Molecular characterisation of methicillin-susceptible and methicillin-resistant Staphylococcus aureus in inpatients and outpatients in Bosnia and Herzegovina

Nosocomial surgical site infections (SSI) are still important complications in surgery. The underlying mechanisms are not fully understood. The aim of this study was to elucidate the possible role of skin flora surviving preoperative antisepsis as a possible cause of SSI. We conducted a two-phase prospective clinical trial in patients undergoing clean orthopedic surgery at a university trauma center in northern Germany. Quantitative swab samples were taken from pre- and postantiseptic skin and, additionally, from the wound base, wound margin, and the suture of 137 patients. Seventy-four patients during phase I and 63 during phase II were investigated. Microbial growth, species spectrum, and antibiotic susceptibility were analyzed. In phase two, the clonal relationship of strains was additionally analyzed. 18.0 % of the swab samples were positive for bacterial growth in the wound base, 24.5 % in the margin, and 27.3 % in the suture. Only 65.5 % of patients showed a 100 % reduction of the skin flora after antisepsis. The microbial spectrum in all postantiseptic samples was dominated by coagulase-negative staphylococci (CoNS). Clonally related staphylococci were detected in ten patients [nine CoNS, one methicillin-susceptible Staphylococcus aureus (MSSA)]. Six of ten patients were suspected of having transmitted identical clones from skin flora into the wound. Ethanol-based antisepsis results in unexpected high levels of skin flora, which can be transmitted into the wound during surgery causing yet unexplained SSI. Keeping with the concept of zero tolerance, further studies are needed in order to understand the origin of this flora to allow further reduction of SSI.

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Molecular Subtyping and Antimicrobial Susceptibilities ofCampylobacter coliIsolates from Diarrheal Patients and Food-Producing Animals in China

Zhang

Liu

et al. 2014

Foodborne Pathogens and Disease

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The aim of this study was to determine the molecular subtyping and antimicrobial susceptibility characteristics of Campylobacter coli isolates from different sources in China. One hundred thirteen C. coli isolates were subtyped by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and porA and flaA short variable region (SVR) nucleotide sequences. Cluster analysis was performed based on the PFGE and sequence types (ST). Eighty-four PFGE patterns (SmaI) were observed in 113 isolates. Fifty-four STs (28 novel) and three clonal complexes (CC), 86% of which were clustered to CC828, were observed, as well as 52 porA and 37 flaA-SVR sequence alleles. MLST, porA, and flaA-SVR analysis demonstrated that many isolates from diarrheal patients shared identical genotypes with chicken isolates. Minimum inhibitory concentration values of 10 antibiotics were analyzed for 109 isolates isolated in 2011 using the E-test method. The most frequently observed resistance agents were nalidixic acid (100%) and ciprofloxacin (100%), followed by levofloxacin (99%), tetracycline (94%), metronidazole (93%), erythromycin (61%), streptomycin (72%), gentamicin (59%), ampicillin (50%), and chloramphenicol (29%). Multidrug resistance was detected in 108 of 109 C. coli isolates (99%).

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Molecular characterisation of methicillin-susceptible and methicillin-resistant Staphylococcus aureus in inpatients and outpatients in Bosnia and Herzegovina

Cited by 7 publications

References 28 publications

Emergency (clonal spread) of methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum (ESBL) – and AmpC beta-lactamase-producing Gram-negative bacteria infections at Pediatric Department, Bosnia and Herzegovina

Emergency (clonal spread) of methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum (ESBL) – and AmpC beta-lactamase-producing Gram-negative bacteria infections at Pediatric Department, Bosnia and Herzegovina

Antimicrobial efficacy of preoperative skin antisepsis and clonal relationship to postantiseptic skin-and-wound flora in patients undergoing clean orthopedic surgery

Molecular Subtyping and Antimicrobial Susceptibilities ofCampylobacter coliIsolates from Diarrheal Patients and Food-Producing Animals in China

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