Multidrug-resistant pathogens: Mechanisms of resistance and epidemiology

Kaye, Keith S.; Kaye, Donald

doi:10.1007/s11908-000-0065-1

Cited by 28 publications

(19 citation statements)

References 47 publications

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“…Hydrated molecular iodine (I 2 ) has the highest antimicrobial potential . Iodophors, composed of iodine complexed with organic compounds, are less irritating and allergenic than iodine solutions owing to slow release (dispersion) of free iodine from the aggregates into aqueous solutions . The concentration of free iodine, and therefore activity, depends on the type of iodophor.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants

Phillips

Yang

Davis

et al. 2013

International Wound Journal

100

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An ex vivo porcine skin explant biofilm model that preserves key properties of biofilm attached to skin at different levels of maturity (0-3 days) was used to assess the efficacy of commercially available antimicrobial dressings and topical treatments. Assays were also performed on the subpopulation of antibiotic tolerant biofilm generated by 24 hours of pre-treatment with gentamicin (120× minimal inhibitory concentration) prior to agent exposure. Five types of antimicrobial agents (iodine, silver, polyhexamethylene biguanide, honey and ethanol) and four types of moisture dressings (cotton gauze, sodium carboxymethylcellulose fibre, calcium alginate fibre and cadexomer beads) were assessed. Time-release silver gel and cadexomer iodine dressings were the most effective in reducing mature biofilm [between 5 and 7 logarithmic (log) of 7-log total], whereas all other dressing formulations reduced biofilm between 0·3 and 2 log in 24 or 72 hours with a single exposure. Similar results were found after 24-hour exposure to silver release dressings using an in vivo pig burn wound model, demonstrating correlation between the ex vivo and in vivo models. Results of this study indicate that commonly used microbicidal wound dressings vary widely in their ability to kill mature biofilm and the efficacy is influenced by time of exposure, number of applications, moisture level and agent formulation (sustained release).

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Section: Discussionmentioning

confidence: 99%

Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants

Phillips

Yang

Davis

et al. 2013

International Wound Journal

100

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“…In India, MRSA All MRSA isolates were resistant to penicillin and ciprofloxacin. Ciprofloxacin and penicillin derivatives are the commonly used antibiotic in Nepalese hospitals and the organisms that are resistant to these antibiotics tend to become the cause of nosocomial infections such as MRSA [16]. The uniform multi-resistance pattern of the MRSA isolates obviously indicates that infections by these isolates are difficult to treat.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic characterization of nosocomial isolates of Staphylococcus aureus with reference to MRSA

Shrestha

Pokhrel

Mohapatra

2009

J Infect Dev Ctries

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Background: Apart from being a major cause of mortality, nosocomial infections due to Staphylococcus aureus have been imposing a burden on patients, hospitals and health care systems. The present study was designed to determine the prevalence of methicillin resistant S. aureus (MRSA) among nosocomial isolates along with their phenotypic characterization. Methodology: MRSA and methicillin sensitive S. aureus (MSSA) were determined by performing four different tests viz: disc diffusion, oxacillin screen agar test, MRSA latex agglutination test, and MIC of oxacillin by E test. Results: Of the 149 S. aureus nosocomial isolates, 44.9% were MRSA, which included 82.1% of homogeneous MRSA and 17.9% of heterogeneous MRSA. Association of MRSA infection was found to be significantly higher in skin and lower respiratory tract infections. Of the MRSA isolates, 65 were multiresistant oxacillin resistant Staphylococcus aureus (MORSA) and 2 were nonmultiresistant oxacillin resistant Staphylococcus aureus (NORSA). D tests performed on 136 isolates showed that Inducible macrolide-lincosamide-streptogramin B (MLS B ) and constitutive MLS B resistance were found to be associated with MRSA. On the contrary, susceptibility to both erythromycin and clindamycin was found to be associated with MSSA. However, MS B (macrolide-streptogramin B) resistance was not found associated either with MRSA or MSSA. Furthermore, both inducible and constitutive MLS B were found to be associated with only homogenous MRSA. Conclusion: D tests may be made mandatory in all S. aureus isolates as inducible MLS B resistance cannot be detected in routine susceptibility test unless erythromycin and clindamycin are placed 15-26 mm apart.

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“…Antimicrobial usage, particularly b-lactams in low concentrations for prolonged periods, leads to selection for resistance among pneumococci in children and adults-both the carrier state and invasive disease; nevertheless, penicillin resistance varies widely among developed countries [15]. In addition to this selective pressure, other factors contribute to the development and spread of resistant pathogens, including an extension of their spectrum of resistance and resistance genes among diverse microorganisms and mutations in common genes [16].…”

Section: Changing Epidemiology Of Acute Bacterial Meningitismentioning

confidence: 99%

Pathophysiology of Bacterial Meningitis: Mechanism(s) of Neuronal Injury

Scheld¹,

et al. 2002

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No bacterial disease has undergone a more dramatic change in epidemiology during the past decade than acute bacterial meningitis. This review describes the changing epidemiology and considers some important recent observations that contribute to our understanding of the pathogenesis and pathophysiology of meningitis. The major focus is on the mechanisms of neuronal injury and the pathophysiologic concepts responsible for death and neurologic sequelae. In recent years, experimental studies have amplified our understanding of the substantial body of evidence that now implicates cytokines and chemokines, proteolytic enzymes, and oxidants in the inflammatory cascade leading to tissue destruction in bacterial meningitis. The molecular mechanisms responsible for oxidant-induced neuronal injury in meningitis are explored in some depth. Genetic targeting and/or pharmacologic blockade of the implicated pathways may be a future strategy for therapeutic adjunctive measures to improve outcome and may hold substantial promise, in concert with antimicrobial agents, in humans with acute bacterial meningitis.

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Multidrug-resistant pathogens: Mechanisms of resistance and epidemiology

Cited by 28 publications

References 47 publications

Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants

Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants

Phenotypic characterization of nosocomial isolates of Staphylococcus aureus with reference to MRSA

Pathophysiology of Bacterial Meningitis: Mechanism(s) of Neuronal Injury

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