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PubMedDate not supplied

[Effect of nosocomial bacteremia caused by oxacillin-resistant Staphylococcus aureus on mortality and length of hospitalization].

OBJECTIVES: To identify the attributed mortality rate of bloodstream hospital infection by Staphylococcus aureus resistant to methicillin (MRSA) and its effect on length of hospital stay. DESIGN: Case-control study. SETTING: Hospital São Paulo da Universidade Federal de São Paulo, a 660-bed, tertiary-care teaching hospital in São Paulo, Brazil. PATIENTS: Seventy one adults patients with hospital-acquired MRSA bacteremia diagnosed between January 1, 1991, and September 30, 1992, and 71 MRSA-free controls were matched by the following criteria: age, sex, underlying disease, surgical procedure, same risk time and admission date. RESULTS: The incidence of patients with hospital sepsis by MRSA accounted for 73.22% of the patients with hospital bloodstream infection by Staphylococcus aureus. The mortality rate of the cases was 56.33 (40/71) and 11.26 (8/71) of the controls. The attributable mortality rate was 45.07% (OR = 17.0; IC 95% = 3.58-202.26; p = 0.000001). The length of hospital stay median time was of 32.55 days for the cases and 29.75 for the controls (p = 0.32). CONCLUSION: A high level of sepsis by MRSA was observed in all the Staphylococcus aureus bacteremia. The bloodstream hospital infection by MRSA itself does provide a high level of mortality independently from the patients base disease, without however, increasing their hospital length of stay.

Adult↗

PubMed2001

[A boy diagnosed SLE after Staphylococcus aureus infection over a long period].

We encountered a 13-year-old boy with SLE who showed specific pathophysiology. The affected child was hospitalized because of long-standing cutaneous empyesis considered to be Staphylococcus aureus infection, followed by manifestation of meningoencephalitis-like symptoms. On a close check up, the patient was diagnosed as having SLE complicated with interstitial lupus nephritis and verrucosis of the left ventricle. Besides the findings, the blastogenesis of the patient's lymphocyte was low against stimulation of sac-1 which connects with the Fc portion of lgG, one of the constituent proteins of Staphylococcus. Moreover, anti-phospholipid antibodies turned positive during immunosuppressive therapy and subcutaneous abscess due to Pseudomonas aeruginosae developed concurrently at about the same time, which posed difficulties in the treatment. The affected child had had Staphylococcus aureus infections over a long period of time before diagnosis of SLE and was susceptible to bacterial infections due to Pseudomonas aeruginosae during the treatment. The clinical course of this case was considered important in presuming the complex immunologically abnormal condition of SLE in childhood.

Adolescent↗

PubMed1985

Efficacy of topical chloramphenicol and tobramycin ophthalmic solutions in preventing severe Staphylococcus aureus keratitis in rabbits.

Various marketed chloramphenicol ophthalmic solutions were compared and various dilutions of Tobrex Ophthalmic Solution were tested for effectiveness in a Staphylococcus aureus rabbit keratitis model. Anesthetized rabbits were each infected intracorneally with 10(4) Staphylococcus aureus ATCC 29737 cells. Treatment groups consisted of five or six rabbits (10 or 12 eyes) per group. One group of rabbits was infected but not treated (Positive Control Group). Topical dosing of commercially available ophthalmic solutions was accomplished by depositing 0.1 mL of a color-coded test solution into the lower cul-de-sac of each eye. Dosing begin one hour after the mid-infection time and continued for a total of nine hourly treatments. Twenty-four hours after infection the rabbit eyes were graded (masked) using standard slit-lamp scoring procedures. The slit-lamp scores for five of eight ocular parameters were used to calculate an eye score value for each rabbit eye. The five ocular parameters were selected, based on previous Stepwise Discriminant Computer Analysis of over 300 rabbit eyes infected with Staphylococcus aureus ATCC 29737 and treated with various antibiotics. The eye score values for each group were averaged and the treatments were compared for significant differences in efficacy using the nonparametric, Wilcoxon-Mann-Whitney Rank Sum Test.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1999

Rhabdomyolysis and aggravation of arthritis in a rheumatoid arthritis patient as a result of sepsis due to Staphylococcus aureus infection of a rheumatoid nodule; a catastrophic outcome.

A 63-year-old man with rheumatoid arthritis presented with rhabdomyolysis and intractable arthritis of acute onset. He was diagnosed to have sepsis due to Staphylococcus aureus infection through of an ulcerated rheumatoid nodule. Staphylococcus aureus isolated from pus in the ulcerated rheumatoid nodule and a blood sample obtained from the heart post-mortem produced the toxic shock syndrome toxin-1 (TSST-1). The TSST-1 and/or unmethylated CpG motifs in the oligonucleotides present in a bacterium, Staphylococcus aureus in this case, might be implicated in the induction of rhabdomyolysis and intractable arthritis.

Arthritis, Rheumatoid↗

PubMed1975

[Reaction of rat embryo tissues to mechanical trauma and to infection with Staphylococcus aureus (strain 209)].

Experiments were conducted on albino rat embryos. A study was made of healing of the skin wounds and the reaction of the tissues to the intrauterine injection of pathogenic Staphylococcus aureus (strain 209). In horizontal cut the orthotonic position of the fetus and retraction of the skeletal muscles prevented wound contraction and epithelialization of its surface. In vertical cut the margins of the wound were approximated and healing took place without formation of granulation tissue by epithelialization of the wound surface 2 days after the operations with regeneration of the squamous epithelium. To the action of the pathogenic staphylococcus the embryos responded by a local untypical reaction with the prevalence of alterative changes and the accumulation of the histiocyte-like cells near some colonies. There was no exudative inflammatory reaction either during the trauma or in injection of a staphylococcus culture at all the periods of the intrauterine life.

Animals↗

PubMed1983

[Purulent Staphylococcus aureus meningitis].

Retrospective study of 14 cases of Staphylococcus aureus meningitis and of data from the literature shows that this as yet infrequent disease which carries a high mortality rate (40%) is always related to neurosurgery, primary or iatrogenic septicemia, or local infection, usually in the lumbar area (spinal, abscess, spondylitis). The major clinical problem is the search for the meningeal lead point of Staphylococcus aureus penetration, whose eradication is more essential than in usual bacterial meningitis. Prognosis is mainly dependent upon the eventual existence of associated severe septicemia. Antibiotics active on Peni-M resistant Staphylococcus aureus and meningeal infection are reviewed.

Adult↗

PubMed1994

[Gluteal abscess caused by Staphylococcus aureus in a patient with systemic lupus erythematosus].

We describe here a 44-year-old female patient with systemic lupus erythematosus (SLE), who developed gluteal abscess resulting in symptoms suggestive of aseptic necrosis of the right femoral head. The patient was diagnosed as active SLE with organic brain syndrome in December 1992, and has been treated with high doses of methylprednisolone (initial dose: 100 mg daily). As she recovered from the manifestations, the dose of methylprednisolone has been gradually decreased. In June 1993, she began to complain of right leg pain on walk with positive Patrick sign in the right hip. A massive gluteal abscess was identified by X-ray and CT scan, and drained. Cultures of the purulent fluid yielded Staphylococcus aureus. Of note, Staphylococcus aureus had been detected from repeated cultures of pharyngeal swabs, suggesting that the organism invading from the pharynx was carried in the blood to a small hematoma in the right gluteal muscle to form an abscess. The importance of an awareness of the possibility of the infection of Staphylococcus aureus in SLE patients is discussed.

Abscess↗

PubMed1976

Nursery outbreak of scalded-skin syndrome. Scarlatiniform rash due to phage group I Staphylococcus aureus.

From Aug 6 to 14, 1973, scariatiniform eruptions that were considered to be mild forms of the staphylococcal scalded-skin syndrome developed in four neonates. One infant had mild epidermal peeling. All had generalized, finely papular erythema that cleared rapidly after treatment with antibiotics. Cultures from the umbilical stumps or anterior nares of three of the infants yielded colonies of group I Staphylococcus aureus, phage type 29/52/79/86/D11/81, that were able to produce epidermal exfoliation in suckling mice. These data indicate that the nursery outbreak was caused by phage group I staphylococci rather than group II organisms previously associated with staphylococcal scalded-skin syndrome. The demonstration that a group I Staphylococcus can produce exfoliative toxin suggests that the same mechanism for toxin production may exist for phage groups I and II staphylococci.

Cross Infection↗

PubMed1988

Staphylococcus epidermidis as a cause of postoperative wound infection after cardiac surgery: assessment of pathogenicity by a wound-scoring method.

Wound infection after clean surgery prolongs hospital stay but the organism most commonly isolated from wound discharge, Staphylococcus epidermidis, is often dismissed as a contaminant or commensal. The wounds of 517 patients were assessed, after cardiac surgery, by a wound-scoring method ('ASEPSIS') and a close comparison was made of the appearance and clinical outcome of 89 wounds, from which bacteria were isolated. There was no significant difference in the scores of 49 wounds, where S. epidermidis was the sole isolate (9.5 per cent of all wounds, 95 per cent CI 6.9-12.0 per cent), and 13 wounds infected with Staphylococcus aureus (2.5 per cent, 95 per cent CI 1.2-3.9 per cent). Repeat cultures were obtained from 21 of the 49 wounds and, in 16 of these, the second isolate showed the same biochemical reactions and antibiotic resistance pattern as the first. Infection of sternal wounds is commoner with coagulase-negative staphylococci than with S. aureus and, clinically, is just as severe.

Cardiac Surgical Procedures↗

PubMed1998

DNA cycle sequencing of a common restriction fragment of Staphylococcus aureus bacteriophages by capillary electrophoresis using replaceable linear polyacrylamide.

The nucleotide sequence of a part of a 4.9 kbp common restriction fragment isolated from Staphylococcus aureus bacteriophage (bacterial virus) 3A has been determined by capillary electrophoresis (CE). The fast separation of sequencing fragments in linear polyacrylamide solution at a temperature of 55 degrees C allowed the reading of more than 650 bases of sequence in 60 min. The single strand (ss)DNA fragments were prepared by cycle sequencing with fluorescently labeled dideoxy-terminators on the cloned bacteriophage DNA template. With respect to analysis speed, sequence read-length, low sample consumption and automation, CE offers a simple, labor-saving and inexpensive procedure for DNA sequencing. Operating the CE columns at elevated temperature proved to be a rapid procedure capable of extending sequence read-length. The resulting sequence of the common restriction fragment can be used for the preparation of specific primers and oligonucleotide hybridization probes for identification of Staphylococcus aureus bacteriophages and/or prophages belonging to the bacteriophage species 3A.

Acrylic Resins↗

PubMed2004

Electric-current-induced detachment of Staphylococcus epidermidis strains from surgical stainless steel.

Infection of percutaneous biomaterials implants, such as fixation frames used for the repair of complicated fractures in orthopedics, is a major complication that almost inevitably leads to replacement of the implant. As antibiotic therapy usually has little impact on biomaterial-associated infections, it is the aim of this article to examine whether implant-associated Staphylococcus epidermidis and Staphylococcus aureus strains could be stimulated to detach from a surgical stainless steel anode during application of an electric current. First, bacteria were allowed to adhere from a flowing suspension of physiological ionic strength in a parallel plate flow chamber to a stainless-steel surface, after which the suspension was replaced by a bacterium-free solution with a specified ionic strength (0.5-150-mM potassium phosphate). DC currents ranging from 15 to 125 microA were applied to induce bacterial detachment. Initial detachment decreased with increasing ionic strength at 100 microA. The percentage detachment achieved by application of an electric current after 2.5 h was highest (95%) in 1-mM potassium phosphate and decreased to 15% when the ionic strength exceeded 40 mM. The electric current did not significantly affect the percentage detachment, but initial detachment rates increased with increasing current from 1000 cm(-2) s(-1) at 15 microA to 7000 cm(-2) s(-1) at 125 microA. Although different isolates of S. epidermidis and S. aureus showed different patterns of current-induced detachment, all strains could be stimulated to detach. The results of this study define ionic-strength conditions and electric currents yielding staphylococcal detachment from surgical stainless steel and therewith point to a pathway for the treatment and prevention of percutaneous metal-implant infection.

Electric Stimulation↗

PubMed1988

The role of capsule as a barrier to bacteriophage adsorption in an encapsulated Staphylococcus simulans strain.

The polyvalent staphylococcal bacteriophage U16 failed to adsorb to an encapsulated Staphylococcus simulans strain. Partially purified cell wall and teichoic acid of this strain could, however, inactivate bacteriophage U16 to a great extent, indicating the presence of the phage receptor. It is concluded that the capsule of Staphylococcus simulans acts as a barrier for the interaction of the phage with its receptor in the bacterial cell wall.

Abscess↗

PubMed1990

Prevalence of Staphylococcus aureus and coagulase-negative staphylococci with decreased sensitivity to glycopeptides as assessed by determination of MICs.

The prevalence of staphylococci with decreased sensitivity to glycopeptides was assessed at a Paris hospital by determination of the MICs. The values obtained using the MIC method were compared to those obtained using the routine disk agar diffusion method. One hundred independently isolated strains were tested including 57 Staphylococcus aureus isolates and 43 coagulase-negative staphylococci (CNS). For all strains vancomycin MICs were less than or equal to 4 mg/l but for 5.3% of the Staphylococcus aureus isolates and 25.6% of the CNS isolates teicoplanin MICs were high (greater than or equal to 8 mg/l). Moreover, teicoplanin MICs did not correlate well with zone sizes. The MIC method is therefore recommended for evaluating the susceptibility of staphylococci to teicoplanin.

Anti-Bacterial Agents↗

PubMed1989

Evaluation of four qualitative methods for detection of beta-lactamase production in Staphylococcus and Micrococcus species.

Four qualitative methods for the detection of beta-lactamase production in Staphylococcus and Micrococcus species were evaluated and compared with a quantitative macroiodometric reference method. The disc diffusion test with penicillin G and the cloverleaf method could not separate beta-lactamase-positive from beta-lactamase-negative strains. Two applications of the chromogenic cephalosporin test, using uninduced strains and strains grown on blood agar plates, gave a large number of false negative and false positive results. False negative reactions were most common among uninduced strains, while the false positive reactions were most often recorded for Staphylococcus saprophyticus. A high degree of efficiency was recorded for the nitrocefin spot test, using induced strains grown on antibiotic susceptibility agar, and for the starch-iodine plate method. The starch-iodine plate with methicillin as inducer gave the most reliable results.

Bacteriological Techniques↗

PubMed1988

Enterotoxigenicity of Staphylococcus intermedius of canine origin.

Seventy-three staphylococcal strains isolated from pyrodermatitis in dogs were classified as Staphylococcus intermedius (52 strains) or Staphylococcus aureus (21 strains) on the basis of acetoin formation, anaerobic mannitol fermentation, aerobic maltose fermentation, pigmentation, coagulation of human plasma, and reaction on crystal violet agar. Enterotoxin was produced by 13 of the 52 S. intermedius strains and 6 of the S. aureus strains. The highest percentage of enterotoxigenic strains produced enterotoxins C (6 strains), D (7 strains), and E (6 strains). Four strains produced the toxic shock syndrome toxin-1. There was little difference in the antibiotic susceptibility between the enterotoxigenic and non-enterotoxigenic strains.

Animals↗

PubMed1994

Effect of three commercial starters on growth of Staphylococcus aureus and enterotoxins (A-D) and thermonuclease production in broth.

The growth of four enterotoxigenic Staphylococcus aureus strains was partially inhibited by three commercial starters used in the meat sausage industry when grown in APT broth at 30 degrees C statically. Starter SP318 (a mixture of selected strains of Lactobacillus sake, Pediococcus pentosaceus and Staphylococcus xylosus) showed the most inhibitory activity. Staphylococcal enterotoxins (A, B, C1 and D) synthesis was totally inhibited by the growth of the three starters, whereas staphylococcal thermonuclease production was partially inhibited in mixed cultures.

Animals↗

PubMedDate not supplied

Relationship of staphylococcal conjugative plasmids to large gentamicin-resistance nonconjugative plasmids in clinical isolates of Staphylococcus epidermidis.

Self-mobilization of large plasmids was not observed in 15 of 15 strains of gentamicin-resistant (Gmr) Staphylococcus epidermidis clinical isolates that were taken from bacteremic newborns in a neonatal intensive care unit. Alternatively, nine Gmr Staphylococcus aureus clinical isolates, which were isolated along with the S. epidermidis strains, were all shown previously to contain Gmr conjugative plasmids. All of the nonconjugative strains had plasmids that were similar in size to the S. aureus conjugative plasmids. Transfer of seven of these nonconjugative plasmids by protoplast transformation indicated that they carried Gmr determinants. The rationale of these studies was to detect the presence of genes for conjugation (tra) on the large Gmr nonconjugative plasmids. It was thought that these plasmids might contain either defective or deleted tra gene sequences. To gain insight into these possibilities, a 6.3-kb probe, which contained a major tra gene region, was hybridized with EcoRI and XbaI digests of nonconjugative plasmid DNA. Hybridization occurred with only one of eight plasmids. It was concluded that seven of the large S. epidermidis plasmids were not self-transmissible because they lacked tra genes. However, pMH6502 contained an excess of tra gene regions compared to prototype conjugative plasmids and was still not self-transmissible.

Conjugation, Genetic↗

PubMed2005

A novel method to control the balance of skin microflora. Part 1. Attack on biofilm of Staphylococcus aureus without antibiotics.

BACKGROUND: Staphylococcus aureus (SA) is usually present in atopic dry skin, and not only in regions seriously affected by atopic dermatitis. SA discharges various toxins and enzymes that injure the skin, and forms a biofilm from fibrin fiber and glycocalyx; the biofilm is important for adhesion of SA to the skin and for resistance to anti-microbial agents. Even highly effective moisturizers do not work perfectly on atopic dry skin. Staphylococcus epidermidis (SE) is a major constituent of skin microflora on healthy human skin, and provides protection against the growth of pathogenic bacteria. OBJECTIVES: Since treatment with anti-microbials may lead to re-growth of SA, which grows faster than other Staphylococci and often shows antibiotic resistance, we searched for novel approaches to control the skin-microfloral balance without using conventional anti-microbials. METHOD: Biofilm formation by SA in vitro was observed in detail using scanning electron microscopy. Approximately 500 substances were screened for a selective effect on SA growth and SA biofilm. RESULTS: We found that xylitol inhibited the formation of glycocalyx, and farnesol dissolved fibrin fibers. Farnesol suppressed the growth of only SA, and did not affect that of SE. Xylitol and farnesol synergistically inhibited biofilm formation by SA. CONCLUSION: Xylitol and farnesol have potential for controlling the skin-microfloral balance because of their selective effects and inhibition of biofilm formation. They might provide a useful and safe method to care for skin colonized by SA, without using antibiotics.

Administration, Cutaneous↗