibiograma, 100,0% dos isolados foram resistentes a trimetoprima e 96,7% a tetraciclina e a neomicina, três cepas (10,0%) foram resistentes aos 12 antibióticos testados e 24 (80,0%) a pelo menos oito. Esses resultados demonstram a dificuldade encontrada no tratamento da mastite devido à resistência dos agentes patológicos.

Asunto(s)

Animales , Femenino , Infecciones Estafilocócicas/microbiología , Staphylococcus/efectos de los fármacos , Industria Lechera , Farmacorresistencia Bacteriana/efectos de los fármacos , Leche/microbiología , Mastitis Bovina/microbiología , Antiinfecciosos/farmacología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/transmisión , Bovinos , Crianza de Animales Domésticos , Mastitis Bovina/tratamiento farmacológico , Mastitis Bovina/transmisión

RESUMEN

Introducción: El Staphylococcus Aureus constituye un agente etiológico frecuente de intoxicaciones alimentarias y se encuentra asociado a diversos alimentos. Objetivo: Describir la frecuencia de portación de Staphylococcus Aureus en manipuladores de alimentos de restaurantes de Asunción durante el 2017. Metodología: Se realizó un estudio observacional, prospectivo, descriptivo de corte transversal a manipuladores de alimentos de restaurantes de Asunción durante los meses de mayo a junio del 2017. Se realizaron tres hisopados nasales a cada uno de los 30 manipuladores de alimentos para determinar si la portación era intermitente, permanente u ocasional. Al mismo tiempo fueron realizadas encuestas donde se midieron variables demográficas. Resultados: La prevalencia de portación de Staphylococcus Aureus fue del 33,3 % (10), siendo el 40% (4) esporádica e intermitente y el 20% (2) permanente. En cuanto a las características demográficas de los manipuladores,el 56,66% (17) fueron del sexo masculino, eran solteros 43,33% (13) y el 50% (15) contaban con estudios secundarios completos. El promedio de edad de 29 de los manipuladores fue de 39,5 años con un rango comprendido entre 18 y 85 años. El 23,33% (7) utilizaban guantes a la hora de manipular los alimentos. Además, se pudo observar que el 26,66% (8) utilizaba gorros. Llamó la atención que el 30% (9) de los encuestados no presentaban uñas limpias durante la manipulación. Palabras clave: Staphylococcus Aureus; manipuladores; alimentos.

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Introduction: Staphylococcus Aureus is a frequent etiologic agent of food poisoning and is associated with various foods. Objective : To describe the frequency of Staphylococcus Aureus in food handlers of restaurants in Asunción during 2017. Methodology: An observational, prospective, descriptive, cross-sectional study was carried out on food handlers in restaurants in Asuncion during the months of May to June 2017. Three nasal swabs were made to each of the 30 food handlers to determine if the carriage was intermittent, permanent or occasional. At thesame time, surveys were carried out where demographic variables were measured. Results: The prevalence of carrying Staphylococcus Aureus was 33.3% (10), being 40% (4) sporadic and intermittent and 20% (2) permanent. Regarding the demographic characteristics of the manipulators, 56.66% (17) were male, were single 43.33% (13) and 50% (15) had complete secondary education. The average age of 29 of the manipulators was 39.5 years with ranger between 18 and 85 years. 23.33% (7) used gloves when handling food. In addition, it was observed that 26.66% (8) used caps. It was noted that 30% (9) of theres pondents did not have clean nails during handling. Keywords: Staphylococcus Aureus; manipulators; food.

Asunto(s)

Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Manipulación de Alimentos , Paraguay/epidemiología , Infecciones Estafilocócicas/transmisión , Staphylococcus aureus/efectos de los fármacos , Farmacorresistencia Microbiana , Higiene , Prevalencia , Estudios Transversales , Estudios Prospectivos

RESUMEN

Introducción. Staphylococcus aureus coloniza mucosas y piel, y causa graves infecciones en el hombre y los animales. Es importante establecer el estatus de portadoras de cepas enterotoxigénicas de este microorganismo en manipuladoras de alimentos, con el fin de prevenir intoxicaciones alimentarias.Objetivo. Establecer las correlaciones entre los genes de enterotoxinas clásicas, el gen tsst-1, la producción de toxinas en cultivo y la resistencia antimicrobiana en aislamientos de S. aureus provenientes de manipuladoras de alimentos que cuidan niños en sus comunidades.Materiales y métodos. Se cultivaron muestras de las fosas nasales y las yemas de los dedos de las manos, y se identificó S. aureus empleando las pruebas de rutina y métodos automatizados. La extracción de ADN se hizo mediante el método de bromuro de cetil-trimetil-amonio (Cetyl-Trimethyl-Ammonium Bromide, CTAB) modificado. Para la detección de superantígenos se emplearon pruebas de reacción en cadena de la polimerasa (PCR) simple y múltiple, y para la de toxinas, estuches comerciales.Resultados. Se encontró que el 22,0 % de los aislamientos correspondía a portadoras de S. aureus: 17,0 % en los aislamientos de fosas nasales; 5,0 % en los de las manos y 6,7 % simultáneamente en los dos sitios. La prevalencia de superantígenos fue de 73,7 %. El genotipo más frecuente fue el seatsst-1, con 10,0 %. La resistencia a un solo antibiótico fue de 74,7 % y, a cuatro antibióticos, de 3,2 %; de los aislamientos, el 93,7 % correspondía a cepas productoras de betalactamasas. La detección de genes clásicos y de tsst-1 mediante PCR fue de 48,4 % y la de toxinas en el sobrenadante, de 42,1 %,con una correlación de 95,7 %. Las mayores correlaciones se establecieron entre las toxinas TSST-1 (22/22) y SEA (17/18). La correlación del gen tsst-1 con la proteína y la resistencia fue de 100 %. Todos los aislamientos con el genotipo sea-tsst-1 t fueron resistentes y productores de las toxinas.Conclusión. La tasa de aislamientos de S. aureus toxigénicos y resistentes obtenidos de mujeres que cuidan y preparan alimentos para niños fue de más de 70 %, lo que demostró su gran virulencia y la consecuente necesidad de aplicar estrictamente las normas higiénicas y sanitarias vigentes para evitar el riesgo de intoxicación alimentaria.

Asunto(s)

Antígenos Bacterianos/análisis , Portador Sano/microbiología , Cuidado del Niño , Farmacorresistencia Bacteriana Múltiple , Enterotoxinas/inmunología , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Superantígenos/análisis , Adulto , Antígenos Bacterianos/genética , Portador Sano/epidemiología , Niño , Femenino , Dedos/microbiología , Manipulación de Alimentos , Genes Bacterianos , Genotipo , Humanos , Cavidad Nasal/microbiología , Prevalencia , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/transmisión , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/genética , Staphylococcus aureus/inmunología , Superantígenos/genética

RESUMEN

Resumen Introducción. Staphylococcus aureus coloniza mucosas y piel, y causa graves infecciones en el hombre y los animales. Es importante establecer el estatus de portadoras de cepas enterotoxigénicas de este microorganismo en manipuladoras de alimentos, con el fin de prevenir intoxicaciones alimentarias. Objetivo. Establecer las correlaciones entre los genes de enterotoxinas clásicas, el gen tsst-1, la producción de toxinas en cultivo y la resistencia antimicrobiana en aislamientos de S. aureus provenientes de manipuladoras de alimentos que cuidan niños en sus comunidades. Materiales y métodos. Se cultivaron muestras de las fosas nasales y las yemas de los dedos de las manos, y se identificó S. aureus empleando las pruebas de rutina y métodos automatizados. La extracción de ADN se hizo mediante el método de bromuro de cetil-trimetil-amonio (Cetyl-Trimethyl- Ammonium Bromide, CTAB) modificado. Para la detección de superantígenos se emplearon pruebas de reacción en cadena de la polimerasa (PCR) simple y múltiple, y para la de toxinas, estuches comerciales. Resultados. Se encontró que el 22,0 % de los aislamientos correspondía a portadoras de S. aureus: 17,0 % en los aislamientos de fosas nasales; 5,0 % en los de las manos y 6,7 % simultáneamente en los dos sitios. La prevalencia de superantígenos fue de 73,7 %. El genotipo más frecuente fue el sea-tsst-1, con 10,0 %. La resistencia a un solo antibiótico fue de 74,7 % y, a cuatro antibióticos, de 3,2 %; de los aislamientos, el 93,7 % correspondía a cepas productoras de betalactamasas. La detección de genes clásicos y de tsst-1 mediante PCR fue de 48,4 % y la de toxinas en el sobrenadante, de 42,1 %, con una correlación de 95,7 %. Las mayores correlaciones se establecieron entre las toxinas TSST-1 (22/22) y SEA (17/18). La correlación del gen tsst-1 con la proteína y la resistencia fue de 100 %. Todos los aislamientos con el genotipo sea-tsst-1 t fueron resistentes y productores de las toxinas. Conclusión. La tasa de aislamientos de S. aureus toxigénicos y resistentes obtenidos de mujeres que cuidan y preparan alimentos para niños fue de más de 70 %, lo que demostró su gran virulencia y la consecuente necesidad de aplicar estrictamente las normas higiénicas y sanitarias vigentes para evitar el riesgo de intoxicación alimentaria.

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Abstract Introduction: Staphylococcus aureus colonizes mucous membranes and skin causing severe infections in humans and animals. It is important to determine carrier status of enterotoxigenic strains of this microorganism in food handlers to prevent food poisoning. Objective: To establish the correlations among classic enterotoxigenic genes, tsst-1 gene, the production of toxins in cultures and antimicrobial resistance in S. aureus isolates from women who handle the food, feed and take care of children in their communities. Materials and methods: Nasal swab and finger samples were cultured and S. aureus was identified using routine methods and automated systems. DNA extraction was done by the CTAB modified method, and superantigen detection by simple and multiplex PCR, while toxins were detected using commercial kits. Results: We found that 22.0% of subjects were S. aureus carriers: 17.0% corresponded to nose samples, 5.0% to hands and 6.7% to both nose and hands. The prevalence of superantigens was 73.7%. The most frequent genotype was sea-tsst-1 with 10%. Resistance to one antibiotic was 74.7%, and to four antibiotics, 3.2%; 93.7% of the isolates were betalactamase-positive. Classical genes and tsst-1 gene were detected by PCR in 48.4% of samples and toxins in supernatant were detected in 42.1% of them with 95.7% of correlation.The highest correlations were established for TSST-1 and SEA with 100% and 94.4%, respectively. The correlation of tsst-1 gene with toxin production and resistance was 100%. All isolates with genotype sea-tsst-1 were toxin-positive and resistant. Conclusion: The rate of toxigenic and resistant S. aureus isolates from women in charge of feeding and taking care of children was higher than 70%, which demonstrates its high virulence. This requires the strict application of hygienic and sanitary regulations in order to avoid the risk of food poisoning.

Asunto(s)

Adulto , Niño , Femenino , Humanos , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Portador Sano/microbiología , Cuidado del Niño , Superantígenos/análisis , Farmacorresistencia Bacteriana Múltiple , Enterotoxinas/inmunología , Antígenos Bacterianos/análisis , Infecciones Estafilocócicas/transmisión , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/genética , Staphylococcus aureus/inmunología , Portador Sano/epidemiología , Prevalencia , Superantígenos/genética , Dedos/microbiología , Manipulación de Alimentos , Genes Bacterianos , Genotipo , Cavidad Nasal/microbiología , Antígenos Bacterianos/genética

RESUMEN

Mastitis is an inflammatory process of the udder tissue caused mainly by the bacteria Staphylococcus aureus. The indiscriminate use of antibiotics fosters conditions that favor the selection of resistant microorganisms, suppressing at the same time susceptible forms, causing a serious problem in dairy cattle. Given the importance in performing an antibiogram to select the most adequate antimicrobial therapy, the aim of this study was to identify bacteria isolated from cow's milk with mastitis, in dairy farms situated in the city of Pelotas, Rio Grande do Sul, and to determinate the susceptibility profile of these isolates against the antibiotics used to treat this illness. A total of 30 isolates of Staphylococcus spp., were selected from milk samples from the udder quarters with subclinical mastitis whose species were identified through the Vitek system. The susceptibility profile was performed by the disk diffusion assay, against: ampicillin, amoxicillin, bacitracin, cephalexin, ceftiofur, enrofloxacin, gentamicin, neomycin, norfloxacin, penicillin G, tetracycline and trimethoprim. In the antibiogram, 100.0% of the isolates were resistant to trimethoprim and 96.7% to tetracycline and neomycin, three strains of Staphylococcus spp., (10.0%) presented resistance to the 12 antibiotics tested and 24 (80.0%) to at least eight. These results showed the difficulty in treating mastitis, due to the pathogens' resistance.

Asunto(s)

Antiinfecciosos/farmacología , Industria Lechera , Farmacorresistencia Bacteriana/efectos de los fármacos , Mastitis Bovina/microbiología , Leche/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus/efectos de los fármacos , Crianza de Animales Domésticos , Animales , Bovinos , Femenino , Mastitis Bovina/tratamiento farmacológico , Mastitis Bovina/transmisión , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/transmisión

RESUMEN

The association of the spread of community infections with poverty and overcrowding is well known. In our hospital, located in José C. Paz, we assist sporadic cases of post-cesarean infections caused by community acquired methicillin-resistant Staphylococcus aureus (CaMRSA). In a prospective study of families treated at our hospital, we investigated the relationship between a history of skin and soft tissue infections (SSTI) and extreme overcrowding defined as households with unsatisfied basic needs type 3 (NBI 3). A total of 264 households were included in the study; 109 (41.3%) had a history of SSTI and 59 (22.3%) were NBI 3. A total of 61.0% of the NBI 3 households and 35.6% of the non-NBI 3 households reported SSTI (p = 0.00047). Using Google Maps, we georeferenced households and identified them on a NBI map adapted from the 2010 demographic census. In neighborhoods with NBI > 9.7%, 51.2% of the households had a history of SSTI. When NBI was < 9.7%, the percentage fell to 31.1% (p = 0.0019). These results are suggestive of an association of SSTI acquired in the community with overcrowding and poverty. The presence of CaMRSA in community SSTIs should be suspected. Vancomycin or clindamycin prophylaxis could be considered when cesarean deliveries are performed in women from areas with high NBI or with a history of SSTI.

Asunto(s)

Aglomeración , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Enfermedades Cutáneas Bacterianas/epidemiología , Infecciones de los Tejidos Blandos/epidemiología , Infecciones Estafilocócicas/epidemiología , Argentina/epidemiología , Cesárea/efectos adversos , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/transmisión , Composición Familiar , Femenino , Humanos , Masculino , Pobreza , Embarazo , Estudios Prospectivos , Enfermedades Cutáneas Bacterianas/transmisión , Infecciones de los Tejidos Blandos/microbiología , Infecciones de los Tejidos Blandos/transmisión , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión

RESUMEN

La asociación entre diseminación de infecciones comunitarias, pobreza y hacinamiento es bien conocida. En nuestro hospital observamos casos esporádicos de infecciones post-cesárea por cepas de Staphylococcus aureus meticilino resistente de origen comunitario (SAMRCo). En un estudio prospectivo de familias de José C. Paz atendidas en nuestro hospital, investigamos la relación entre antecedentes de infecciones de piel y partes blandas (IPPB) y hacinamiento extremo (hogares con necesidades básicas insatisfechas tipo 3, (NBI 3). Fueron incluidos 264 hogares; 109 (41.3%) tenían historia de IPPB y 59 (22.3%) eran NBI 3. El 61.0% de los hogares NBI 3 y el 35.6% de los hogares no NBI 3 refirieron IPPB (p = 0.00047). Georreferenciamos los domicilios con Google Maps y los ubicamos en un plano de José C. Paz NBI del censo nacional 2010. En barrios con un porcentaje de NBI > 9.7%, el 51.2% de los hogares tuvo antecedentes de IPPB. Cuando este porcentaje era ≤ 9.7% el porcentaje bajó al 31.1% (p = 0.0019). Estos resultados son sugestivos de diseminación comunitaria de estas infecciones asociada a hacinamiento y barrios pobres. Se debe considerar la presencia de SAMRCo en IPPB comunitarias. Por ello, en mujeres procedentes de zonas con alto porcentaje NBI o con antecedentes de IPPB se podría considerar la inclusión de la vancomicina o la clindamicina en la profilaxis de los partos por cesárea.

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The association of the spread of community infections with poverty and overcrowding is well known. In our hospital, located in José C. Paz, we assist sporadic cases of post-cesarean infections caused by community acquired methicillin-resistant Staphylococcus aureus (CaMRSA). In a prospective study of families treated at our hospital, we investigated the relationship between a history of skin and soft tissue infections (SSTI) and extreme overcrowding defined as households with unsatisfied basic needs type 3 (NBI 3). A total of 264 households were included in the study; 109 (41.3%) had a history of SSTI and 59 (22.3%) were NBI 3. A total of 61.0% of the NBI 3 households and 35.6% of the non-NBI 3 households reported SSTI (p = 0.00047). Using Google Maps, we georeferenced households and identified them on a NBI map adapted from the 2010 demographic census. In neighborhoods with NBI > 9.7%, 51.2% of the households had a history of SSTI. When NBI was < 9.7%, the percentage fell to 31.1% (p = 0.0019). These results are suggestive of an association of SSTI acquired in the community with overcrowding and poverty. The presence of CaMRSA in community SSTIs should be suspected. Vancomycin or clindamycin prophylaxis could be considered when cesarean deliveries are performed in women from areas with high NBI or with a history of SSTI.

Asunto(s)

Humanos , Masculino , Femenino , Embarazo , Infecciones Estafilocócicas/epidemiología , Aglomeración , Enfermedades Cutáneas Bacterianas/epidemiología , Infecciones de los Tejidos Blandos/epidemiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Argentina/epidemiología , Pobreza , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión , Cesárea/efectos adversos , Composición Familiar , Estudios Prospectivos , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/transmisión , Infecciones Comunitarias Adquiridas/epidemiología

RESUMEN

BACKGROUND The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated. METHODS The presence of ORSH on swabs taken from fomite surfaces in a Brazilian hospital was assessed using standard microbiological procedures. Antibiotic susceptibility profiles were determined by the disk diffusion method, and clonal distribution was assessed in pulsed-field gel electrophoresis (PFGE) assays. Minimum inhibitory concentrations (MICs) of oxacillin and vancomycin were evaluated via the broth microdilution method. Polymerase chain reaction (PCR) assays were performed to detect the mecA and icaAD genes. ORSH strains grown in media containing 1/4 MIC of vancomycin or oxacillin were investigated for slime production and biofilm formation on glass, polystyrene and polyurethane catheter surfaces. FINDINGS ORSH strains comprising five distinct PFGE types were isolated from sphygmomanometers (n = 5) and a thermometer (n = 1) used in intensive care units and surgical wards. ORSH strains isolated from fomites showed susceptibility to only linezolid and vancomycin and were characterised as multi-drug resistant (MDR). Slime production, biofilm formation and the survival of sessile bacteria differed and were independent of the presence of the icaAD and mecA genes, PFGE type and subtype. Vancomycin and oxacillin did not inhibit biofilm formation by vancomycin-susceptible ORSH strains on abiotic surfaces, including on the catheter surface. Enhanced biofilm formation was observed in some situations. Moreover, a sub-lethal dose of vancomycin induced biofilm formation by an ORSH strain on polystyrene. MAIN CONCLUSIONS Sphygmomanometers and thermometers are fomites for the transmission of ORSH. A sub-lethal dose of vancomycin may favor biofilm formation by ORSH on fomites and catheter surfaces.

Asunto(s)

Humanos , Oxacilina/farmacología , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión , Termómetros/microbiología , Vancomicina/farmacología , Infección Hospitalaria/microbiología , Biopelículas/crecimiento & desarrollo , Esfigmomanometros/microbiología , Staphylococcus haemolyticus/aislamiento & purificación , Staphylococcus haemolyticus/efectos de los fármacos , Staphylococcus haemolyticus/fisiología , Antibacterianos/farmacología , Resistencia a Medicamentos , Pruebas de Sensibilidad Microbiana , Infección Hospitalaria/transmisión , Electroforesis en Gel de Campo Pulsado , Electroforesis

RESUMEN

BACKGROUND: The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES: In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated. METHODS: The presence of ORSH on swabs taken from fomite surfaces in a Brazilian hospital was assessed using standard microbiological procedures. Antibiotic susceptibility profiles were determined by the disk diffusion method, and clonal distribution was assessed in pulsed-field gel electrophoresis (PFGE) assays. Minimum inhibitory concentrations (MICs) of oxacillin and vancomycin were evaluated via the broth microdilution method. Polymerase chain reaction (PCR) assays were performed to detect the mecA and icaAD genes. ORSH strains grown in media containing 1/4 MIC of vancomycin or oxacillin were investigated for slime production and biofilm formation on glass, polystyrene and polyurethane catheter surfaces. FINDINGS: ORSH strains comprising five distinct PFGE types were isolated from sphygmomanometers (n = 5) and a thermometer (n = 1) used in intensive care units and surgical wards. ORSH strains isolated from fomites showed susceptibility to only linezolid and vancomycin and were characterised as multi-drug resistant (MDR). Slime production, biofilm formation and the survival of sessile bacteria differed and were independent of the presence of the icaAD and mecA genes, PFGE type and subtype. Vancomycin and oxacillin did not inhibit biofilm formation by vancomycin-susceptible ORSH strains on abiotic surfaces, including on the catheter surface. Enhanced biofilm formation was observed in some situations. Moreover, a sub-lethal dose of vancomycin induced biofilm formation by an ORSH strain on polystyrene. MAIN CONCLUSIONS: Sphygmomanometers and thermometers are fomites for the transmission of ORSH. A sub-lethal dose of vancomycin may favor biofilm formation by ORSH on fomites and catheter surfaces.

Asunto(s)

Antibacterianos/farmacología , Biopelículas/crecimiento & desarrollo , Fómites/microbiología , Esfigmomanometros/microbiología , Staphylococcus haemolyticus/fisiología , Termómetros/microbiología , Infección Hospitalaria/microbiología , Infección Hospitalaria/transmisión , Farmacorresistencia Bacteriana , Electroforesis en Gel de Campo Pulsado , Humanos , Pruebas de Sensibilidad Microbiana , Oxacilina/farmacología , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión , Staphylococcus haemolyticus/efectos de los fármacos , Staphylococcus haemolyticus/aislamiento & purificación , Vancomicina/farmacología

Asunto(s)

Niño , Humanos , Juego e Implementos de Juego , Infecciones Estafilocócicas/transmisión , Staphylococcus aureus , Pruebas de Sensibilidad Microbiana , Staphylococcus aureus Resistente a Meticilina , Hospitalización , Hospitales Pediátricos

RESUMEN

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial pathogen in community settings. MRSA colonized individuals may contribute to its dissemination; the risk of MRSA infection is increased in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients, although the prevalence of colonization in this group is not well established. The present study addressed this issue by characterizing MRSA isolates from HIV/AIDS patients and their healthcare providers (HCPs) to determine whether transmission occurred between these two populations. METHODS: A total of 24 MRSA isolates from HIV-infected patients and five from HCPs were collected between August 2011 and May 2013. Susceptibility to currently available antimicrobials was determined. Epidemiological typing was carried out by pulsed-field gel electrophoresis, multilocus sequence typing, and Staphylococcus cassette chromosome (SCCmec) typing. The presence of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) and heterogeneous daptomycin-resistant Staphylococcus aureus (hDRSA) was confirmed by population analysis profile. Isolates characterized in this study were also compared to isolates from 2009 obtained from patients at the same hospital. RESULTS: A variety of lineages were found among patients, including ST5-SCCmecII and ST30-SCCmecIV. Two isolates were Panton-Valentine leukocidin-positive, and hVISA and hDRSA were detected. MRSA isolates from two HCPs were not related to those from HIV/AIDS patients, but clustered with archived MRSA from 2009 with no known relationship to the current study population. CONCLUSIONS: ST105-SCCmecII clones that colonized professionals in 2011 and 2012 were already circulating among patients in 2009, but there is no evidence that these clones spread to or between HIV/AIDS patients up to the 7th day of their hospitalization.

Asunto(s)

Antibacterianos/farmacología , Infección Hospitalaria/transmisión , Infecciones por VIH/microbiología , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/estadística & datos numéricos , Staphylococcus aureus Resistente a Meticilina/genética , Infecciones Estafilocócicas/transmisión , Técnicas de Tipificación Bacteriana , Infección Hospitalaria/microbiología , Electroforesis en Gel de Campo Pulsado , Humanos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , Epidemiología Molecular , Tipificación de Secuencias Multilocus , Infecciones Estafilocócicas/microbiología , Centros de Atención Terciaria

Asunto(s)

Humanos , Personal de Salud , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Mano/microbiología , Cavidad Nasal/microbiología , Infecciones Estafilocócicas/transmisión , Portador Sano/microbiología , Conocimientos, Actitudes y Práctica en Salud , Unidades de Cuidados Intensivos , Nepal

Asunto(s)

Mano/microbiología , Personal de Salud , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Cavidad Nasal/microbiología , Portador Sano/microbiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Unidades de Cuidados Intensivos , Nepal , Infecciones Estafilocócicas/transmisión

Asunto(s)

Juego e Implementos de Juego , Infecciones Estafilocócicas/transmisión , Staphylococcus aureus , Niño , Hospitalización , Hospitales Pediátricos , Humanos , Staphylococcus aureus Resistente a Meticilina , Pruebas de Sensibilidad Microbiana

RESUMEN

Purpose: To identify the causes and outcomes of pars plana vitrectomy (PPV) in patients undergoing phacoemulsification with intraoperative complication and to analyze whether the interval between phacoemulsification and PPV interferes with best-corrected final visual acuity. Methods: This descriptive and retrospective analytical study was conducted in Paraná Eye Hospital in 2013. Data were collected from medical records of 38 patients who underwent complicated phacoemulsification and also required PPV. Results: The most frequent complication as a result of phacoemulsification was posterior capsule rupture, observed in 35 patients (92.10%), followed by capsular bag detachment, in three patients (7.89%). Twenty-eight patients (73.68%) had cortical fragments that were removed during PPV. Twelve patients (31.57%) had their intraocular lens repositioned. PPV was performed on the same day of phacoemulsification in one patient (2.63%), within 1 week in 15 patients (39.47%), between 1 week and 1 month in 13 patients (34.21%), and 1 month after phacoemulsification in 9 patients (23.68%). Conclusion: This study is in agreement with worldwide literature, asserting that major complications of phacoemulsification are posterior capsule rupture and capsular bag detachment, and in addition, there is an improvement in the final visual acuity in almost half the cases, even when there are complications during modern cataract surgery, when complementary appropriate treatment is provided. .

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Objetivos: Identificar as causas e os resultados da vitrectomia via pars plana (VPP) em pacientes submetidos à cirurgia de facoemulsificação com complicação intraoperatória, analisando se o tempo cirúrgico entre a facoemulsificação e a VPP interfere na melhor acuidade visual corrigida final. Métodos: Estudo analítico descritivo e retrospectivo realizado no Hospital de Olhos do Paraná em 2013. Os dados foram coletados de prontuários de 38 pacientes que foram submetidos à cirurgia de facoemulsificação complicada e que também precisaram de VPP. Resultados: A complicação intraoperatória mais frequente na cirurgia de facoemulsificação, nos pacientes estudados, foi à ruptura de cápsula posterior, que ocorreu em 35 pacientes (92,10%), seguido de desinserção zonular em 3 pacientes (7,89%). Em 28 pacientes (73,68%) foram encontrados restos corticais, que foram removidos durante a VPP. Em 12 pacientes (31,57%) foi realizado o reposicionamento da lente intraocular. A cirurgia de VPP foi realizada no mesmo dia da facoemulsificação em 1 paciente (2,63%), dentro de 7 dias em 15 pacientes (39,47%), entre 1 semana e 1 mês em 13 pacientes (34,21%) e após 1 mês da facoemulsificação em 9 pacientes (23,68%). Conclusão: O presente estudo encontrou dados semelhantes aos descritos na literatura mundial, que afirmam que as principais complicações da facoemulsificação são a ruptura de cápsula posterior e desinserção zonular; e que a acuidade visual final melhora, em aproximadamente metade dos casos, mesmo após ocorrer complicações na cirurgia de catarata moderna, quando instituído tratamento complementar adequado. .

Asunto(s)

Humanos , Infecciones por Clostridium/transmisión , Contaminación de Equipos , Infecciones Estafilocócicas/transmisión , Estetoscopios/microbiología , Clostridioides difficile , Recuento de Colonia Microbiana , Infección Hospitalaria/etiología , Staphylococcus aureus Resistente a Meticilina

RESUMEN

Impression cytology (IC) has been widely used as a method for evaluating the ocular surface and superficial cells layers in the diagnosis and follow-up after treatment of several ocular surface tumors of both epithelial and melanocytic origin. Information regarding this can be found in the English-language literature since 1992. Using either cellulose acetate or Biopore membranes for specimen collection, a high correlation has been found between IC and tissue histology. Compared with exfoliative cytology with spatula, IC is less traumatic to the patient’s eye, provides a precise location of the area being studied, and allows accurate observation of the cells the way they exist in vivo. The additional advantage of IC is the preservation of limbal stem cells responsible for continuous corneal epithelium renewal; these can be affected after incisional or excisional biopsy at the corneoscleral limbus, which is the most frequent site of appearance of tumors in the stratified epithelium. Treatment for ocular surface squamous neoplasia has historically included surgery, but nonsurgical interventions have also been adopted. Hence, in certain cases, ophthalmologists may prefer interventions less invasive than surgical biopsy such as of impression cytology for both initial diagnosis and therapeutic monitoring of treatment for ocular surface lesions. Nevertheless, it should be considered that IC may be less helpful if the results conflict with the clinical picture or if the clinical diagnosis is uncertain and results are negative. In such cases, surgical biopsy is required for accurate diagnosis. The purpose of this review is to examine the published literature on the utilization of IC for the diagnosis and management of ocular surface tumors and to discuss the requirement for further investigation on the subject.

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A citologia de impressão (CI) tem sido amplamente utilizada como um método de avaliação da superfície ocular e das camadas de células superficiais no diagnóstico e no seguimento após tratamento de vários tumores da superfície ocular de origem epitelial ou melanocítica. As informações podem sem encontradas na literatura em língua inglesa desde 1992. Utilizando-se de membranas de acetato de celulose ou Biopore na coleta dos espécimes, uma alta correlação tem sido encontrada entre a CI e a histologia do tecido. Comparando-se com a citologia esfoliativa, a citologia de impressão é menos traumática para o olho do paciente, fornece uma localização precisa da área estudada e permite ver as células da forma como elas organizam-se in vivo. A vantagem adicional da citologia de impressão é a preservação das células- tronco germinativas responsáveis pela renovação contínua do epitélio da córnea. Elas podem ser afetadas após biópsia cirúrgica na região do limbo que é o sítio mais frequentemente acometido pelos tumores do epitélio estratificado. O tratamento para a neoplasia escamosa da superfície ocular tem sido historicamente a cirurgia, mas intervenções não cirúrgicas também foram adotadas. Por esta razão, em certos casos, oftalmologistas podem recorrer a formas menos invasivas que a biópsia cirúrgica (como a citologia de impressão) tanto para o diagnóstico inicial quanto para o monitoramento terapêutico das lesões da superfície ocular. No entanto, deve-se ter em mente que a citologia de impressão deixa de ser útil quando seu resultado não coincide com o quadro clínico ou quando o diagnóstico clínico é incerto e o resultado da citologia de impressão negativo. Nesses casos, a biópsia cirúrgica deve ser realizada para o diagnóstico. O objetivo desta revisão é examinar a literatura sobre a utilização da citologia de impressão no diagnóstico e tratamento dos tumores da superfície ocular bem como discutir a necessidade de uma investigação mais aprofundada sobre o assunto.

Asunto(s)

Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Contaminación de Equipos , Control de Infecciones , Unidades de Cuidados Intensivos , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Antibacterianos/farmacología , Trazado de Contacto , Infección Hospitalaria/prevención & control , Infección Hospitalaria/transmisión , Farmacorresistencia Bacteriana , Francia , Fómites/microbiología , Glicopéptidos/farmacología , Hospitales Universitarios , Oximetría/instrumentación , Estudios Retrospectivos , Infecciones Estafilocócicas/prevención & control , Infecciones Estafilocócicas/transmisión , Staphylococcus aureus/efectos de los fármacos

RESUMEN

INTRODUCTION: Healthcare waste (HCW) might potentially harbor infective viable microorganisms in sanitary landfills. We investigated the antimicrobial susceptibility patterns and the occurrence of the mecA gene in coagulase-negative Staphylococcus strains (CoNS) recovered from the leachate of the HCW in an untreated sanitary landfill. METHODOLOGY: Bacterial identification was performed by physiological and molecular approaches, and minimum inhibitory concentrations (MICs) of antimicrobial drugs were determined by the agar dilution method according to CLSI guidelines. All oxacillin-resistant bacteria were screened for the mecA gene. RESULTS: Out of 73 CoNS, seven different species were identified by 16S rDNA sequencing: Staphylococcus felis (64.4%; n = 47), Staphylococcus sciuri (26.0%; n = 19), Staphylococcus epidermidis (2.7%; n = 2), Staphylococcus warneri (2.7%; n = 2), Staphylococcus lentus (1.4%; n = 1), Staphylococcus saprophyticus (1.4%; n = 1), and Staphylococcus haemolyticus (1.4%; n = 1). Penicillin was the least effective antimicrobial (60.3% of resistance; n = 44) followed by erythromycin (39.8%; n = 29), azithromycin (28.8%; n = 21), and oxacillin (16.5%; n = 12). The most effective drug was vancomycin, for which no resistance was observed, followed by gentamicin and levofloxacin, for which only intermediate resistance was observed (22%, n = 16 and 1.4%, n = 1, respectively). Among the oxacillin-resistant strains, the mecA gene was detected in two isolates. CONCLUSIONS: Considering the high antimicrobial resistance observed, our results raise concerns about the survival of putative bacterial pathogens carrying important resistance markers in HCW and their environmental spread through untreated residues discharged in sanitary landfills.

Asunto(s)

Coagulasa/deficiencia , Farmacorresistencia Bacteriana Múltiple , Microbiología Ambiental , Eliminación de Residuos Sanitarios/métodos , Infecciones Estafilocócicas/transmisión , Staphylococcus/aislamiento & purificación , Instalaciones de Eliminación de Residuos , Antibacterianos/farmacología , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Humanos , Residuos Sanitarios , Pruebas de Sensibilidad Microbiana , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN , Infecciones Estafilocócicas/microbiología , Staphylococcus/clasificación , Staphylococcus/enzimología , Staphylococcus/genética