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PubMed1998

Identification of oxacillin-susceptible and oxacillin-resistant Staphylococcus aureus using commercial latex agglutination tests.

Four hundred thirteen Staphylococcus sp. were identified by Staphaurex, Staphaurex Plus, and BACTiStaph kits using tube coagulase as reference. Among 222 coagulase-positive isolates, 56 were oxacillin-resistant Staphylococcus aureus. All tests were accurate in distinguishing between coagulase-positive and -negative staphylococci with sensitivities and specificities > or = 97% and only nine discrepancies.

Agglutination Tests↗
PubMed2000

An unusual epidemic of Staphylococcus-negative infections involving anterior cruciate ligament reconstruction with salvage of the graft and function.

We performed a retrospective study of 13 patients who had postoperative clinical and laboratory signs of infection after autogenous bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstructions. From January 1991 to November 1996 we experienced only 2 infected knees in 1,300 reconstructions, but between December 1996 and February 1997 10 patients in 70 ACL reconstructions developed a postoperative suspected infection. We found the origin of contamination (coagulase-negative Staphylococcus) in the supposedly sterile inflow cannula. When we changed this device, we had only 1 infection in the next 400 reconstructions. The diagnosis in these cases was derived from clinical signs and laboratory results, but only 2 of 11 samples of aspirated synovial fluid tested positive for Staphylococcus. The mean interval between the surgery and the onset of signs of infection and the start of antibiotic therapy was 7.7 days. All the patients had antibiotic association at the highest level. Six knees underwent arthroscopic debridement when the clinical signs indicated resistence to antibiotics. The normal postoperative rehabilitation program was modified but was not discontinued. Although recovery time was longer, overall results were similar to uncomplicated reconstructions. On the basis of our experience, we believe that when there is a notable increase in infection rates, a thorough search for contamination is indicated. Our source of infection was material that was thought to be sterile. Ultimately, early diagnosis and treatment is of critical importance to obtain good results. Even suspicion of infective postoperative complication should be sufficient cause to search for responsible microorganisms and begin antibiotic therapy. Arthroscopic debridement should be proposed to patients with resistence to antibiotics.

Adult↗
PubMedDate not supplied

[Treatment and prevention of Staphylococcus aureus].

The number of Staphylococcus aureus (S. aureus) community and nosocomial acquired infections have increased in the last twenty years. Between 1990 and 1992, this pathogen has become the most frequent source of nosocomial infections 1,2. On the other hand, as result of antibiotherapy selection pressure, we observe a dramatic increase in the methicillin-resistant S. aureus (MRSA) infections 3,4. With the recent emergence of multiresistant strains, including glycopeptides resistance, the treatment of these infections became still more difficult 2,4-6. It's important to prevent resistant strains emergence. To prevent further emergence of resistant strains, the use of antibiotherapy must be optimised, laboratory methods for the detection of resistant pathogens must be enhanced and strict precautions should be taken following of the infection or colonization of patients 6-10. In this paper, we review anti-staphylococci history evolution and point out the present recommendations for the treatment and prevention of Staphylococcus aureus infections and colonization.

Community-Acquired Infections↗
PubMed2003

Limited success with open debridement and retention of components in the treatment of acute Staphylococcus aureus infections after total knee arthroplasty.

The purpose of this study was to review our experience in treating acute gram-positive infections after total knee arthroplasty with debridement, component retention, and intravenous antibiotics. Thirty-one total knee arthroplasties with acute gram-positive infections, seen at our institution over a 10-year period, were treated with open debridement and component retention. Eleven (35%) of 31 patients successfully retained their components at most recent follow-up, without ongoing infection (mean, 4 years; range, 2-10 years). Only one (8%) of the 13 patients infected with Staphylococcus aureus was successfully treated, compared with 10 (56%) of 18 patients with either Staphylococcus epidermidis or a streptococcal species. The difference between these groups is statistically significant (P=.007). The high failure rate of debridement and component retention suggests that immediate component removal should be considered in the presence of acute S. aureus infection in total knee arthroplasty.

Acute Disease↗
PubMed2001

In vitro adherence of Staphylococcus epidermidis to silicone punctual plugs and collagen implants.

PURPOSE: To evaluate in vitro adherence of Staphylococcus epidermidis to silicone punctal plugs and collagen implants. SETTING: Loyola University Medical Center, Maywood, Illinois, USA. METHODS: Silicone punctal plugs and collagen implants were exposed to S epidermidis (3 x 10(8) colony forming units/mL) for 0, 5, 30, and 60 minutes, rinsed in sterile saline, and processed for light, scanning (SEM), and transmission (TEM) electron microscopy. Scanning electron microscopy (x2000) was used to quantify bacteria/mm2 adhering to the devices. RESULTS: The mean S epidermidis/mm2 +/- (SD) adhering to each device were as follows: baseline, silicone punctal plug, 1593 +/- 899, and collagen implant, 7168 +/- 2895 (P =.000, paired Student t test); 5 minutes, silicone punctal plug, 3833 +/- 537, and collagen implant, 6571 +/- 2240 (P =.008); 30 minutes, silicone punctal plug, 13 988 +/- 9076, and collagen implant, 10 404 +/- 1731 (P =.2616); and 60 minutes, silicone punctal plug, 12 644 +/- 10 402, and collagen implant, 11 748 +/- 2685 (P =.8056). CONCLUSIONS: Staphylococcus epidermidis adhered significantly more to collagen implants than to silicone punctal plugs at 0 and 5 minutes. No significant difference in bacterial adherence was seen at 30 and 60 minutes. For both devices, bacterial adherence increased with increasing exposure.

Bacterial Adhesion↗
PubMed2002

Effect of vancomycin on Staphylococcus epidermidis adherence to poly(methyl methacrylate) intraocular lenses.

PURPOSE: To study the adherence of Staphylococcus epidermidis in variable loads (10(8) cfu/mL and 10(3) cfu/mL) to poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) and to evaluate the effect of vancomycin treatment on S epidermidis adherence to the IOL. SETTING: L.V. Prasad Eye Institute, Hyderabad, India. METHODS: The study was designed in 2 parts. Phase I: Twelve PMMA IOLs were soaked in a solution of S epidermidis, randomized to 10(8) cfu/mL or 10(3) cfu/mL. They were rinsed or rinsed and vortexed and cultured. Phase II: Twelve IOLs were treated with vancomycin (10 mg/mL), randomized to before and after treatment with S epidermidis. RESULTS: Staphylococcus epidermidis adhered to all portions of the IOL with 10(8) cfu/mL and 10(3) cfu/mL bacterial loads. Treatment with vancomycin reduced S epidermidis adherence. CONCLUSION: Pretreatment of an IOL with vancomycin or a suitable antibiotic agent appears to reduce bacterial adherence to the IOL. Placement of a sustained-release device that could release an antibiotic agent over a specific period, reducing the incidence of postcataract endophthalmitis, should be studied.

Anti-Bacterial Agents↗
PubMed1997

Biofilm formation of Staphylococcus aureus strains isolated from impetigo and furuncle: role of fibrinogen and fibrin.

The formation of membranous structure (thickness from the plastic tissue-culture coverslip (hematoxylin-eosin) > 1 mm; periodic acid-Schiff-positive) was more prominent with Staphylococcus aureus (S. aureus) strains isolated from impetigo (coagulase types I.V origin) than with S. aureus strains isolated from furuncle (coagulase type IV origin) (P < 0.05) in the plastic tissue-culture coverslip in human plasma after 72 h. Attachment of S. aureus cells to a plastic tissue-culture coverslip was more marked in 0-3% fibrinogen/tryptic soy broth (TSB) than in plasma (P < 0.05). The formation of the membranous structure was observed on the plastic tissue-culture coverslip with 0.3% fibrinogen/human serum but not with 0.3% fibrinogen + 5% glucose/TSB. Electron microscopy revealed abundant fibrin around S. aureus cells at 4 h and Ruthenium red-positive materials increased at 24 and 72 h in plasma. Staphylococcus aureus cell attachment to the plastic tissue-culture coverslip in plasma decreased by addition of levofloxacin (LVFX) at 1/2 minimum inhibitory concentration (MIC) and clarithromycin (CAM) at 1/4 MIC. Polysaccharide production of S. aureus cells on the plastic tissue-culture coverslip in plasma decreased with the addition of CAM at 1/4 MIC. Fibrinogen is closely related to initiation of infection but biofilm formation requires the conversion of fibrinogen to fibrin. Thus, attachment of S. aureus cells to the plastic tissue-culture coverslip, conversion of fibrinogen to fibrin by coagulase-prothrombin complex, and production of abundant glycocalyx by S. aureus cells are at least required for the production of biofilm in staphylococcal skin infection.

Anti-Bacterial Agents↗
PubMed1997

Changes in Staphylococcus aureus density and lesion severity after topical application of povidone-iodine in cases of atopic dermatitis.

A case-control study was performed to examine the efficacy of 10% povidone-iodine solution applied to atopic dermatitis patients. The density of Staphylococcus aureus on the eczematous lesions and the lesion severity before and after the topical application of povidone-iodine were compared. We found a 10-100-fold decrease in the density of S. aureus after povidone-iodine treatment in patients colonizing S. aureus at an initial density of > 1000 CFU/10 cm2. Erythema and exudation also decreased after povidone-iodine treatment in patients colonizing S. aureus at an initial density of > 1000 CFU/10 cm2. The 10% povidone-iodine solution disinfected S. aureus cells when added immediately after the cells were mixed in human plasma; however, 10% povidone-iodine solution only reduced the density of S. aureus cells by 10-100-fold when S. aureus cells were harvested after a 24 h incubation in human plasma. Staphylococcus aureus cells harvested after 24 h incubation in human plasma were often surrounded by fibrin bundles and cells circumscribed by fibrin bundles could not be disinfected with 10% povidone-iodine solution. We suggest that S. aureus cells may produce biofilm-like structures in atopic dermatitis patients and that these structures may help S. aureus cells resist the 10% povidone-iodine treatment.

Administration, Topical↗
PubMed2001

Rate of Staphylococcus aureus nasal carriage in immunocompromised patients receiving haemodialysis treatment.

Specimens from the nose and throat were collected from 28 long-term haemodialysed patients. Staphylococcus aureus strains were isolated from sixteen patients who been on haemodialysis for over 113 months. Cytokine levels, as well as full blood cell differential counts and cell surface antigens were determined in these patients. The serum concentration of TGF-beta was significantly higher in patients carrying Staphylococcus aureus. CD14 and HLA-DR molecule expression on monocytes, as well as NK cell percentage was significantly different in S. aureus carriers. Our preliminary results suggest that immune status imbalance in haemodialysed patients could be related to the high incidence of S. aureus nasal carriage and infections.

Adult↗
PubMed2003

Relationship between haemolytic and sphingomyelinase activities in a partially purified beta-like toxin from Staphylococcus schleiferi.

beta-Toxins of staphylococcal species possess dual activity in that they can both lyse erythrocytes (by 'hot-cold' lysis) and catalyse hydrolysis of membrane-associated sphingomyelin. However, the precise relationship between these two activities has not been extensively studied. We have partially purified a beta-like toxin from culture supernatants of Staphylococcus schleiferi N860375 which exhibits both 'hot-cold' lysis of erythrocytes and neutral sphingomyelinase activities. This toxin has a strong preference for sheep erythrocytes, the membranes of which are rich in sphingomyelin. Kinetic analysis suggests that haemolysis and sphingomyelinase activities are very closely associated obeying identical Michaelis-Menten kinetics. However, pre-treatment with antibodies to Staphylococcus aureus beta-toxin, Ca(2+), dithiothreitol and phenylmethylsulfonyl fluoride appear to inhibit sphingomyelinase activity significantly more strongly than haemolysis while Mg(2+) activates sphingomyelinase activity more strongly than haemolysis. We attribute these effects to differences in binding properties in the two assays. Micropurification by both sphingosylphosphocholine-agarose affinity chromatography and preparative electrophoresis revealed that the 34-kDa toxin associates non-covalently with individual proteins.

Bacterial Toxins↗
PubMed1991

Evidence for degradation of synthetic polyurethanes by Staphylococcus epidermidis.

The survival of Staphylococcus epidermidis strain KH 11 in the presence of synthetic high molecular polyurethanes was prolonged in comparison to control experiments performed in the absence of any nutrients. Investigations of the bacteria after contact with the polymers revealed changes in their surface properties and metabolism, in particular a marked induction of urease activity. ESCA (Electron Spectroscopy for Chemical Analysis) measurements detected a decrease in elementary nitrogen in the polyurethane surfaces after incubation with the bacteria. The alterations observed indicate an urease-induced degradation of synthetic polymers by Staphylococcus epidermidis KH 11.

Absorption↗
PubMed1991

Comparative evaluation of five agglutination techniques and a new miniaturized system for rapid identification of methicillin-resistant strains of Staphylococcus aureus.

The speciation of methicillin-resistant Staphylococcus aureus (MRSA) poses a significant diagnostic problem when rapid identification methods such as slide agglutination tests, are used, because of the high proportion of false-negative reactions. 150 perfectly identified MRSA strains were tested on 5 commonly used agglutination reagents ("Bacto staph latex test", "Monostaph", "Pastorex staph", "Staphaurex", and "Staphyslide test") in comparison with a new micromethod ("RAPIDEC staph") which detects a type of staphylocoagulase within 2 hours by a fluorescence test. The "RAPIDEC staph" reagent enabled identification of all the MRSA while the agglutination tests gave poorer results: "Monostaph" correctly identified 64.6% of strains, "Staphyslide", 59.3%, "Bacto staph latex test", 44.6%, "Pastorex staph", 38.6% and "Staphaurex", 28.6%. These results show that agglutination slide tests are not reliable enough for the identification of MRSA which are more and more encountered in hospital wards. The authors recommend not to use slide agglutination methods. They suggest the tube test for coagulase which is the reference technique, although it is time-consuming and not well standardized. The results of this evaluation encourage the use of the "RAPIDEC staph" reagent since it is an easy-to-use, reliable technique for the rapid identification of Staphylococcus aureus.

Agglutination Tests↗
PubMed1990

Functional similarity of Listeria ivanovii and Staphylococcus aureus in CAMP test.

On the basis of synergistic haemolysis of Listeria ivanovii and Rhodococcus equi, we suspected CAMP positiveness of R. equi and complete CAMP negativeness of L. ivanovii and confirmed that the latter, showing a double-zone haemolysis like Staphylococcus aureus, could produce the same phenomenon in the CAMP test if used instead of staphylococci. This functional similarity of L. ivanovii and CAMP Staphylococcus could be used as an additional diagnostic test for L. ivanovii.

Hemolysis↗
PubMed1992

The role of capsular antigens in Staphylococcus aureus immunity.

Most clinical blood isolates of Staphylococcus aureus have been shown to be encapsulated. Techniques are now available for the preparation of type-specific capsular antisera and to provide reliable serologic methods for the identification of clinical isolates of Staphylococcus aureus. Epidemiologic studies in the U.S.A. and Europe indicated the prevalence of capsular types 5 and 8 among clinical isolates from human, bovine, and poultry. Encapsulated types 5 and 8 resisted in vitro phagocytosis and specific anti-capsular serum facilitated type-specific opsonization of S. aureus by polymorphonuclear leukocytes (PMN). The structure of the prevalent types 5 and 8 capsular polysaccharides (CP) have been elucidated. Vaccines of CP conjugated to exotoxin A of Pseudomonas aeruginosa have been prepared and have been injected into animals and human volunteers. Antibodies elicated by these conjugates facilitated opsonization of specific S. aureus types by human PMN.

Antigens, Bacterial↗
PubMed1993

Identification and characterization of surface proteins from Staphylococcus saprophyticus.

Staphylococcus saprophyticus, a well known cause of urinary tract infections, possesses several properties, such as hemagglutination of sheep erythrocytes, adherence to various cell types and production of urease, which may be virulence factors. In this contribution, we summarise the present knowledge about recently discovered surface proteins of Staphylococcus saprophyticus, a 95 kDa surface-associated protein (Ssp) and the hemagglutinin, a 160 kDa surface polypeptide. We describe culture conditions conducive to production of these surface proteins and discuss the molecular and clinical implications of our findings.

Bacterial Adhesion↗
PubMed1989

Trospectomycin enhances surface phagocytosis of Bacteroides and Staphylococcus by altering the bacterial glycocalyx.

The influence of trospectomycin on phagocytosis of Bacteriodes thetaiotaomicron, Bacteroides fragilis and Staphylococcus epidermidis was studied in the presence or absence of glycocalyx isolated from these microorganisms. Bacteria were grown with or without 0.25 or 0.5 of the minimal inhibitory concentration (MIC) of trospectomycin, a new chemically synthesized analog of spectinomycin. Surface phagocytosis by human polymorphonuclear leukocytes (PMNL) was determined using a modified fluorochrome assay. Subinhibitory concentrations of trospectomycin significantly enhanced surface phagocytosis of Bacteroides and Staphylococcus. When homologous or heterologous isolated glycocalyx was added to trospectomycin treated bacteria prior to incubation with PMNL, phagocytosis was reduced to levels observed in the untreated bacteria. Addition of glycocalyx to untreated strains produced no significant reduction of phagocytosis. The glycocalyx preparations were free of lipopolysaccharide and did not affect PMNL viability.

Anti-Bacterial Agents↗
PubMed1996

Frequency, clonal heterogeneity and antibiotic resistance of methicillin-resistant Staphylococcus aureus (MRSA) isolated in 1992-1994.

Since 1992, the proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolated from patients of the University Hospital of Frankfurt/Main and six community hospitals increased to a level of 11% and has remained constant during the following two years. MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) were distributed equally among almost all specimens except blood. There was evidence of a diminished potency of MRSA to cause bacteremia. All MRSA strains were susceptible to glycopeptides and mupirocin. Resistance rates to other non-beta-lactam antibiotics were low for fusidic acid (7.1%), fosfocin (8.3%), amikacin (11.4%) and cotrimoxazole (18.3%) and high for gentamicin (90.7%), ofloxacin (94.3%) and erythromycin (95.5%). Among 378 MRSA strains originating from 180 individuals, macrorestriction analysis of chromosomal DNA revealed 39 different genotypes. These could be divided into 14 epidemic strains isolated from 155 patients and 25 sporadic strains isolated from single patients. As most of the sporadic strains emerged in close local proximity to epidemic strains, we suppose a horizontal genetic transfer from MRSA to MSSA leading to the appearance of novel MRSA genotypes. Upon repeated isolation of MRSA strains from the same individuals, resistance rates and genotypes remained stable. Resistance patterns of the non-beta-lactams correlated poorly with macrorestriction analysis, whereas several MRSA genotypes could be distinguished by particular MICs of methicillin.

Anti-Bacterial Agents↗