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vancomycin resistance

E Yoko Furuya, Bevin Cohen, Haomiao Jia, Elaine L Larson
OBJECTIVE To evaluate the impact of universal contact precautions (UCP) on rates of multidrug-resistant organisms (MDROs) in intensive care units (ICUs) over 9 years DESIGN Retrospective, nonrandomized observational study SETTING An 800-bed adult academic medical center in New York City PARTICIPANTS All patients admitted to 6 ICUs, 3 of which instituted UCP in 2007 METHODS Using a comparative effectiveness approach, we studied the longitudinal impact of UCP on MDRO incidence density rates, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Klebsiella pneumoniae...
March 22, 2018: Infection Control and Hospital Epidemiology
Takeshi Yamada, Miu Yagita, Yutaka Kobayashi, Goh Sennari, Hiroyuki Shimamura, Hidehito Matsui, Yuki Horimatsu, Hideaki Hanaki, Tomoyasu Hirose, Satoshi Omura, Toshiaki Sunazuka
Total synthesis of bottromycin A2 can be accomplished through a diastereoselective Mannich reaction of a chiral sulfinamide, mercury-mediated intermolecular amidination, and cyclization of a constrained tetracyclic peptide. Exploitation of this process allowed the synthesis of several novel bottromycin analogs. The antimicrobial activity of these analogs was evaluated in vitro against Gram-positive bacteria, such as methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE)...
March 21, 2018: Journal of Organic Chemistry
Sen Zheng, Kenji Sonomoto
Bacteriocins are ribosomally synthesised small antimicrobial peptides produced from a wide range of bacteria, and also rich sources for potential alternatives to traditional antibiotics. Many bacteriocins have highly specific antibacterial activity against target pathogens, even including drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. As the final and essential step during biosynthesis, the leader sequence removal and exportation of matured bacteriocin are lacking of research and therefore the last to be understood...
March 20, 2018: Applied Microbiology and Biotechnology
Chih-Hsun Tai, Chi-Hao Shao, Chen-You Chen, Shu-Wen Lin, Chien-Chih Wu
Background: Treatment options are limited for infections due to multidrug-resistant Gram-positive pathogens. Daptomycin is a lipopeptide antibiotic with concentration-dependent killing characteristic and dose-dependent post-antibiotic effect. To achieve optimized pharma-codynamic effect, some experts advocated using a high dose of daptomycin (≥9 mg/kg) for severe infections. However, the safety of high-dose therapy in patients with renal impairment remains unknown. This study was aimed to evaluate the safety of daptomycin in patients with severe renal impairment...
2018: Therapeutics and Clinical Risk Management
Kieu-Nhi Tran, Michael J Rybak
Background: Increasing utilization of vancomycin due to the high prevalence of methicillin-resistant S. aureus (MRSA) infections has lead to the emergence of vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA). In vitro data suggest the potential for potent synergy between several beta-lactams and vancomycin. The objective of this study is to evaluate the synergy between beta-lactams and vancomycin against MRSA that is vancomycin susceptible, vancomycin susceptible Staphylococcus aureus (VSSA), hVISA, and VISA...
March 19, 2018: Antimicrobial Agents and Chemotherapy
Andrew M Stoessel, Cory M Hale, Robert W Seabury, Christopher D Miller, Jeffrey M Steele
OBJECTIVE: This study aimed to assess the impact of area under the curve (AUC)-based vancomycin monitoring on pharmacist-initiated dose adjustments after transitioning from a trough-only to an AUC-based monitoring method at our institution. METHODS: A retrospective cohort study of patients treated with vancomycin for complicated methicillin-resistant Staphylococcus aureus (MRSA) infection between November 2013 and December 2016 was conducted. The frequency of pharmacist-initiated dose adjustments was assessed for patients monitored via trough-only and AUC-based approaches for trough ranges: 10 to 14...
January 1, 2018: Journal of Pharmacy Practice
Adham Abu Taha, Ayman Daoud, Sawsan Zaid, Sajida Sammour, Maram Belleh, Refqa Daifi
BACKGROUND: Active surveillance is important in infection control programmes, allowing the detection of patients colonised with multi-drug resistant organisms and preventing the spread of multi-drug resistant organisms. The aim of this study was to determine the rate of asymptomatic colonisation with multi-drug resistant organisms and the prevalence of each organism in patients transferred to An-Najah National University Hospital, Nablus, occupied Palestinian territory. METHODS: Patients transferred from other hospitals between January and December, 2015, were screened at time of admission by taking nasal, groin, and axillary swabs...
February 21, 2018: Lancet
Hegde Sharat Shivaramaiah, Nidhi Relhan, Avinash Pathengay, Nitin Mohan, Harry W Flynn
Purpose: To report the clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes of patients with endophthalmitis caused by gram-positive bacteria resistant to vancomycin. Methods: Retrospective case series of all patients with culture-proven endophthalmitis caused by gram-positive bacteria resistant to vancomycin between January 2010 and December 2016 in LV Prasad Eye Institute, Visakhapatnam, India. Results: The current study included 14 patients...
June 2018: American Journal of Ophthalmology Case Reports
Anna Rubio-Cosials, Eike C Schulz, Lotte Lambertsen, Georgy Smyshlyaev, Carlos Rojas-Cordova, Kristoffer Forslund, Ezgi Karaca, Aleksandra Bebel, Peer Bork, Orsolya Barabas
Conjugative transposition drives the emergence of multidrug resistance in diverse bacterial pathogens, yet the mechanisms are poorly characterized. The Tn1549 conjugative transposon propagates resistance to the antibiotic vancomycin used for severe drug-resistant infections. Here, we present four high-resolution structures of the conserved Y-transposase of Tn1549 complexed with circular transposon DNA intermediates. The structures reveal individual transposition steps and explain how specific DNA distortion and cleavage mechanisms enable DNA strand exchange with an absolute minimum homology requirement...
March 2, 2018: Cell
Mercedes Pérez-Bonilla, Daniel Oves-Costales, Mercedes de la Cruz, Maria Kokkini, Jesús Martín, Francisca Vicente, Olga Genilloud, Fernando Reyes
Phocoenamicins B and C ( 1 and 2 ), together with the known spirotetronate phocoenamicin ( 3 ), were isolated from cultures of Micromonospora sp. The acetone extract from a culture of this strain, isolated from marine sediments collected in the Canary Islands, displayed activity against methicillin-resistant Staphylococcus aureus (MRSA), Mycobacterium tuberculosis H37Ra and Mycobacterium bovis . Bioassay-guided fractionation of this extract using SP207ss column chromatography and preparative reversed-phased HPLC led to the isolation of the new compounds 1 and 2 belonging to the spirotetronate class of polyketides...
March 16, 2018: Marine Drugs
Khaled R Alkharsah, Suriya Rehman, Fatimah Alkhamis, Amani Alnimr, Asim Diab, Amein K Al-Ali
BACKGROUND: Methicillin resistant Staphylococcus aureus (MRSA) constitutes a major global health concern causing hospital and community acquired infections. A wide diversity of MRSA genotypes are circulating in geographically related regions. Therefore understanding the molecular epidemiology of MRSA is fundamental to design control and clearance measures. METHODS: A total of 106 MRSA isolates from infection (51) and carrier colonization sites (55) are characterized genetically based on SCCmec and MLST genotyping methods in addition to detection of PVL, TSST-1 and enterotoxins...
March 15, 2018: Annals of Clinical Microbiology and Antimicrobials
Bruna Maria Salotti de Souza, Taís Fernanda Borgonovi, Sabrina Neves Casarotti, Svetoslav Dimitrov Todorov, Ana Lúcia Barretto Penna
The objective of this study was to evaluate the probiotic properties of Lactobacillus casei and Lactobacillus fermentum strains, as well as to select novel and safe strains for future development of functional fermented products. The in vitro auto-aggregation, co-aggregation, hydrophobicity, β-galactosidase production, survival to gastrointestinal tract (GIT), and antibiotic susceptibility were evaluated. The selected strains were additionally tested by the presence of genes encoding adhesion, aggregation and colonization, virulence factors, antibiotic resistance, and biogenic amine production, followed by the evaluation of acidifying kinetic parameters in milk, and survival of the strains under simulated GIT conditions during refrigerated storage of fermented milk...
March 14, 2018: Probiotics and Antimicrobial Proteins
Shuaishuai Ni, Baoli Li, Feifei Chen, Hanwen Wei, Fei Mao, Yifu Liu, Yixiang Xu, Xiaoxi Qiu, Xiaokang Li, Wenwen Liu, Linghao Hu, Dazheng Ling, Manjiong Wang, Xinyu Zheng, Jin Zhu, Lefu Lan, Jian Li
Diapophytoene desaturase (CrtN) is a potential novel target for intervening in the biosynthesis of the virulence factor staphyloxanthin. In this study, 38 1,4-benzodioxan-derived CrtN inhibitors were designed and synthesized to overwhelm the defects of leading compound 4a . Derivative 47 displayed superior pigment inhibitory activity, better hERG inhibitory properties and water solubility, and significantly sensitized MRSA strains to immune clearance in vitro. Notably, 47 displayed excellent efficacy against pigmented S...
March 8, 2018: ACS Medicinal Chemistry Letters
Leron Khalifa, Daniel Gelman, Mor Shlezinger, Axel Lionel Dessal, Shunit Coppenhagen-Glazer, Nurit Beyth, Ronen Hazan
The deteriorating effectiveness of antibiotics is propelling researchers worldwide towards alternative techniques such as phage therapy: curing infectious diseases using viruses of bacteria called bacteriophages. In a previous paper, we isolated phage EFDG1, highly effective against both planktonic and biofilm cultures of one of the most challenging pathogenic species, the vancomycin-resistant Enterococcus (VRE). Thus, it is a promising phage to be used in phage therapy. Further experimentation revealed the emergence of a mutant resistant to EFDG1 phage: EFDG1r ...
2018: Frontiers in Microbiology
Shiho Fujisaka, Julian Avila-Pacheco, Marion Soto, Aleksandar Kostic, Jonathan M Dreyfuss, Hui Pan, Siegfried Ussar, Emrah Altindis, Ning Li, Lynn Bry, Clary B Clish, C Ronald Kahn
Diet, genetics, and the gut microbiome are determinants of metabolic status, in part through production of metabolites by the gut microbiota. To understand the mechanisms linking these factors, we performed LC-MS-based metabolomic analysis of cecal contents and plasma from C57BL/6J, 129S1/SvImJ, and 129S6/SvEvTac mice on chow or a high-fat diet (HFD) and HFD-treated with vancomycin or metronidazole. Prediction of the functional metagenome of gut bacteria by PICRUSt analysis of 16S sequences revealed dramatic differences in microbial metabolism...
March 13, 2018: Cell Reports
Megumi Yazaki, Takehiko Oami, Kazuya Nakanishi, Ryota Hase, Hiroyuki Watanabe
Although vancomycin administration is recommended for the treatment of infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA), it is unclear whether an alternative agent, daptomycin, can be used to treat IE with pulmonary complications. A 26-year-old female who had undergone surgical repair of a ventricular septal defect as an early teenager presented with fever, headache, and vomiting. She was admitted to our hospital and diagnosed with right-sided IE with septic pulmonary embolism caused by MRSA...
March 10, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
John Pham, Talal Asif, Majdi S Hamarshi
Methicillin-resistant S taphylococcus aureus (MRSA) was previously considered a purely nosocomial pathogen. However, community-acquired MRSA has recently emerged as an important cause of severe necrotizing community-acquired pneumonia (CA-MRSA) in previously healthy individuals. This new pathogen exhibits antibiotic resistance and is linked to extended hospital stay and higher mortality. CA-MRSA has presented new therapeutic challenges due to high vancomycin treatment failure and lack of specificity of clinical findings...
January 3, 2018: Curēus
Julie Hui-Chih Wu, Bradley J Langford, Kevin L Schwartz, Rosemary Zvonar, Sumit Raybardhan, Valerie Leung, Gary Garber
Background: Antimicrobial allergy labels, either self-reported or placed in a patient's medical record, are common, but in many cases they are not associated with a true immunoglobulin E-mediated allergic response. Objective: To assess the impact of antimicrobial allergy labels on antimicrobial prescribing, resource utilization, and clinical outcomes. Data Sources: The MEDLINE, Embase, CINAHL, and Scopus electronic databases were searched for the period 1990 to January 2016...
January 2018: Canadian Journal of Hospital Pharmacy
Megan K Luther, Diane M Parente, Aisling R Caffrey, Katie Daffinee, Vrishali V Lopes, Emily T Martin, Kerry L LaPlante
Background. Molecular and clinical factors associated with biofilm-forming methicillin-resistant Staphylococcus aureus (MRSA) are incompletely understood. Methods. Biofilm production was quantified in 182 MRSA isolates from clinical culture sites (2004-2013). Microbiologic toxins, pigmentation, and genotypes were evaluated, and patient demographics were collected. Logistic regression was used to quantify the effect of strong biofilm production (versus weak) on clinical outcomes and independent predictors of strong biofilm...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Myreen E Tomas, Thriveen S C Mana, Brigid M Wilson, Michelle M Nerandzic, Joussef Samira, Miguel Quinones-Mateu, Curtis J Donskey
Vancomycin taper regimens are commonly used for the treatment of recurrent Clostridium difficile infections. One rationale for tapering and pulsing of the dose at the end of therapy is to reduce the selective pressure of vancomycin on the indigenous intestinal microbiota. Here, we used a mouse model to test the hypothesis that the indigenous microbiota that provide colonization resistance against C. difficile and vancomycin-resistant enterococci (VRE) is re-populated during tapering courses of vancomycin. Mice were treated orally with vancomycin daily for 10 days, vancomycin in a tapering dose for 42 days, fidaxomicin for 10 days, or saline...
March 12, 2018: Antimicrobial Agents and Chemotherapy
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