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PubMed1980

[Staphylococcus aureus infection in chickens in industrialized poultry units. 3. Experimental infection of chickens and comparison of pathogenicity of Staphylococcus aureus of different origin].

Day-old chicks were subcutaneously infected with Staphylococcus aureus strains of site variety gallinae and crystalviolet Type A. The lysis patterns involved were with phages 84 as well as with phages 53, 77, and 84 of the international base scheme for human staphylococci. In fowl with synovitis and arthritis, osteomyelitis, dermatitis, and septicaemia, 52 of 57 tested strains (91.2 per cent) produced on the site of injection pathognomic oedematous-haemorrhagic and necrotising changes of the skin and hypodermis (haemorrhagic dermatitis) in a way which is characteristic also of natural diseases. However, no specific skin changes could be produced by subcutaneous infection of nine strains of site variety hominis or undefinable category with differentiated biochemical properties and lysis patterns. They had been isolated from cases of compound infection, salpingitis and wound infections as well as from one case of arthritis. Fifty-seven strains, obtained from mammals, were tested subcutaneously, on day-old chicks, among them 21 strains of site varieties of bovis, canis, ovis, and hominis. However, only four of those strains, isolated from miscarried pig foetuses and cattle with mastitis, caused, oedematisation and exudation (7.02 per cent), but no haemorrhagia and only minor lysis and necrosis of skin. The minimum dose required to induce haemolytic dermatitis was 11 x 10(3) pathogens, and the lowest lethal dose of six tested strains was between 11 x 10(5) and 26 x 10(7) pathogens. The lowest dose of mammalian strains with lethality to day-old chicks was [10 bis]10(4) times as high as the lowest dose of fowl strains. Subcutaneous infection of day-old chicks has worked well as a high-speed test by which to differentiate between fowl-pathogenic Staphylococcus aureus strains, on the one hand, and mammalian strains, on the other. The need for delimitation of such strains has been confirmed by the above experimental infections. Against the background of the above results, guidelines are proposed for the control of Staphylococcus aureus infection of fowl.

Animals↗
PubMed2004

Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study.

BACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical patients. OBJECTIVE: To assess the efficacy of mupirocin prophylaxis in preventing nosocomial S. aureus infections in nonsurgical patients. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: 3 tertiary care academic hospitals and 1 nonacademic hospital. PATIENTS: 1602 culture-proven S. aureus carriers hospitalized in nonsurgical departments. INTERVENTION: Therapy with mupirocin 2% nasal ointment (n = 793) or placebo ointment (n = 809), twice daily for 5 days, started 1 to 3 days after admission. MEASUREMENTS: Nosocomial S. aureus infections according to defined criteria, in-hospital mortality, duration of hospitalization, and time to nosocomial S. aureus infection. Staphylococcus aureus isolates were genotyped to assess whether infection was caused by endogenous strains. RESULTS: The mupirocin and placebo groups did not statistically differ in the rates of nosocomial S. aureus infections (mupirocin, 2.6%; placebo, 2.8%; risk difference, 0.2 percentage point [95% CI, -1.5 to 1.9 percentage points]), mortality (mupirocin, 3.0%; placebo, 2.8%; risk difference, -0.2 percentage point [CI, -1.9 to 1.5 percentage points]), or duration of hospitalization (median for both, 8 days). However, time to nosocomial S. aureus infection was decreased in the mupirocin group from 12 to 25 days (P > 0.2). A total of 77% of S. aureus nosocomial infections were endogenous. LIMITATIONS: A few infections in both groups may have been missed because investigators assessed a patient for infection only if microbiology culture results were positive for S. aureus. CONCLUSION: Routine culture for S. aureus nasal carriage at admission and subsequent mupirocin application does not provide effective prophylaxis against nosocomial S. aureus infections in nonsurgical patients.

Administration, Intranasal↗
PubMed1984

Staphylococcus aureus bacteremia and endocarditis: comparison of nosocomial and community-acquired infection.

Staphylococcus aureus bacteremia continues to be a frequent clinical problem even in communities where intravenous drug abuse is relatively rare. One-hundred-three evaluable cases of S. aureus bacteremia that occurred in a large tertiary care facility over a four year period (1979-1982) are reviewed. A comparison of nosocomial and community-acquired S. aureus bacteremia reveals several fundamental differences. Community-acquired S. aureus bacteremia frequently develops in the absence of a primary focus of infection and is more likely to result in endocarditis and secondary metastatic foci of clinical infection. In contrast, nosocomial S. aureus bacteremia tends to be diagnosed earlier, a primary site of portal entry is usually identified and endocarditis is less frequent as are secondary foci of infection. Irrespective of the epidemiological origin of S. aureus bacteremia, the mortality remains high particularly in nosocomial infection where the presence of severe underlying disease contributes to the high mortality. Methicillin resistant S. aureus adds a new dimension to the challenge of successful treatment of staphylococcal bacteremia.

Adolescent↗
PubMed2006

Three-year surveillance of community onset health care-associated staphylococcus aureus infections in children.

BACKGROUND: Staphylococcus aureus causes skin and soft tissue or invasive infections in children in the community, in the hospital or in other ways associated with the health care system (HCA). METHODS: Prospective community-acquired S. aureus infection surveillance at Texas Children's Hospital was initiated on August 1, 2001. Community onset HCA (CO HCA) infections were identified. Demographic and clinical data were collected. Antibiotic susceptibilities were determined. Data were analyzed by chi or Student's t test. CO HCO-isolates were characterized by pulsed field gel electrophoresis and staphylococcal chromosomal cassette carrying the mecA methicillin-resistant gene (SCCmec) typing. RESULTS: From August 1, 2001 to July 31, 2004, 61.5% of 322 in year 1, 62.9% of 259 in year 2 and 56.9% of 318 in year 3 of CO HCA isolates were methicillin-resistant S. aureus (MRSA). Among the CO HCA-MRSA isolates, 8.9% of 542 were from children with invasive infections compared with 24.1% of 357 CO HCA-methicillin-susceptible S. aureus (MSSA; P < 0.001). Sixty-six percent of children with CO HCA-S. aureus isolates were admitted to the hospital. Clindamycin resistance increased over the 3 years (CO HCA-MRSA, from 3.5% to 18.8%, P < 0.001; CO HCA-MSSA, from 3.2% to 10.2%, P = 0.053). Thirty-three of 35 (94.3%) CO HCA-MRSA carried SCCmecIV; 30 were USA300. Only 3 of 35 MSSA were related to USA300 by pulsed field gel electrophoresis. CONCLUSIONS: CO HCA-S. aureus infections remained steady over the 3-year study at Texas Children's Hospital. Clindamycin resistance increased >4-fold for CO HCA-S. aureus isolates over the 3 years and is no longer appropriate for empiric treatment of invasive infections suspected to be caused by CO HCA-MRSA at our hospital. In our setting, CO HCA-MRSA infections are steady in number despite substantial increases in community-acquired MRSA infections and both being related to the same clone.

Anti-Bacterial Agents↗
PubMed2002

[Staphylococcus aureus infections--the clinical picture and treatment].

Infections caused by Staphylococcus aureus comprise relatively benign local skin infections, as well as serious generalised conditions. In Denmark, more than 85% of all S. aureus isolates are found resistant to penicillin, whereas resistance to methicillin is rare (< 1%) and therefore one of the penicillinase-stable penicillins is still the drug of choice. Dicloxacillin is usually chosen, because of its superior penicillinase stability. Infections caused by methicillin resistant strains may be treated with different combinations of macrolides, fusidic acid, aminoglycosides, fluoroquinolones, and rifampicin, but vancomycin is generally used. Newer drugs like the oxazolidinones and streptogramins are effective against methicillin-resistant strains and will be available in Denmark within a short time. Antibiotic treatment, however, is most often only a supplement to surgical intervention. This paper deals with the clinical picture and treatment of some common S. aureus infections.

Anti-Bacterial Agents↗
PubMed2003

Antimicrobial therapy of methicillin resistant Staphylococcus aureus infection.

Methicillin-resistant Staphylococcus aureus (MRSA) is now one of the commonest causes of nosocomial infection worldwide. The mainstay of treatment until now has been the glycopeptides (vancomycin and teicoplanin). They are not without toxicity and need parenteral administration and monitoring of levels. The increasing frequency of MRSA infections, coupled with the emergence of glycopeptide resistance in S. aureus has made the introduction of new drugs active against Gram-positive organisms essential. New agents active against Gram-positive organisms represent either genuinely novel classes of antimicrobials (e.g., oxazolidinones and lipoproteins) or those derived from existing classes (e.g., tetracyclines, glycopeptides, streptogramins and cephalosporins). Some of these newer antibiotics appear to be effective against multi-resistant organisms including MRSA.

Administration, Oral↗
PubMedDate not supplied

Determinants of mortality in oncology patients colonized or infected with Staphylococcus aureus.

Oxacillin-resistant Staphylococcus aureus (ORSA) infection is an important cause of hospital morbidity and mortality. The objective of this study was to identify the main factors associated with death in patients colonized or infected with Staphylococcus aureus in a cancer center. A matched-pair case-control study enrolled all patients infected or colonized with ORSA (cases) admitted to the Hospital do Câncer in Rio de Janeiro from 01/01/1992 to 12/31/1994. A control was defined as a patient hospitalized during the same period as the case-patients and colonized or infected with oxacillin-susceptible Staphylococcus aureus (OSSA). The study enrolled 95 cases and 95 controls. Patient distribution was similar for the two groups (p > or = 0.05) with respect to gender, underlying diseases, hospital transfer, prior infection, age, temperature, heart and respiratory rates, neutrophil count, and duration of hospitalization. Univariate analysis of putative risk factors associated with mortality showed the following significant variables: admission to the intensive care unit (ICU), presence of bacteremia, use of central venous catheter (CVC), ORSA colonization or infection, pneumonia, use of urinary catheter, primary lung infection, prior use of antibiotics, mucositis, and absence of cutaneous abscesses. Multivariate analysis showed a strong association between mortality and the following independent variables: admission to ICU (OR [odds ratio] = 7.2), presence of Staphylococcus bacteremia (OR = 6.8), presence of CVC (OR = 5.3), and isolation of ORSA (OR = 2.7). The study suggests a higher virulence of ORSA in comparison to OSSA in cancer patients.

Catheterization, Central Venous↗
PubMed1985

Protective effect of acidic mannan fraction of bakers' yeast against Staphylococcus aureus infection in mice.

Protective activity of an acidic fraction of bakers' yeast mannan containing protein and phosphorus, designated as WAM025, against infection of Staphylococcus aureus beta H 248 strain in mice was investigated. WAM025 elicited a marked increase in the survival ratio of mice challenged with viable cells of the S. aureus strain, 5 X 10(8) cells per mouse, when the fraction was administered to mice 150 mg/kg/d, 5 times, intraperitoneally. This effect was stronger than that of WNM, a neutral fraction of mannan obtained from the same bakers' yeast. The difference seemed to correlate with the strength of activating effects of WAM025 and WNM on the reticuloendotherial system of the host animal. WAM025 induced higher activities of serum lysozyme and carbon clearance in mice than WNM. Also, mice treated with WAM025 showed a greater increase in number and activity of oxygen-generating blood polymorphonuclear leucocytes than mice treated with WNM.

Animals↗