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PubMedDate not supplied

Activity of 18 antimicrobial agents against multi-resistant strains of Staphylococcus aureus isolated from intensive care patients.

During an outbreak of infections with multiple-resistant Staphylococcus aureus, 22 strains were isolated from 12 patients between November 1983 and March 1984 on two surgical intensive care units at Kiel University Hospital. Susceptibility of all strains was tested with the disc diffusion method and a microdilution test using different inocula of 10(2) and 10(5) cfu/ml. All strains were resistant to beta-lactam antibiotics, including thienamycin as well as to gentamicin, clindamycin, doxycycline, erythromycin and fosfomycin. Rifampicin was the most active substance in terms of w/v, followed by fusidic acid, ciprofloxacin, vancomycin, and trimethoprim/sulfamethoxazole. Netilmicin and chloramphenicol showed only moderate activity in relation to the antibiotic breakpoint, but were considered sensitive according to the disc diffusion test. Caution should be reserved for the use of imipenem against multiply-resistant staphylococci.

Anti-Bacterial Agents↗
PubMed1992

Comparative activity of the topical quinolone OPC-7251 against bacteria associated with acne vulgaris.

The antibacterial activity of the topical quinolone OPC-7251 against bacteria commonly found in acne vulgaris was tested in vitro by an agar dilution method. The MIC50 was 0.25 mg/l for Propionibacterium acnes, 0.125 mg/l for Propionibacterium granulosum, 0.03 mg/l for Staphylococcus aureus and 0.06 mg/l for coagulase-negative staphylococci. Compared with seven other antibiotics tested (ciprofloxacin, penicillin, erythromycin, tetracycline, clindamycin, fusidic acid and gentamicin), OPC-7251 had potent activity against both propionibacteria and staphylococci and the lowest incidence of resistant strains.

Acne Vulgaris↗
PubMed1994

Long-term efficacy of a program to control methicillin-resistant Staphylococcus aureus.

The long-term efficacy of a program to control methicillin-resistant Staphylococcus aureus (MRSA) was evaluated in a 350-bed university hospital. Three periods were monitored: pre-epidemic (January 1989-November 1989), outbreak (December 1989-June 1990) and control program (July 1990-December 1992) periods. Control measures included cohort isolation, patient care measures and therapy (oral cotrimoxazole plus fusidic acid ointment) of MRSA carriage in patients, roommates and personnel. A total of 117 MRSA-infected patients were detected. For each period respectively, MRSA incidence (number of cases per 1,000 patient-days) was 3.2, 8.2 and 2.0 in the intensive care unit (ICU) and 0.08, 0.23 and 0.26 in the general wards. During the outbreak there was a 2.7-fold overall increase of baseline MRSA incidence (p < 0.02). The crude mortality was 68% and the attributable mortality was estimated to be 50%. The program was estimated to have prevented 76% (CI95 28-91, p < 0.0001) of expected MRSA cases and 85% (CI95 62-94, p < 0.0001) of expected fatalities due to MRSA in the ICU, but it had no significant effect in the general wards. The program did not control vancomycin consumption.

Carrier State↗
PubMed1978

Evaluation of microdilution trays (sensititre) for antimicrobial susceptibility testing of Bacteroides fragilis.

Microdilution trays (Sensititre) for antimicrobial susceptibility testing of Bacteroides fragilis has been compared for accuracy with the standard agar dilution method. The microtrays were found to be reliable for all antimicrobials tested (benzylpenicillin, clindamycin, doxycycline, chloramphenicol, fusidic acid, cefoxitin, and cephalotin) but not for metronidazole.

Anti-Bacterial Agents↗
PubMed2001

Antibiotic susceptibility and phage typing of methicillin-resistant and -sensitive Staphylococcus aureus clinical isolates at three periods during 1991-1997.

The aim of the study presented here was to evaluate the antibiotic susceptibility of Staphylococcus aureus over a 7-year period. A total of 2,122 clinical isolates of Staphylococcus aureus were collected from hospitalized patients at 3-year intervals during the period 1991-1997. The prevalence of methicillin-resistant isolates was 41.6%, 38.2% and 36% in 1991, 1994 and 1997, respectively; all of these isolates were sensitive to vancomycin. Over the study period, resistance to pristinamycin and fusidic acid increased slightly and resistance to imipenem, rifampicin and amikacin increased greatly, while resistance to trimethoprim/sulfamethoxazole decreased. For methicillin-sensitive Staphylococcus aureus isolates, significantly increased resistance was observed against amikacin only. Phage typing was conducted using the international set of phages. All of the isolates that were sensitive to group I, group II, or group V phages were sensitive to methicillin. Of the isolates that were sensitive to group III phages, 96% were methicillin resistant, and 70.5% of them were sensitive to phages 75 and 85.

Amikacin↗
PubMed2006

The microbiology of infected hip arthroplasty.

Infection following joint replacement surgery although rare presents a challenging problem. Bacterial resistance to antibiotics is an emerging problem. We analysed the microbiology of 337 single-stage revisions for deep infection. Coagulase negative staphylococcus was found to be the predominant organism, although staphylococcus aureus is gaining importance. Gentamicin only provides cover for 64.1% of organisms. Resistance to this commonly used antibiotic prophylaxis is escalating. Fusidic acid and erythromycin provide improved cover. We would suggest on a microbiological basis that these antibiotics be considered for addition to acrylic bone cement. This will provide local antibiotic delivery when performing a revision for deep infection.

Arthroplasty, Replacement, Hip↗
PubMed1996

Antibiotic-associated colitis in orthopaedic patients.

Antibiotic-associated colitis was diagnosed in 23 orthopaedic patients: 17 had abdominal symptoms, 3 had a fever and the remaining 3 had no symptoms but increasing C-reactive protein values or white blood count. The antibiotic was clindamycin in 19, cephalosporins in 3 and a combination of vancomycin and fusidic acid intravenously in one. The antibiotics were stopped in 12, changed in 5 and continued in the remaining 5. Oral treatment for colitis was given in 21 patients, and in one patient the only treatment was stopping the antibiotics. One patient died after a myocardial infarct; the remaining 22 were discharged after successful treatment of their primary condition and the colitis.

Adult↗
PubMed2025

Isolation and Molecular Characterization of Three Staphylococcus pseudintermedius Strains from Dogs and Humans in Egypt.

Staphylococcus pseudintermedius is an opportunistic pathogen that is largely associated with canine hosts but is becoming more widely recognized as a zoonotic pathogen. Understanding its genetic and phenotypic properties, such as virulence factors and antimicrobial resistance (AMR) profiles, is critical for infection control and vaccine development. In this study, we isolated and molecularly characterized three S. pseudintermedius isolates from dogs (hereafter referred to as S. pseudintermedius D8) and humans (hereafter referred to as S. pseudintermedius H10 and S. pseudintermedius H11) in Egypt. All three isolates showed 100% sequence identity with the nuc gene of the S. pseudintermedius SP_11304-3A reference genome. Multilocus sequence typing (MLST) revealed novel sequence types (STs) in the three isolates. The AMR determinants varied substantially among the isolates. While the mecA gene was absent, blaZ was detected in the canine isolate, indicating beta-lactamase-mediated penicillin resistance. Additionally, tetK and tetM genes were found conferring tetracycline resistance in different isolates. Resistance genes for aminoglycosides, chloramphenicol, fusidic acid, macrolides, streptothricin, and trimethoprim were also identified. All isolates were positive for key virulence genes, including immune evasion (AdsA), coagulase (coa), immunoglobulin-binding protein (sbi/spsK), exfoliative toxin (speta), enterotoxins (se-int and siet), fibrinogen binding protein gene (fnbB), and two-component pore-forming leukocidin genes (lukF and lukS). The S. pseudintermedius H11 isolate uniquely harbored the neuraminidase gene (nanB), while none of the isolates contained the gene coding for immunoglobulin G binding protein (spsQ). These findings highlight the differences in virulence and antimicrobial resistance genes among these S. pseudintermedius isolates, underlining the need for global surveillance and molecular characterization of this pathogen.

Dogs↗
PubMed1999

Meta-analysis of six clinical phase III studies comparing lomefloxacin 0.3% eye drops twice daily to five standard antibiotics in patients with acute bacterial conjunctivitis.

BACKGROUND: Lomefloxacin 0.3% ophthalmic solution twice daily has been compared in patients with bacterial conjunctivitis in six randomized double-blind or investigator-masked phase III studies with either chloramphenicol 0.5% 5x/day, gentamicin 0.3% 4x/day, fusidic acid 1% 2x/day, tobramycin 0.3% 4x/day or norfloxacin 0.3% 4x/day. METHODS: A meta-analysis of all individual data of these six studies was performed. A total of 582 patients with clinically diagnosed bacterial conjunctivitis were evaluated by slit-lamp examination with grading of eight key signs and symptoms and by conjunctival swab cultures at baseline, on day 3-5 and on day 7-9. Success of therapy, local tolerance and safety were evaluated at termination. In vitro sensitivity of the ocular isolates to 6-10 antibiotics was evaluated by disk diffusion tests. RESULTS: Two hundred and ninety patients treated with lomefloxacin 0.3% (LF) and 292 patients treated by one of the control antibiotics (combined control group, CCG) were enrolled in the studies. Two hundred and seventy-eight LF and 283 CCG patients were evaluable for the intent-to-treat (ITT) analysis, while 85 LF and 95 CCG patients had bacteria above the pathological threshold and formed the core subpopulation. The mean cumulative sum score in the LF group was 9. 47 on day 1, and decreased by 5.70 on day 3-5 and by 8.10 on day 7-9. In the CCG it decreased significantly less: it was 9.19 at baseline, decreased by 5.15 on day 3-5 and by 7.33 on day 7-9. Swab counts decreased in the LF and CCG group similarly, with the major decrease observed between day 1 and day 3-5. Most of the organisms considered resistant in vitro were still eradicated with the regimen used. Of the few surviving organisms also isolated on the next follow-up visit, one isolate in the LF group and seven in the CCG showed decreased in vitro sensitivity towards the treatment antibiotic used. Local tolerance was good or excellent, without any significant differences except for burning sensation, which lasted significantly longer in the CCG group than in the LF group. Adverse events were observed in 18 LF and 23 CCG patients; four LF and three CCG patients had to be withdrawn. All adverse events were non-serious. CONCLUSION: Lomefloxacin eye drops used with a loading dosage followed by a twice daily regimen proved as effective, safe and well tolerated as five established standard treatments used at a 2, 4 or 5 times daily regimen, caused less discomfort upon instillation, and showed a lower risk to generate or select new resistant strains.

Acute Disease↗
PubMed2005

Emergence of methicillin-resistant Staphylococcus aureus with Panton-Valentine leukocidin genes in central Europe.

The aim of the present study was to investigate strains of methicillin-resistant Staphylococcus aureus (MRSA) for the presence of the lukS-lukF determinant of Panton-Valentine leukocidin and to further characterize strains found to contain the genes. During the past 2 years, MRSA containing the lukS-lukF genes for Panton-Valentine leukocidin, particularly those emerging outside of hospitals, have become of interest. MRSA strains sent to the national reference center in Germany were investigated for lukS-lukF by polymerase chain reaction (PCR). If the presence of lukS-lukF was demonstrated, strains were further characterized by molecular typing (determination of SmaI pattern, spa sequence, and multilocus sequence type), PCR demonstration of resistance genes, and characterization of the SCCmec element. Since the end of 2002, MRSA containing Panton-Valentine leukocidin genes have been demonstrated as the causative agent of 28 cases of infection (9 community-acquired cases, 19 sporadic nosocomial cases) in different areas of Germany. Twenty-seven of these 28 isolates exhibited a unique pattern of genomic typing: all exhibited multilocus sequence type 80, spa sequence type 44, and a SmaI macrorestriction pattern that corresponds to a community-acquired strain of MRSA from France and Switzerland. In addition to resistance to oxacillin, the strains exhibited resistance to ciprofloxacin, tetracycline (tetM), and fusidic acid, the last of which is encoded by the far-1 gene. The far-1 gene was shown to be located on the plasmid. One isolate corresponded to community MRSA (cMRSA) of multilocus sequence type 1 from the USA.

Anti-Bacterial Agents↗
PubMed1984

Prevention of infections of skin and skin structures.

Treatment of nasal carriers of coagulase-positive staphylococci with a wide variety of topical systemic antibiotics suppressed these organisms only during treatment. Treatment of methicillin-sensitive or methicillin-resistant staphylococci with oral rifampin plus cloxacillin, vancomycin, fusidic acid, or trimethoprim-sulfamethoxazole eradicated the colonizing Staphylococcus aureus in approximately 80 percent of studies. An alternative approach is replacement of virulent S.aureus with the 502 A S. aureus strain. The latter approach has aborted epidemics of staphylococcal diseases in newborn nurseries and has prevented recurrent furunculosis.

Adult↗
PubMed1985

Protein S4 is near the elongation factor G binding site in the ribosome.

Using a mild iodination method for protein radioactive labeling, it has been shown that elongation factor G, when bound to the ribosome as EFG-GDP-fusidic acid complex, protects protein S4 from labeling. The results indicate that protein S4 is probably near the ribosomal EFG binding site.

Chloramines↗
PubMed1987

Mechanism of ribosomal translocation. tRNA binds transiently to an exit site before leaving the ribosome during translocation.

Escherichia coli ribosomes have a site (E) to which deacylated tRNA binds transiently before leaving the ribosome during translocation. The affinity of the site is Mg2+ dependent and low at physiological Mg2+ concentrations. Correct codon-anticodon interaction is unnecessary in this site. With these features, the E site cannot reduce frameshift errors through additional mRNA anchorage. Occupancy of the A site does not influence the tRNA binding in the E site, although a conformational change of elongation factor G, brought about by GTP hydrolysis, is necessary for efficient tRNA release. The tRNA can dissociate unhindered from the E site when the elongation factor is bound to the ribosome by fusidic acid. During elongation, the thermodynamically stable state is not attained, since E site occupation inhibits translocation. However, the E site can aid elongation by providing an intermediate state for tRNA dissociation, dispersing the process into more than one step.

Allosteric Site↗
PubMed1988

Domain VI of Escherichia coli 23 S ribosomal RNA. Structure, assembly and function.

Domain VI at the 3' end of the 23 S ribosomal RNA from Escherichia coli was prepared using the in vitro T7 RNA polymerase system. Its structure was examined by probing with ribonucleases and chemical reagents, including a psoralen derivative, of various nucleotide specificities, using a reverse transcriptase procedure for analysis. The data provided support for the most recent secondary structure derived from phylogenetic sequence comparisons and for additional structuring that was inferred from earlier experimental data. Moreover, the structure was essentially the same in the free domain, in renatured 23 S RNA and in 50 S subunits. Protein L3 bound to the isolated domain and its binding site was located at a long-range double helix containing a large internal loop. This structure is unusual for a protein-RNA binding site and it may characterize a new (third) class of site. Protein L3 has been implicated, together with L24, in initiating assembly of the 50 S subunit and it shares the exceptional property with L24 that it binds adjacent to the junction of two RNA domains from where it can maximally influence RNA folding. Protein L6 also assembled to domain VI and, in a control experiment, protein L2 bound to isolated domain IV. Domain VI was largely inaccessible in the 50 S subunit and the few accessible RNA sites occurred mainly within conserved sequence regions that constitute potential functional sites. alpha-Sarcin inactivates ribosomes by cutting at one of these sites in 50 S subunits; it also recognized the same site in the free 23 S RNA and in the free domain. Both the EF-Tu ternary complex, and the EF-G ternary complex stabilized by fusidic acid or by a non-hydrolyzable GTP derivative, inhibited alpha-sarcin attack while non-enzymatically bound tRNA did not, thus providing evidence, more direct than before, for the involvement of the RNA region in a common elongation factor binding site.

Autoradiography↗
PubMed1988

Staphylococcal infections in hospital: the Greek experience.

Resistance rates of various species to many antimicrobials are very high in Greece. Mean resistance rates of Staphylococcus aureus isolated in 12 Athens hospitals in the second half of 1986 were 80% for penicillin, 32% for methicillin, 22% for gentamicin, 27% for erythromycin, 17% for lincomycin and 16% for co-trimoxazole. In a prospective study in the General Hospital of Athens from May to July 1987, 40 coagulase-positive staphylococcal strains were isolated from various materials from inpatients. Of these 78% were resistant to penicillin, 50% to methicillin at 37 degrees C, 62% to methicillin at 30 degrees C, 38% to erythromycin, 32% to tobramycin, 15% to clindamycin, 15% to fusidic acid, 9% to amikacin, 5% to netilmicin and 0% to vancomycin. Ten of these strains (seven methicillin-resistant) were responsible for severe infections and three of the affected patients died (two nosocomial pneumonias, one infected burn, all due to methicillin-resistant strains). Another 11 strains (eight methicillin-resistant) were responsible for mild infections. From 41 coagulase-negative staphylococci isolated from inpatients, seven (five methicillin-resistant) were held responsible for mild infections. Of the 20 patients with infections due to methicillin-resistant strains, nine had previously received a beta- lactam antibiotic. Staphylococci are not responsible, however, for a large proportion of infections in our hospital at the moment. High resistance rates in Greece are due to overuse of antibiotics, a phenomenon attributed to a consumer's society behaviour of doctors and patients.

Anti-Bacterial Agents↗
PubMed1992

A study of 245 infected surgical wounds in Singapore.

The aims of the study were to correlate the laboratory detection rate of wound infections with the actual wound infection rate, and to analyse the bacteriology of these wounds to provide a rationale for antibiotic usage in prophylaxis and treatment of surgical wound infections. The wound infection rate in a general surgical unit was determined using the most comprehensive surveillance available to us and was correlated with the laboratory detection rate. A correlation coefficient of 0.8 was obtained, allowing a reasonable estimation of the actual wound infection rate from laboratory data. Review of the bacteriology of consecutive infected surgical wounds over a 4 year period in a university hospital, revealed that the commonest organisms cultured were Staphylococcus aureus, Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, enterococci and beta-haemolytic streptococci. Methicillin-resistant S. aureus (MRSA) caused 50% of all staphylococcal wound infections. All MRSA isolates were sensitive to fusidic acid and vancomycin. All the non-MRSA isolates of S. aureus were sensitive to cephalexin. Some 89% of E. coli were sensitive to gentamicin, with 93% and 100% sensitive to cefuroxime and ceftriaxone respectively. Klebsiella isolates have shown an increased resistance to aminoglycosides, with a new strain from one patient, isolated in 1990, resistant to penicillins, aminoglycosides and third generation cephalosporins. Pseudomonas spp., enterococci and beta-haemolytic streptococci did not show a change in resistance patterns over the same time period.

Anti-Bacterial Agents↗
PubMed1994

Methicillin resistant Staphylococcus aureus: the scale of the problem in a Shri Lankan hospital.

A three month surveillance study of methicillin resistant Staphylococcus aureus (MRSA) was carried out in the male surgical unit of the General Hospital, Peradeniya, Shri Lanka. Nose, throat, axillary, perineal and wound swabs were taken from 251 patients and 35 staff members. Eighty-four (27.5%) of 305 isolates of S. aureus from patients were MRSA. Seventy-three of these isolates were also resistant to penicillin, tetracycline, erythromycin, gentamicin, chloramphenicol and co-trimoxazole. All isolates were sensitive to fusidic acid, clindamycin, vancomycin and rifampicin. The acquisition of MRSA was higher than of methicillin sensitive S. aureus (MRSA). No deaths occurred due to MRSA. Staff carriage was only 6%. The treatment and management of MRSA in hospitals with very poor resources requires further study of interventions which are practicable in this situation.

Carrier State↗
PubMed1980

Construction and characterization of E. coli promoter-probe plasmid vectors. II. RNA polymerase binding studies on antibiotic-resistance promoters.

The binding of Escherichia coli RNA polymerase to antibiotic-resistance promoters was examined using the nitrocellulose filter assay. Four filter-retainable HaeIII fragments were observed with pBR322 and the promoter-probe plasmids, pBRH1, pBRH2 and pBRH4. Of the three fragments studied, two were shown to carry promoters for the ampicillin (Ap) and tetracycline (Tc) resistance genes, while the third present in pBRH1 appears to be the promoter for colicin E1 immunity (Colimm). Although the formation of filter-retainable complexes involving the Tcr promoter was sensitive to high salt, Apr promoter complexes were not. It was also shown that plasmids containing only the "firm-binding" portion of the Tcr promoter could still bind RNA polymerase in vitro despite the fact that these plasmids confer no in vivo Tcr. Additional filter-binding experiments performed with AluI-digested pBR322 DNA revealed the presence of a fifth RNA polymerase binding site on pBR322. This site is probably the promoter for the 100 bp transcript thought to be involved in the initiation of plasmid replication. An analysis of the recombinant plasmid (pKTR25) which carries the Kan-B portion of the EcoRI kanamycin (Kn) resistance fragment revealed that this fragment contains two RNA polymerase binding sites. We believe that these sites are responsible for the insertional activation of the Tcr gene and may be the promoters for the Knr and fusidic acid (Fa) resistance genes.

DNA, Bacterial↗