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Acute renal failure developed in a diabetic with staphylococcal arthritis and septicaemia in the absence of endocarditis. Renal biopsy showed proliferative glomerulonephritis and there was evidence of alternative pathway of complement activation. Renal function recovered following haemodialysis for 2 months. The association of glomerulonephritis with staphylococcal infection is reviewed.
From January to December 1994, 752 consecutive patients admitted to intensive care units (ICU) for more than two days were studied prospectively for Staphylococcus aureus colonization and infection. Nasal swabs were obtained at admission and weekly during the ICU stay. At ICU admission 166 patients (22.1%) were Staphylococcus aureus nasal carriers, while 586 were free of nasal colonization. Of the 166 nasal carriers, 163 harbored methicillin-sensitive Staphylococcus aureus (MSSA) and three methicillin-resistant Staphylococcus aureus (MRSA). During the ICU stay 24 of the 586 noncolonized patients became nasal carriers (11 MSSA and 13 MRSA), and one nasal carrier initially colonized by MSSA was reconlonized by MRSA. Staphylococcal infections were documented in 51 (6.8%) of the total 752 patients. After 14 days of ICU stay, the probability of developing staphylococcal infections was significantly higher for those patients who were nasal carriers at ICU admission than for those found to be initially negative (relative risk 59.6, 95% CI 20.37-184.32; p < 0.0001). In patients with ICU-acquired nasal colonization, most infections were documented prior to or at the time of the detection of the nasal colonization; thus, in this group of patients nasal carriage showed a lower predictive value for subsequent Staphylococcus aureus infections that that described classically. Paired isolates of nasal colonizing and clinical strains were studied by pulsed-field gel electrophoresis (PFGE) and mecA polymorphism analysis in 30 patients; identity was demonstrated in all but two patients. The results suggest that, outside the setting of an outbreak of MRSA, the detection of Staphylococcus aureus nasal carriers on admission may be particularly useful in identifying those patients who are at high risk for developing staphylococcal infections during their ICU stay.
A comparative experimental study was carried out of antigenic staphylococcal preparations developed in the USSR and Czechoslovakia for the immune therapy of chronic staphylococcal infection. The efficiency of the preparations was unequivocally confirmed using the rabbit staphylococcal sepsis model. The immunogenicity of tested strains was shown not to always correlate with their virulence. Preparations obtained by means of aqueous extraction from mildly virulent immunogenic strains exhibited greater protective activity than those prepared from highly virulent strains. The PCA phenomenon did not differ significantly provided the tested preparations were administered at doses which ensured equal protective action.
In this study, we evaluated whether ultrasound instruments are important in the spread of nosocomial staphylococcal infections. Following genomic typing by pulsed-field gel electrophoresis, it was apparent that ultrasound procedures transferred colonizing staphylococci from a patient's skin to the ultrasound instruments. Staphylococcus aureus survived in the transmission medium for longer than in water. Furthermore, S. aureus was more resistant to the ultrasonic medium than Pseudomonas aeruginosa, also a significant cause of hospital-acquired infections. To prevent staphylococcal transmission by ultrasound equipment, we recommend disinfection of the probe and removal of the medium after each examination.
Experiments on CBA and (CBA X C57BL)F1 mice have revealed that a prolonged period of antigen-nonspecific immunosuppression of humoral immunity develops in experimental staphylococcal infection; this period of suppression may be preceded by a short phase of antigen-nonspecific immunostimulation. Immunosuppression is linked with the accumulation of antigen-nonspecific T-suppressors in the spleen, these T-suppressors being capable of the manifestation of their activity both in vitro and in vivo in cases of their transplantation to semi-syngeneic recipients. Immunosuppression does not aggravate the course of staphylococcal infection and is accompanied by an increase in resistance to Pseudomonas aeruginosa superinfection, which is due to the stimulation of inflammatory reaction at the site of the injection of the superinfecting agent.
77 patients with serious resistant staphylococcal infections, including septicemia, lower respiratory infection, intraabdominal infection, skin and soft tissue infections and urinary tract infection, were treated with demethyl-vancomycin. 82% of the organisms were methicillin-resistant. Most of the patients had severe underlying diseases and were immunocompromised hosts. The infections were serious. The clinical efficacy rate was 73% and the bacteria clearance rate 68%. Mild adverse reactions happened in 11% of the patients and no obvious nephrotoxicity was noted. MIC90 of demethyl-vancomycin against staph. aureus was 2 micrograms/ml. All isolates in this study were highly susceptible to the drug. Demethyl-vancomycin was found more active against staphylococcus than the other 16 antibacterial agents, which are commonly used in this country. The indication and the use of the drug were discussed.
Over a six year period, in the Clinic of Communicable Diseases of Cluj Napoca, 2301 patients with staphylococcal infections were admitted to the Clinic, representing 8% of the total number of patients admitted, and 3513 staphylococcal strains were isolated. A number of 43 of the 2301 patients died (1.8%), but staphylococcal infection was actually the cause of death in only 35 cases (1.5%) (septicemia, staphylococcal meningitis and pulmonary infections). Eight of the patients died from the basic disease (hepatitis, tetanus, paratyphoid C fever etc.). A number of 2246 Staphylococcus hemolyticus aureus, 80 non-hemolytic Staphylococcus aureus and 162 Staphylococcus albus strains were isolated; most of the strains were resistant to antibiotics in different proportions.
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The work deals with the results of experimental evaluation of the influence of some new modified derivatives of muramyldipeptide (MDP) on the course of staphylococcal infection in mice. The preparations under study were found to produce rapid elimination of bacteria from kidneys and the increase of phagocytic activity of blood macrophages in animals. At the same time MDP and its derivatives stimulated natural killer cells whose activity was inhibited during infection. The dependence between the structure of these compounds and their protective action in staphylococcal infection, as well as the increase of the natural immunity characteristics of the body was followed.
BACKGROUND: We report our experience with quinupristin/ dalfopristin in combination with a glycopeptide in the treatment of severe staphylococcal infections failing previous glycopeptide regimens. PATIENTS AND METHODS: Five patients, affected by persistent bacteremia (n = 2), post-cardiothoracic surgery infection (n = 2) and post-traumatic bone infection (n = 1) due to methicillin-resistant Staphylococcus aureus (MRSA, n = 4) methicillin-resistant coagulase-negative Staphylococcus (MRCNS, n = 1) and unsuccessfully treated with antibiotics including a glycopeptide, were treated with a quinupristin/ dalfopristin and glycopeptide combination. RESULTS: Three patients were clinically cured; one patient with MRSA thoracic aorta prosthetic infection relapsed after 3 months; one patient was lost to follow-up. CONCLUSION: Quinupristin/dalfopristin, in combination with a glycopeptide, is an effective treatment option for severe methicillin-resistant staphylococcal infections failing previous glycopeptide regimens.
The microbiological monitoring in the Intensive Care Units, in the last few years, revealed a significant increase of infections caused by Gram+ bacteria. Authors of multi-center studies focus upon the problems related to the treatment of the infections caused by the methicilline-resistant staphylococci (MRS) as well as to its spreading. The Staphylococcal infections were 26.6 % of all bacterial infections in the Intensive Care Unit of the Department of Anesthesiology and Intensive Care of the Medical Academy in Białystok, during one year observation. MRS rods counted 21.4% among all pathogens isolated from the specimens collected from the patients, undergoing the treatment in the ICU, and were responsible for 83.6% of all Staphylococcal infections. The analysis revealed the significant percentage MRS rods resistant to commonly used empirical antibiotic therapy. Our experience shows that vancomycin or linezolid should be used, as an empirical antibiotic therapy, in suspected MRS-caused severe infections along with the simultaneous monitoring of changes in G+ bacteria drug resistance and strict infection-control regime.
Chemotherapeutic activity of various benzylpenicillin combinations with 10-nitro-so-trans-anti-cys-perhydroacridine (MT-2) was studied on 2 experimental staphylococcal infections caused by pathogenic penicillin resistant strains of staphylococci. It was found that the combined use of the antibiotic and MT-2 in doses of 25-100 and 12.5 mg/kg respectively administered subcutaneously increased the therapeutic effect of benzylpenicillin as compared to the antibiotic used alone. The oral use of MT-2 in a dose of 400 mg/kg also increased the therapeutic action of benzylpenicillin used in a dose of 100 mg/kg subcutaneously simultaneously with MT-2. A favourable effect of ointments containing MT-2 in a concentration of 10-20 per cent and benzylpenicillin in a dose of 50 000 or 100 000 units per 1 g of the ointment was noted in treatment of mice with localized staphylococcal infection.
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Explore the source record for details and available documents.
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Staphylococcus epidermidis is a major nosocomial pathogen, even though it is a member of the normal bacterial flora of skin and the mucous membranes. A major complication is the development of biofilms on implanted medical devices. Diagnosis of coagulase-negative staphylococcal infections relies on the presence of clinical manifestation of infections and on microbiologic evidence, usually obtained after the removal of the biomaterial. Solid-phase immunoassays have not yet been used for routine diagnosis of coagulase-negative staphylococcal infections and distinction between pathogenic and normal cocci. The enzyme immunoassays developed in the last decade are presented in this review article. Serodiagnosis has been attempted by determining antibodies against bacterial cells, mixtures of S. epidermidis slime antigens and discrete slime antigens. Detection or typing of staphylococcal cells has been performed by specific antibodies and lectins. There is still a long way until the application of such assays in the routine clinical laboratory and large clinical studies are necessary.
Sixteen children with "scalded skin" due to staphylococcal infections are described [six cases of staphylococcal scarlet fever, 6 cases of bullous impetigo and 4 cases of toxic epidermal necrolysis (Lyell's disease--of which Ritter's disease is only the neonatal manifestation)]. The clinical features of each of these conditions are described, the common feature being the severity of the pathological changes. The role of the exfoliating toxin secreted by the pathogenic staphylococci mostly belonging to phagegroup II, phagetype 3A, 3N, 3C, 55 or 71) is emphasized. Treatment should be aimed at reducing secondary infection by strict asepsis and by eradicating staphylococci with appropriate antibiotic therapy. Corticosteroids have no beneficial effect. The outcome is good if these principles are applied strictly.