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      Translated title: Staphylococcus aureus: estado de portador en personal de enfermería y patrones de susceptibilidad antimicrobiana

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          Abstract

          Para detectar el estado de portador de S. aureus y los patrones de susceptibilidad antimicrobiana de las cepas aisladas, se procesaron muestras de exudado nasal e hisopado de manos de 126 profesionales de la enfermería. El aislamiento e identificación bacteriana se hizo siguiendo la metodología convencional y se determinó la susceptibilidad antimicrobiana mediante el método de difusión del disco. Se determinó la producción de β-lactamasas, resistencia a oxacilina, concentración inhibitoria mínima a oxacilina, vancomicina y penicilina G y producción de PBP2. 18.25% (23) de los individuos muestreados resultó portador. Para penicilina G se obtuvo 86.79% de resistencia y 18.87% para oxacilina. La presencia de cepas SAMR fue observada en la UCIA (26.09%). 84.91% de las cepas resultó β-lactamasa-positivas y 16,98%, productoras de PBP2. El estado de portador nasal representa un importante reservorio hospitalario para S. aureus, no encontrándose ningún perfil de resistencia específico entre las cepas aisladas

          Translated abstract

          Abstract In order to determine carrier state and antimicrobial susceptibility patterns of S. aureus, nasal and hands swabs coming from 126 professional nurses, were processed. Isolation and bacterial identification were made by conventional methodology and antimicrobial susceptibility was determined by disk diffusion method. β-lactamases production, oxacillin screening test, minimal inhibitory concentration to oxacillin, vancomycin and penicillin G, and PBP2 production were also determined. 18.25% (23) of the individuals were S. aureus carriers. For penicillin G resistance was 86.79% and 18.87% to oxacillin. The presence of MRSA strains was observed in the adult intensive care units (26.09%). 84.91% of the strains were β-lactamase positive and 16.98% PBP2 producers. Nasal carriage represents an important hospital reservoir of S. aureus; none specific resistance profile was found among the isolated strains

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          Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group.

          The consequences of infection with Staphylococcus aureus can be severe, so strategies for prevention are important. We examined S. aureus isolates from blood and from nasal specimens to determine whether the organisms in the bloodstream originated from the patient's own flora. In a multicenter study, swabs for culture were obtained from the anterior nares of 219 patients with S. aureus bacteremia. A total of 723 isolates were collected and genotyped. In a second study, 1640 S. aureus isolates from nasal swabs were collected over a period of five years and then compared with isolates from the blood of patients who subsequently had S. aureus bacteremia. In the multicenter study of S. aureus bacteremia, the blood isolates were identical to those from the anterior nares in 180 of 219 patients (82.2 percent). In the second study, 14 of 1278 patients who had nasal colonization with S. aureus subsequently had S. aureus bacteremia. In 12 of these 14 patients (86 percent), the isolates obtained from the nares were clonally identical to the isolates obtained from blood 1 day to 14 months later. A substantial proportion of cases of S. aureus bacteremia appear to be of endogenous origin since they originate from colonies in the nasal mucosa. These results provide support for strategies to prevent systemic S. aureus infections by eliminating nasal carriage of S. aureus.
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            Determinants of Staphylococcus aureus nasal carriage.

            Nasal carriage of Staphylococcus aureus has been identified as a risk factor for community-acquired and nosocomial infections. We screened 230 donors of diverse ethnic and socioeconomic backgrounds and identified 62 (27%) whose nasal secretions were colonized by S. aureus. In 18 donors in whom the various regions of the nasal luminal surface were separately sampled, the predominant region of S. aureus colonization was the moist squamous epithelium on the septum adjacent to the nasal ostium. Nasal fluid from carriers was defective in killing endogenous S. aureus and nasal carrier isolates of S. aureus but not a laboratory S. aureus strain. Transmission electron microscopy revealed that S. aureus isolates incubated in nasal fluid from carriers for 2 h at 37 degrees C were less damaged than those incubated in noncarrier fluid and were coated with an electron-dense layer. Compared with that from healthy donors and patients with acute rhinitis, nasal fluid from carriers contained elevated concentrations of the neutrophil-derived defensins human neutrophil peptides 1 to 3 (47- and 4-fold increases, respectively), indicative of a neutrophil-mediated inflammatory host response to S. aureus colonization. The concentration of the inducible epithelial antimicrobial peptide human beta-defensin 2 was also highly elevated compared to that in healthy donors, in whom the level was below the detection limit, or patients with acute rhinitis (sixfold increase). Thus, nasal carriage of S. aureus takes hold in nasal fluid that is permissive for colonization and induces a local inflammatory response that fails to clear the colonizing bacteria.
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              Antimicrobial resistance: the example of Staphylococcus aureus

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                Author and article information

                Journal
                rsvm
                Revista de la Sociedad Venezolana de Microbiología
                Rev. Soc. Ven. Microbiol.
                Organo Oficial de la Sociedad Venezolana de Microbiología. (Caracas, DF, Venezuela )
                1315-2556
                February 2005
                : 25
                : 2
                : 72-78
                Article
                S1315-25562005000200004 S1315-2556(05)02500204
                31b282a1-412e-45b2-bd94-3f7a1920d0db

                http://creativecommons.org/licenses/by/4.0/

                History
                : 10 October 2005
                : 20 July 2005
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 7
                Product

                SciELO Venezuela

                Categories
                ARTICULOS ORIGINALES

                resistencia antimicrobiana,Staphylococcus aureus,carriers,antimicrobial resistance,portadores

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