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JAC-antimicrobial Resistance Jun 2024We performed a multicentre study (2020-2022) to compare the activity of ozenoxacin and comparator agents against and clinical isolates from skin and soft-tissue...
OBJECTIVES
We performed a multicentre study (2020-2022) to compare the activity of ozenoxacin and comparator agents against and clinical isolates from skin and soft-tissue infections (SSTI).
METHODS
A total of 1725 isolates (1454 and 271 ) were collected in 10 centres from eight countries between January 2020 and December 2022. Antimicrobial susceptibility testing was determined (microdilution-SENSITITRE). Results were interpreted following European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2023 (clinical breakpoints, ECOFF) and CLSI criteria.
RESULTS
Ozenoxacin exhibited high activity against (MIC = 0.002/0.12 mg/L) and (MIC = 0.015/0.03 mg/L), inhibiting 99% of the isolates at MIC ≤ 0.5 mg/L and at MIC ≤ 0.06, respectively. The most active comparators against were retapamulin (MIC = 0.12 mg/L), fusidic acid (MIC = 0.25 mg/L) and mupirocin (MIC = 0.5 mg/L); and against were retapamulin (MIC = 0.03 mg/L), clindamycin (MIC = 0.12 mg/L) and mupirocin (MIC = 0.25 mg/L). Ciprofloxacin and methicillin resistant rates for were 31.3% (455/1454) and 41% (598/1454), respectively. Additionally, 62% (373/598) of the MRSA were also ciprofloxacin non-susceptible, whereas only 10% (23/271) of the MSSA were ciprofloxacin resistant. Ozenoxacin was more active against ciprofloxacin-susceptible than against ciprofloxacin-resistant isolates, and showed a slightly higher MIC in MRSA isolates than in MSSA. However, ozenoxacin activity was comparable in both ciprofloxacin-resistant MSSA and MRSA subsets. On the other hand, ozenoxacin had similar activity in ciprofloxacin-susceptible and resistant isolates.
CONCLUSIONS
Ozenoxacin is a potent antimicrobial agent of topic use against Gram-positive bacteria causing SSTI, including MRSA isolates non-susceptible to ciprofloxacin.
PubMed: 38872714
DOI: 10.1093/jacamr/dlae088 -
Heliyon Jun 2024The increasing emergence of as the primary causative agent of otitis externa has been noted; however, detailed information regarding the molecular characteristics of...
The increasing emergence of as the primary causative agent of otitis externa has been noted; however, detailed information regarding the molecular characteristics of these strains in Iran remains scarce. The current study aims to investigate both genotypic and phenotypic attributes of strains implicated in ear infections. In the present work, we analyzed 60 strains isolated from cases of otitis externa over a period of 45 months. The resistance patterns were determined using disk diffusion and microbroth dilution methods. All isolates were confirmed by the polymerase chain reaction assay, and their biofilm production was assessed by a microtiter plate assay. Molecular characterization of the isolates was performed using the staphylococcal cassette chromosome multilocus sequence typing, and staphylococcus protein A typing methods. Overall, the results indicated that 44 out of 60 isolates (73.3 %) were methicillin-resistant . Resistance to mupirocin and vancomycin was observed in 13.3 % and 1.7 % of the tested isolates, respectively. Furthermore, out of the 60 isolates, 56 strains (93.4 %) were classified as positive biofilm strains at different levels. Twelve distinct clonal lineages were identified. The vast majority of isolates belonged to CC30/ST30-MRSA IV/t019 (41.7 %). Among the 31 strong biofilm producers, the majority (64.5 %) belonged to CC30/ST30-MRSA IV/t019 clone. Biofilm negative isolates belonged to CC22/ST22 (2 isolates), CC8/ST585 (one isolate), and CC8/ST8 (one isolate). Our result revealed that about three-quarters of PVL-positive strains belonged to CC30/ST30. Our data confirmed the presence of MSSA strains among CC30/ST30 and CC22/ST22 isolates. The mupirocin resistant isolates (n = 8) belonged to CC8/ST585-MRSA III/t713 (37.5 %), CC8/ST239-MRSA III/t030 (25 %), CC8/ST8-MRSA IV/t008 (12.5 %), CC8/ST239-MRSA III/t037 (12.5 %), and CC22/ST22-MRSA IV/t790 (12.5 %) lineages. The VRSA strain belonged to the CC8/ST8-MRSA IV/t008 lineage, carrying the determinant. iMLS phenotypes (n = 14) were distributed across different lineages, including CC30/ST30-MRSA IV/t019 (21.5 %), CC30/ST30-MSSA/t021 (21.5 %), CC22/ST22-MSSA/t005 (14.3 %), CC8/ST239-MRSA III/t030 (14.3 %), CC22/ST22-MSSA/t1869 (7.1 %), CC22/ST22-MRSA IV/t790 (7.1 %), CC8/ST239-MRSA III/t037 (7.1 %), and CC1/ST772-MRSA IV/t10795 (7.1 %). These findings highlight significant genotypic diversity and high biofilm formation among our isolates. The frequent occurrence of the CC/ST30 clone in strains isolated from otitis externa reflects the emergence of these lineages as a predominant clone in Iran, posing a significant public health concern.
PubMed: 38868027
DOI: 10.1016/j.heliyon.2024.e32002 -
Frontiers in Pediatrics 2024This article reports a case of neonatal incontinentia pigmenti onset in only one male monozygotic twin with characteristic skin lesions after birth followed by severe...
BACKGROUND
This article reports a case of neonatal incontinentia pigmenti onset in only one male monozygotic twin with characteristic skin lesions after birth followed by severe cerebrovascular lesions.
CASE PRESENTATION
A male infant, the first of monozygotic twins, was born with multiple yellow pustules all over his body, repeated new herpes at different sites during the course of the disease, aggravated by fusion, warty crusts, and hyperpigmentation; biopsy pathology suggested eosinophilic spongiform edema of the skin. Peripheral blood eosinophils were significantly elevated, and brain magnetic resonance imaging revealed diffuse multiple cystic and lamellar abnormal signal areas in the left frontal and parietal lobes. On day 30, the infant showed neurological symptoms, such as poor response and apnea, and an emergency cranial computed tomography scan revealed abnormal changes in the left cerebral hemisphere and bilateral cerebellum. After admission, he was given a potassium permanganate bath and topical mupirocin for 1 month, and the skin abnormalities improved. He was treated with mechanical ventilation and vasoactive drugs for 2 days after the cerebrovascular accident, and died the same day after the parents chose hospice care. No deletion variants or point mutations were detected in subsequent genetic tests, and chromosomal copy number variation tests revealed different degrees of chimeric duplications and deletions in different regions of chromosomes Y and 3. The parents were healthy, and his twin brother had normal growth and development with no abnormalities at multiple follow-up visits.
CONCLUSION
Neonatal incontinentia pigmenti in only one male monozygotic twin is extremely rare and the genetic diagnosis is challenging. Awareness of the combined cerebrovascular lesions needs to be enhanced, and potential prevention and treatment methods need to be explored to improve the prognosis.
PubMed: 38832002
DOI: 10.3389/fped.2024.1338054 -
Euro Surveillance : Bulletin Europeen... May 2024BackgroundAntimicrobial resistance to mupirocin and fusidic acid, which are used for treatment of skin infections caused by is of concern.AimTo investigate resistance...
BackgroundAntimicrobial resistance to mupirocin and fusidic acid, which are used for treatment of skin infections caused by is of concern.AimTo investigate resistance to fusidic acid and mupirocin in meticillin-susceptible (MSSA) from community-acquired skin and soft tissue infections (SSTIs) in Belgium.MethodsWe collected 2013-2023 data on fusidic acid and mupirocin resistance in SSTI-associated MSSA from two large Belgian laboratories. Resistant MSSA isolates sent to the Belgian Reference Centre were -typed and analysed for the presence of the and virulence genes and the resistance gene. In addition, we whole genome sequenced MSSA isolates collected between October 2021 and September 2023.ResultsMupirocin resistance increased between 2013 and 2023 from 0.5-1.5% to 1.7-5.6%. Between 2018 and 2023, 91.4% (64/70) of mupirocin-resistant isolates were co-resistant to fusidic acid. By September 2023, between 8.9% (15/168) and 10.1% (11/109) of children isolates from the two laboratories were co-resistant. Of the 33 sequenced isolates, 29 were sequence type 121, clonal and more distantly related to the European epidemic fusidic acid-resistant impetigo clone (EEFIC) observed in Belgium in 2020. These isolates carried the and genes conferring resistance to mupirocin and fusidic acid, respectively, and the and virulence genes.ConclusionWe highlight the spread of a mupirocin-resistant EEFIC in children, with a seasonal trend for the third quarter of the year. This is of concern because this variant is resistant to the two main topical antibiotics used to treat impetigo in Belgium.
Topics: Belgium; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Fusidic Acid; Genome, Bacterial; Impetigo; Mupirocin; Staphylococcal Skin Infections; Staphylococcus aureus; Virulence Factors; Humans
PubMed: 38726693
DOI: 10.2807/1560-7917.ES.2024.29.19.2300668 -
Pharmaceutics Mar 2024Simon P [...].
Simon P [...].
PubMed: 38675232
DOI: 10.3390/pharmaceutics16040448 -
Journal of Thoracic Disease Mar 2024Indwelling pleural catheters (IPCs) are used in the management of malignant pleural effusions, but they can become infected in 5.7% of cases. This review aims to provide... (Review)
Review
Indwelling pleural catheters (IPCs) are used in the management of malignant pleural effusions, but they can become infected in 5.7% of cases. This review aims to provide a summary of the development of IPC infections and their microbiology, diagnosis and management. IPC infections can be deep, involving the pleural space, or superficial. The former are of greater clinical concern. Deep infection is associated with biofilm formation on the IPC surface and require longer courses of antibiotic treatment. Mortality from infections is low and it is common for patients to undergo pleurodesis following a deep infection. The diagnosis of pleural infections is based upon positive IPC pleural fluid cultures, changes in pleural fluid appearance and biochemistry, and signs or symptoms suggestive of infection. IPCs can also become colonised, where bacteria are grown from pleural fluid drained via an IPC but without evidence of infection. It is important to distinguish between infection and colonisation clinically, and though infections require antibiotic treatment, colonisation does not. It is unclear what proportion of IPCs become colonised. The most common causes of IPC infection and colonisation are and Coagulase-negative Staphylococci respectively. The management of deep IPC infections requires prolonged antibiotic therapy and the drainage of infected fluid, usually via the IPC. Intrapleural enzyme therapy (DNase and fibrinolytics) can be used to aid drainage. IPCs rarely need to be removed and patients can generally be managed as outpatients. Work is ongoing to study the incidence and significance of IPC colonisation. Other topics of interest include topical mupirocin to prevent IPC infections, and whether IPCs can be designed to limit infection risk.
PubMed: 38617774
DOI: 10.21037/jtd-23-1761 -
Journal of Experimental & Clinical... Apr 2024Ferroptosis is a newly identified iron-dependent form of death that is becoming increasingly recognized as a promising avenue for cancer therapy. N6-methyladenosine (mA)...
Ferroptosis is a newly identified iron-dependent form of death that is becoming increasingly recognized as a promising avenue for cancer therapy. N6-methyladenosine (mA) is the most abundant reversible methylation modification in mRNA contributing to tumorigenesis. However, the crucial role of mA modification in regulating ferroptosis during colorectal cancer (CRC) tumorigenesis remains elusive. Herein, we find that mA modification is increased during ferroptotic cell death and correlates with the decreased mA demethylase fat mass and obesity-associated protein (FTO) expression. Functionally, we demonstrate that suppressing FTO significantly induces CRC ferroptotic cell death, as well as enhancing CRC cell sensitivity to ferroptosis inducer (Erastin and RSL3) treatment. Mechanistically, high FTO expression increased solute carrier family 7 member 11 (SLC7A11) or glutathione peroxidase 4 (GPX4) expressions in an mA-YTHDF2 dependent manner, thereby counteracting ferroptotic cell death stress. In addition, we identify Mupirocin as a novel inhibitor of FTO, and Mupirocin induces CRC ferroptosis and inhibits tumor growth. Clinically, the levels of FTO, SLC7A11, and GPX4, are highly correlated expression in CRC tissues. Our findings reveal that FTO protects CRC from ferroptotic cell death in promoting CRC tumorigenesis through triggering SLC7A11/GPX4 expression.
Topics: Humans; Alpha-Ketoglutarate-Dependent Dioxygenase FTO; Amino Acid Transport System y+; Carcinogenesis; Cell Death; Cell Transformation, Neoplastic; Colorectal Neoplasms; Mupirocin
PubMed: 38600610
DOI: 10.1186/s13046-024-03032-9 -
Trials Apr 2024Malignant pleural effusion (MPE) is a debilitating condition as it commonly causes disabling breathlessness and impairs quality of life (QoL). Indwelling pleural...
Australasian Malignant PLeural Effusion (AMPLE)-4 trial: study protocol for a multi-centre randomised trial of topical antibiotics prophylaxis for infections of indwelling pleural catheters.
BACKGROUND
Malignant pleural effusion (MPE) is a debilitating condition as it commonly causes disabling breathlessness and impairs quality of life (QoL). Indwelling pleural catheter (IPC) offers an effective alternative for the management of MPE. However, IPC-related infections remain a significant concern and there are currently no long-term strategies for their prevention. The Australasian Malignant PLeural Effusion (AMPLE)-4 trial is a multicentre randomised trial that evaluates the use of topical mupirocin prophylaxis (vs no mupirocin) to reduce catheter-related infections in patients with MPE treated with an IPC.
METHODS
A pragmatic, multi-centre, open-labelled, randomised trial. Eligible patients with MPE and an IPC will be randomised 1:1 to either regular topical mupirocin prophylaxis or no mupirocin (standard care). For the interventional arm, topical mupirocin will be applied around the IPC exit-site after each drainage, at least twice weekly. Weekly follow-up via phone calls or in person will be conducted for up to 6 months. The primary outcome is the percentage of patients who develop an IPC-related (pleural, skin, or tract) infection between the time of catheter insertion and end of follow-up period. Secondary outcomes include analyses of infection (types and episodes), hospitalisation days, health economics, adverse events, and survival. Subject to interim analyses, the trial will recruit up to 418 participants.
DISCUSSION
Results from this trial will determine the efficacy of mupirocin prophylaxis in patients who require IPC for MPE. It will provide data on infection rates, microbiology, and potentially infection pathways associated with IPC-related infections.
ETHICS AND DISSEMINATION
Sir Charles Gairdner and Osborne Park Health Care Group Human Research Ethics Committee has approved the study (RGS0000005920). Results will be published in peer-reviewed journals and presented at scientific conferences.
TRIAL REGISTRATION
Australia New Zealand Clinical Trial Registry ACTRN12623000253606. Registered on 9 March 2023.
Topics: Humans; Pleural Effusion, Malignant; Quality of Life; Mupirocin; Pleurodesis; Talc; Catheters, Indwelling; Catheter-Related Infections; Anti-Bacterial Agents; Randomized Controlled Trials as Topic; Multicenter Studies as Topic
PubMed: 38594766
DOI: 10.1186/s13063-024-08065-1 -
Veterinary Medicine and Science May 2024Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is an important veterinary pathogen. In general, only a few antimicrobials show in vitro activity against...
BACKGROUND
Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is an important veterinary pathogen. In general, only a few antimicrobials show in vitro activity against MRSP isolates.
OBJECTIVES
The objective of this study was to determine the in vitro activity of selected antimicrobials, including last-choice drugs, against clinical MRSP isolates of canine origin. The activity of 10 selected agents was evaluated against 41 clinical MRSP isolates.
METHODS
The disk diffusion method and minimal inhibitory concentration values were used for antimicrobial susceptibility testing (AST). The guidelines for staphylococci of canine or human origin were employed for the interpretation of the results.
RESULTS
Among the examined MRSP isolates, resistance to enrofloxacin and clindamycin was the most prevalent (n = 40; 97.6%). Resistance to doxycycline and gentamicin was observed in 83.0% (n = 34) and 68.3% (n = 28) of the isolates, respectively. Single isolates were resistant to chloramphenicol (n = 5; 12.2%) and rifampicin (n = 3; 7.3%), whereas all showed susceptibility to amikacin, vancomycin, mupirocin and linezolid. Predominantly, the results of AST obtained by both methods were consistent. Some discrepancies were observed for gentamicin; however, clinical breakpoints for staphylococci of human origin were used.
CONCLUSIONS
Amikacin and chloramphenicol constitute potential treatment options in infections caused by MRSP and may be included in extended susceptibility testing in our geographical region. The determination of clinical breakpoints for some antimicrobials not incorporated in the recommendations should be a high priority in the veterinary diagnostics.
Topics: Animals; Dogs; Humans; Methicillin-Resistant Staphylococcus aureus; Methicillin Resistance; Staphylococcal Infections; Amikacin; Poland; Anti-Infective Agents; Gentamicins; Chloramphenicol; Dog Diseases; Staphylococcus
PubMed: 38547160
DOI: 10.1002/vms3.1385 -
Pathogens (Basel, Switzerland) Mar 2024Coagulase-negative staphylococci (CoNS) species in healthy dogs and their owners could be transferred between these hosts and carry diverse antimicrobial resistance...
Coagulase-negative staphylococci (CoNS) species in healthy dogs and their owners could be transferred between these hosts and carry diverse antimicrobial resistance (AMR) genes of public health concern. This study determined the frequency, diversity, and AMR genes of nasal CoNS from healthy dogs and in-contact people as well as the rate of intra-household (between healthy dogs and dog-owners) transmission of CoNS. Nasal samples were collected and processed from 34 dogs and 41 humans from 27 households, and CoNS identification was done by MALDI-TOF-MS. The AMR determinants and genetic lineages were determined by PCR/sequencing. A total of 216 CoNS isolates were initially obtained and identified, and the AMR phenotypes were determined. From these, 130 non-repetitive CoNS were selected (one isolate of each species per sample or more than one if they presented different AMR phenotypes) and further characterized. The predominant species from dog carriers were (26.5%), (8.8%), and (8.8%), whereas in the human carriers, the predominant ones were (80.4%), (9.8%), and (9.8%). Intra-host species diversity (>one CoNS species) was detected in 37.5% of dogs and 21.6% of dog-owners. Conversely, 50% of dogs and 70.3% of dog-owners had intra-species AMR diversity (2-4 AMR-CoNS profiles). About 20% were susceptible to all antimicrobial agents tested, 31.5% displayed a multidrug resistance phenotype, and 17.4% were -positive, located in SCC type V (24.2%), III (18.1%), IVc (12.1%), and II (6.1%). The other positive CoNS isolates (39.5%) had non-typeable SCC. The highest AMR rates were found against erythromycin (32.3%/(C), (A)) and mupirocin (20.8%/), but the resistance rates for other antimicrobial agents were <10% each. Remarkably, one linezolid-resistant -ST35 isolate was identified and mediated by four amino acid substitutions in L3 and one in L4 ribosomal proteins. Dogs and dog-owners as carriers of with similar AMR patterns and genetic lineages (ST59, ST61, ST166 and ST278) were detected in four households (14.8%). Diverse CoNS carriage and moderate level of AMR were obtained from this study. The detection of CoNS carrying diverse SCC elements and intra-species AMR diversity highlights the roles of dog ownership in the potential transmission of antimicrobial-resistant CoNS in either direction.
PubMed: 38535572
DOI: 10.3390/pathogens13030229