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PubMed1993

Reduced bacterial adhesion to heparin-surface-modified intraocular lenses.

Bacterial adherence to intraocular lenses (IOLs) could be the cause of endophthalmitis following cataract surgery and lens implantation. There are previous reports that heparin bound to the surface of poly(methyl methacrylate) (PMMA) IOLs reduces cell adhesion. In this study, the in vitro adherence of Staphylococcus epidermidis, Staphylococcus aureus, and Pseudomonas aeruginosa to regular PMMA IOLs and to heparin-surface-modified (HSM) PMMA IOLs was investigated. The three bacterial strains attached in significantly lower numbers to HSM-PMMA IOLs than to PMMA IOLs (P < .01). Heparin in solution also inhibited attachment of Staphylococcus epidermidis to regular PMMA IOLs. Heparin may reduce adherence by placing a highly hydrated layer between the bacteria and the IOL surface. Therefore, the use of HSM-PMMA IOLs could diminish the incidence of endophthalmitis.

Bacterial Adhesion↗
PubMed1985

The influence of skeletal implants on incidence of infection. Experiments in a canine model.

We have performed experiments in 187 dogs in order to evaluate the effect of commonly used implant materials on rate of infection. We opened the femoral canal with a hand drill and awl, instilled a suspension of bacteria, and then inserted one of the implants. The implants--stainless-steel and cobalt-chromium alloys, high-density polyethylene, prepolymerized polymethylmethacrylate, and polymethylmethacrylate polymerized in vivo--were compared with no implant (control). The effect of the different implants on the incidence of infection with Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli was compared by determining the number of bacteria required to produce infection in 50 per cent of the femora. All of the implants were significantly more likely than the controls to be associated with infection with Staphylococcus aureus. Polymethylmethacrylate polymerized in vivo was found to be significantly more likely than all other implants to be associated with infection with Escherichia coli and Staphylococcus epidermidis. In addition to evaluating all specimens bacteriologically, we carried out a histological evaluation, and found that infection was highly correlated with an increased inflammatory response for all three bacteria. However, even with this highly statistically significant correlation, the correlation was not absolute; when only limited portions of randomly selected specimens of tissue were examined, the correlation was reduced.

Animals↗
PubMed1990

Pathogenicity of Staphylococcus lugdunensis, Staphylococcus schleiferi, and three other coagulase-negative staphylococci in a mouse model and possible virulence factors.

Staphylococcus lugdunesis and Staphylococcus schleiferi, two newly described species, have been isolated from numerous types of human infections. We compared the pathogenicity of 30 strains of S. lugdunensis, S. schleiferi, Staphylococcus epidermidis, Staphylococcus warneri, and Staphylococcus hominis, using a mouse model in which a foreign body preadhered with the test strain was implanted subcutaneously, followed by injection of the test strain. All five species of staphylococci produced abscesses. Staphylococcus epidermidis, S. schleiferi, and S. lugdunensis yielded species means of 76-91% abscess formation; 80-100% of the infected foreign bodies and tissues were culture positive. These three species were more virulent than S. warneri or S. hominis, which produced abscesses in 54 and 65% of mice, respectively; only 10-48% of the infected samples were culture positive. Transmission electron microscopy of pure cultures of selected strains showed that all species possessed glycocalyx. All species produced a variety of possible virulence factors, such as alpha and delta hemolysins, as well as the aggressins lipase and esterase. The production of exoenzymes did not always correlate with virulence as demonstrated by abscess formation in mice.

Abscess↗
PubMed2000

Limited role of direct exchange arthroplasty in the treatment of infected total hip replacements.

A literature review was performed to determine when direct exchange was most likely to be successful. Twelve reports provided outcome data on infected hip replacements treated with direct exchange. The average duration of followup was 4.8 years, but the range was broad (0.1-17.1 years). Of the 1,299 infected hip replacements treated with direct exchange, 1,077 (83%) were thought to be free of infection at the last followup. Antibiotic-impregnated bone cement was used in 1,282 of the cases (99%). There was wide variability in the duration of parenteral antibiotic therapy, ranging from just 24 hours to as many as 8 weeks. In some cases, no oral antibiotics ever were given, whereas in others, oral antibiotics were given for as many as 8 months after parenteral therapy. Factors associated with a successful direct exchange included: (1) absence of wound complications after the initial total hip replacement; (2) good general health of the patient; (3) methicillin-sensitive Staphylococcus epidermidis, Staphylococcus aureus, and Streptococcus species; and (4) an organism that was sensitive to the antibiotic mixed into the bone cement. Factors associated with failure included: (1) polymicrobial infection; (2) gram-negative organisms, especially Pseudomonas species; and (3) certain gram-positive organisms such as methicillin-resistant Staphylococcus epidermidis and Group D Streptococcus. Methicillin-resistant organisms have become more common. Many current revision surgical techniques use cementless implants. Fixation without any cement (no depot antibiotics) may be a contraindication to direct exchange. Additionally, there essentially are no data on the use of bone graft in association with direct exchange. For these reasons, the indications for direct exchange are limited.

Arthroplasty, Replacement, Hip↗
PubMed1989

[Impact of infections on mortality in children with cancer].

A study of the role infections play in the death of 29 children with cancer was conducted from 1983 to 1988. An infection was the main cause of death in twelve patients and was associated with hemorrhage in nine. Five of the patients were free of infection at the time of their death. The most frequently found etiological agents found in hemocultures taken while still alive were: Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus viridans, Salmonella enteritidis, Escherichia coli, Enterobacter sp and Candida spp. A retrospective study on the role of infections in the death of children with cancer was conducted. The clinical and autopsy records of 29 children who died between 1983 and 1988 were reviewed. Infection was the main cause of death in twelve patients and was associated with hemorrhage in nine. Five of the patients were free of infection at the time of death. The most frequent etiologic agents found in blood cultures taken while still alive were: Staphylococcus epidermidis.

Adolescent↗
PubMed1986

Identification of coagulase-negative Staphylococci isolated from urinary tract infections.

Coagulase-negative Staphylococci isolated from urinary tract infections were identified using the API Staph-Ident System. Organisms were excluded if there was no sign of pyuria or if normal urethral flora was present in significant amounts. While Staphylococcus saprophyticus and Staphylococcus epidermidis accounted for 81% of the isolates from females, 87% of isolates from males were S. epidermidis, Staphylococcus warneri, or Staphylococcus haemolyticus. The females fell into two main age groups, those with infections due to S. saprophyticus (mean age 25 years) and those due to other Staphylococci (mean age 40-49 years). All males were in a single age group (mean age 70-74 years) irrespective of the infecting agent. In males, S. warneri was associated with cellular changes in the bladder. No similar association was apparent with the other organisms. The results suggest that, apart from S. saprophyticus, three species of Staphylococcus (S. epidermidis, S. haemolyticus, S. warneri) account for most urinary tract infections, irrespective of the sex of the patient.

Adult↗
PubMed1986

Semipermeable occlusive dressings. Effects on growth of pathogenic bacteria and reepithelialization of superficial wounds.

Six commercially available semiocclusive dressings were tested for their effect on the growth of resident and pathogenic bacteria and the reepithelialization of experimentally induced wounds in human volunteers. Scarification and abrasion-type wounds inoculated with Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeruginosa were quantitatively cultured at different times after being covered with the dressings. Reepithelialization was assessed by serial stereomicrographs. None of the dressings was able to prevent clinical infection. All dressings provided microenvironments that were conducive to the growth of resident and pathogenic bacteria. There was no difference in the rates of reepithelialization.

Adult↗
PubMed2002

Concurrent serious bacterial infections in 2396 infants and children hospitalized with respiratory syncytial virus lower respiratory tract infections.

BACKGROUND: At Driscoll Children's Hospital (Corpus Christi, Tex), we observed that most infants and children hospitalized for treatment of respiratory syncytial virus (RSV) bronchiolitis and/or pneumonia received broad-spectrum intravenous antibiotics despite having typical RSV signs and symptoms and positive RSV-rapid-antigen tests on admission. Physicians were concerned about the possibility of concurrent serious bacterial infections, especially in infants younger than 3 months and in those with infiltrates present on the chest x-ray films. OBJECTIVE: To report the frequency of concurrent serious bacterial infections in infants and children hospitalized for treatment of RSV lower respiratory tract infections. METHODS: The medical records of 2396 infants and children admitted to Driscoll Children's Hospital with RSV bronchiolitis and/or pneumonia during 7 RSV seasons from July 1, 1991, through June 30, 1998, were reviewed. RESULTS: There were positive cultures obtained from initial sepsis/meningitis workups on admission in 39 infants and children (1.6%). Of these, 12 (31%) were positive blood cultures and 27 (69%) were positive urine cultures. There were no positive cerebrospinal fluid cultures. All of the positive blood cultures contained either Staphylococcus epidermidis, Staphylococcus warneri, or Bacillus species, which are common contaminants. None of the patients received a standard 10-day course of intravenous antibiotic therapy. All of the positive urine cultures were typical urinary tract pathogens. All of the patients were treated. CONCLUSIONS: Concurrent serious bacterial infections are rare in infants and children hospitalized with RSV lower respiratory tract infections and the empiric use of broad-spectrum intravenous antibiotics is unnecessary in children with typical signs and symptoms of RSV bronchiolitis.

Anti-Bacterial Agents↗
PubMed2001

Influence of dynamic conditions on biofilm formation by staphylococci.

The modified microtiter plate test was used to investigate biofilm formation by staphylococci under both static and dynamic conditions. The quantity of biofilm produced under static conditions was used as a reference. Dynamic conditions, which were achieved by incubating microtiter plates on a horizontal shaker with and without the presence of glass beads in wells, either reduced biofilm formation or left it unchanged. Dynamic conditions particularly affected the capacity of certain species to produce biofilm: these species included the causative agents of infections associated with a foreign body (Staphylococcus epidermidis, Staphylococcus aureus). On the basis of these results, dynamic conditions should be included as a parameter for evaluating biofilm formation by staphylococci in vitro.

Biofilms↗