Carriage of <i>Staphylococcus aureus</i> and of Gram-Negative Bacilli Resistant to Third-Generation Cephalosporins in Cirrhotic Patients A Prospective Assessment of Hospital-Acquired Infections

Dupeyron, C; Campillo, Bernard; Mangeney, Nicole; Bordes, Muriel; Richardet, Jean-Philippe; Leluan, G

doi:10.1086/501929

Cited by 41 publications

(22 citation statements)

References 26 publications

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“…48 In the only comparative study to assess the independent use of antiseptic body washes for elimination of endemic S. aureus colonization, little difference was found between intra-nasal and wound mupirocin alone and mupirocin accompanied by chlorhexidine body washes, but this was an inadequately powered, non-randomized study. 68 Prevention of infection in a colonized patient Nasal decolonization S. aureus nasal carriage is a risk factor for subsequent infection, such as bacteraemia 23 and surgical-site infections (SSI), including cardiac 22 and orthopaedic surgery, 69 in patients with cirrhosis 70,71 and with HIV infection, 72 and in liver transplant recipients, 73 intensive care unit patients, 21,29,74 patients undergoing chronic ambulatory peritoneal dialysis (CAPD) 75 and haemodialysis patients. 76 It would seem reasonable to contend that eradication of nasal carriage would prevent infections with S. aureus, but the published randomized, controlled trials do not support this.…”

Section: Reduction In the Pool Of Mrsa Colonized Patientsmentioning

confidence: 99%

Control of endemic MRSA—what is the evidence? A personal view

Marshall¹,

Wesselingh²,

McDonald³

et al. 2004

Journal of Hospital Infection

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Section: Reduction In the Pool Of Mrsa Colonized Patientsmentioning

confidence: 99%

Control of endemic MRSA—what is the evidence? A personal view

Marshall¹,

Wesselingh²,

McDonald³

et al. 2004

Journal of Hospital Infection

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“…Cirrhosis of the liver is often associated with systemic endotoxaemia in the absence of sepsis [9][10][11], with the degree of endotoxaemia paralleling the degree of hepatic decompensation [12]. This was the basis for the Vallance and Moncada [8] hypothesis suggesting that the splanchnic/systemic endotoxin load could be the trigger for activating NOS activity with subsequent excess NO production.…”

Section: Endotoxaemia In Cirrhosismentioning

confidence: 99%

Nitric oxide and the hyperdynamic circulation in cirrhosis: is there a role for selective intestinal decontamination?

2004

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Abnormal vascular tone is responsible for many of the complications seen in cirrhosis making the identification of the pathophysiology of abnormal dilatation a major focus in hepatology research. The study of abnormal vascular tone is complicated by the multiple vascular beds involved (hepatic, splanchnic, peripheral, renal and pulmonary), the differences in the underlying cause of portal hypertension (hepatic versus pre-hepatic) and the slow evolution of the hyperdynamic state. The autonomic nervous system, circulating vasodilators and abnormalities in vascular smooth muscle cells (receptors, ion channels, signalling systems and contraction) have all been implicated. There is overwhelming evidence for an overproduction of NO (nitric oxide) contributing to the peripheral dilatation in both animal models of, and in humans with, cirrhosis and portal hypertension. This review focuses on the proposal that endotoxaemia, possibly from gut-derived bacterial translocation, causes induction of NOS (NO synthase) leading to increased vascular NO production, which is the primary stimulus for the development of vasodilatation in cirrhosis and its accompanying clinical manifestations. The current controversy lies not in whether NO production is elevated, but in which isoform of NOS is responsible. We review the evidence for endotoxaemia in cirrhosis and the factors contributing to gut-derived bacterial translocation, including intestinal motility and permeability, and finally discuss the possible role of selective intestinal decontamination in the management of circulatory abnormalities in cirrhosis.

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“…The nasal carriage of Staph. aureus is common, 20-50 % of the population (Cespedes et al, 2005), but also intestinal carriage appears to be increased among hospitalized patients (Dupeyron et al, 2001;Ray et al, 2003;Rimland & Roberson, 1986;Squier et al, 2002) and infants (Lindberg et al, 2000). Lindberg et al (2000) showed that over 75 % of Swedish infants have Staph.…”

Section: Introductionmentioning

confidence: 99%

Staphylococcus aureus adheres to human intestinal mucus but can be displaced by certain lactic acid bacteria

et al. 2006

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There is increasing evidence that Staphylococcus aureus may colonize the intestinal tract, especially among hospitalized patients. As Staph. aureus has been found to be associated with certain gastrointestinal diseases, it has become important to study whether this bacterium can colonize the intestinal tract and if so, whether it is possible to prevent colonization. Adhesion is the first step in colonization; this study shows that Staph. aureus adheres to mucus from resected human intestinal tissue. Certain lactic acid bacteria (LAB), mainly commercial probiotics, were able to reduce adhesion and viability of adherent Staph. aureus. In displacement assays the amount of adherent Staph. aureus in human intestinal mucus was reduced 39–44 % by Lactobacillus rhamnosus GG, Lactococcus lactis subsp. lactis and Propionibacterium freudenreichii subsp. shermanii. Moreover, adherent Lactobacillus reuteri, Lc. lactis and P. freudenreichii reduced viability of adherent Staph. aureus by 27–36 %, depending on the strain, after 2 h incubation. This was probably due to the production of organic acids and hydrogen peroxide and possibly in the case of L. reuteri to the production of reuterin. This study shows for the first time that Staph. aureus can adhere to human intestinal mucus and adherent bacteria can be displaced and killed by certain LAB strains via in situ production of antimicrobial substances.

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Carriage of Staphylococcus aureus and of Gram-Negative Bacilli Resistant to Third-Generation Cephalosporins in Cirrhotic Patients A Prospective Assessment of Hospital-Acquired Infections

Abstract: Carriage of CephR strains is not associated with subsequent infection by these organisms in hospitalized cirrhotic patients. In contrast, MRSA carriage was an important risk factor for MRSA bacteremia and urinary tract infection.

Cited by 41 publications

References 26 publications

Control of endemic MRSA—what is the evidence? A personal view

Control of endemic MRSA—what is the evidence? A personal view

Nitric oxide and the hyperdynamic circulation in cirrhosis: is there a role for selective intestinal decontamination?

Staphylococcus aureus adheres to human intestinal mucus but can be displaced by certain lactic acid bacteria

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