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      RESISTENCIA ANTIMICROBIANA EN Staphylococcus aureus Y Staphylococcus epidermidis: TENDENCIA TEMPORAL (2010-2016) Y FENOTIPOS DE MULTIRRESISTENCIA, CARTAGENA (COLOMBIA) Translated title: ANTIMICROBIAL RESISTANCE IN Staphylococcus aureus AND Staphylococcus epidermidis: TEMPORAL TENDENCIES (2010-2016) AND MULTI-DRUG RESISTANCE PHENOTYPES, CARTAGENA (COLOMBIA)

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          Abstract

          RESUMEN Introducción: Las especies de Staphylococcus spp. son patógenos oportunistas que causan enfermedades como osteomielitis y bacteriemias. Estas bacterias pueden adquirir resistencia a antibióticos, lo que hace que se conviertan en un problema de salud pública debido a la restricción de opciones terapéuticas. Objetivo: Evaluar la tendencia de los perfiles de resistencia antimicrobiana de S. aureus y S. epidermidis aislados en un hospital de Cartagena entre 2010 y 2016. Materiales y métodos: Estudio de corte transversal. El método de microdilución en caldo fue usado para la determinación de la concentración mínima inhibitoria de 12 agentes antimicrobianos. Se estudió el comportamiento de la resistencia antimicrobiana de acuerdo a la especie Staphylococcus, el sitio de infección y el período de tiempo. Resultados: Se aislaron 1218 cocos grampositivos, de los cuales 42,7 % fueron S. aureus y 18,9 % S. epidermidis. El 47,5 % de S. aureus fueron resistentes a meticilina y se encontraron principalmente en secreciones (43,3 %); mientras que el 68,7 % de S. epidermidis fueron meticilino resistentes y aislados principalmente en sangre (76,9 %). Conclusión: Se identificaron aislamientos clínicos de S. aureus y S. epidermidis con perfil de multirresistencia. Se observo un comportamiento constante en sus perfiles de resistencia durante el período de estudio, excepto en los dos últimos años en los que se identificó una reducción significativa de la meticilino resistencia en S. epidermidis.

          Translated abstract

          ABSTRACT Introduction: Staphylococcus spp. are opportunistic pathogens that cause diseases like osteomyelitis and bacteremia. These bacteria can acquire resistance to antibiotics being a public health problem due to the restriction of therapeutic options. Objective: To evaluate the tendency of antimicrobial resistance profiles of Staphylococcus aureus and Staphylococcus epidermidis isolated in a hospital in CartagenaColombia between 2010 and 2016. Materials and methods: Cross-sectional study. The broth microdilution method was used to determine the minimum inhibitory concentration of 12 antimicrobial agents. The behavior of antimicrobial resistance was studied according to the Staphylococcus species, the site of infection and the time period. Results: A total of 1218 Gram-positive cocci were isolated of which 42.7% were S. aureus, and 18.9% belonged to S. epidermidis. Of the isolates of S. aureus, 47.5% were resistant to methicillin and were found mainly in secretions (43.3%). In the case of S. epidermidis, 68.7% were resistant to methicillin and were found mainly in the blood (76.9%). Conclusion: Clinical isolates of S. aureus and S. epidermidis with a multi-resistance profile was identified. A constant behavior in their resistance profiles was detected during the study period except in the last two years in which a significant reduction of methicillin resistance in S. epidermidis was recognized.

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          Sifting the evidence-what's wrong with significance tests?

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            Strategies of adaptation of Staphylococcus epidermidis to hospital and community: amplification and diversification of SCCmec.

            Staphylococcus epidermidis is a harmless commensal, but it can become a human pathogen, mainly in the hospital environment. In order to clarify strategies used by these bacteria to adapt to the hospital environment, we compared the population structure and staphylococcal cassette chromosome mec (SCCmec) content of S. epidermidis from the community and hospital. S. epidermidis were collected from nasal swabs of both healthy military draftees (192 isolates) and patients (94 isolates) recovered in the same time period and geographical region. S. epidermidis were characterized by PFGE, multilocus sequence typing and SCCmec typing. Clonal complex 5 was predominant in the hospital (100%) and the community (58%), but some clonal types were specific to each environment and others were found in both (C/H clones). The methicillin-resistant S. epidermidis (MRSE) colonization rate in the community was very low (7%) when compared with the hospital (30%; P < 0.05). Community-associated MRSE carried mostly SCCmec IV and V [Simpson's index of diversity (SID) = 57.52%; 95% CI 38.35-76.69], whereas hospital-associated MRSE carried 17 SCCmec structures (SID = 82.67%; 95% CI 77.38-87.96). Isolates of the same PFGE type had a much higher number of different SCCmec types when collected in the hospital than in the community. Our data suggest that the S. epidermidis population is composed of hospital-associated clonal types, community-associated clonal types and types that are able to survive in both environments. Moreover, adaptation to the hospital environment in S. epidermidis appears to promote an increase in the frequency and diversification of SCCmec.
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              Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with infection at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

              Background Staphylococcus aureus is one of the major pathogens of public health importance responsible for various forms of infection. Development of resistance to commonly used antimicrobials limited treatment options against infections due to this pathogen. Antimicrobial resistance profile of Staphylococcus aureus isolated from patients with surgical site infection and ear infection and corresponding nasal swab was investigated in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Methods Wound and corresponding nasal swabs from patients with surgical site infection from general surgery ward (n = 14), orthopedic ward (n = 21) and those with otitis media (n = 59) from Ear Nose and Throat (ENT) ward were cultured for S. aureus isolation according to standard procedures from December 2013 to June 2014. Isolates were investigated for susceptibility to panel of 17 antimicrobials using Kirby Bauer disc diffusion assay. Susceptibility to methicillin was phenotypically determined based on sensitivity of isolates to cefoxitin and oxacillin. Results A total of 79 S. aureus isolates were recovered from 54(57.4%) of patients. The isolates were resistant to ampicillin (100%), oxacillin and cefoxitin (68.4%, each), clindamycin (63.3%), cephalothin (59.5%), tetracycline (57%), sulfamethoxazole + trimethoprim and bacitracin (53.2%, each), and erythromycin (51.9%). Resistance to two or more antimicrobials was recorded in 74 (95%) of the isolates, while resistance to 3 or more antimicrobials was detected in 65(82.3%) of the isolates. Fifty-four (68.4%) of the isolates were methicillin resistant S. aureus (MRSA). Rate of occurrence of MRSA was more common among isolates from surgical wards (p < 0.001) compared to those from ENT ward. High level of multi-drug resistance (MDR) was detected more commonly among isolates from orthopedic ward than those from general surgical ward and patients with ear infection (p < 0.001). One of the isolate cultured from wound swab of a patient with surgical site infection from orthopedic ward was resistant to all of the 17 antimicrobials tested. Conclusion S. aureus isolates from patients in TASH exhibited resistance to majority of antimicrobials commonly employed for the treatment of staphylococcal infections which calls for urgent need of prudent use of antimicrobials and the need for implementation of effective infection control practices to hamper spread of MDR S. aureus.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                biosa
                Biosalud
                Biosalud
                Universidad de Caldas (Manizales, Caldas, Colombia )
                1657-9550
                July 2018
                : 17
                : 2
                : 25-36
                Affiliations
                [1] Cartagena orgnameUniversidad de San Buenaventura Colombia rorozco@ 123456usbctg.edu.co
                [3] Cartagena orgnameUniversidad de San Buenaventura Colombia
                [4] Cartagena Bolívar orgnameUniversidad de Cartagena Colombia
                [2] Cartagena Bolívar orgnameCorporación Universitaria Rafael Núñez Colombia lucy.villafane@ 123456curnvirtual.edu.co
                Article
                S1657-95502018000200025
                10.17151/biosa.2018.17.2.2
                c9e93ffb-c38f-4669-9574-57ab257de28c

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 November 2017
                : 21 September 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 12
                Product

                SciELO Colombia

                Categories
                Artículos

                farmacorresistencia microbiana,unidades de cuidados intensivos,resistencia a la meticilina,infecciones estafilocócicas,Staphylococcus aureus,Staphylococcus epidermidis,microbial drug resistance,methicillin resistance,intensive care units,staphylococcal infections

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