mupirocin and Wounds-and-Injuries

Staphylococcus aureus as an opportunistic bacterial pathogen with intrinsic and acquired resistance to many antibiotics is a worldwide problem. The current study was undertaken to evaluate the resistance pattern, and determine the genetic types of multidrug-resistant S. aureus isolated from wound. This cross-sectional study was conducted over the period of two years (from December 2018 to November 2020) at the hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. In present study, 75 multidrug-resistant S. aureus isolates collected from wound infections were investigated. Phenotypic resistance was assessed by Kirby-Bauer disk diffusion method. Conventional PCR was performed for the detection of virulence encoding genes. Genotyping of strains was performed based on coa gene polymorphism using multiplex-PCR assay. SCCmec typing, spa typing and MLST were also used to characterize the genotype of the mupirocin, tigecycline and vancomycin resistant multidrug-resistant S. aureus isolates. All 75 multidrug-resistant S. aureus isolates in the study were confirmed as MRSA. Coagulase typing distinguished isolates into five genotypic patterns including III (40%), I (24%), IVb (16%), V (10.7%) and type X (9.3%). Resistance to tigecycline was detected in 4% of MDR-MRSA isolates and all belonged to CC8/ST239- SCCmec III/t421 lineage. According to our analysis, one VRSA strain was identified that belonged to coa type V and CC/ST22-SCCmec IV/t790 lineage. Resistance to mupirocin was detected in 9.3% of strains. All 7 mupirocin resistant MDR-MRSA isolates exhibited resistance to mupirocin in high level. Of these, 4 isolates belonged to CC/ST8-SCCmec IV/t008 (57.1%), 2 isolates belonged to CC/ST8-SCCmec IV/t064 (28.6%) and one isolate to CC/ST22-SCCmec IV/t790 (14.3%). Altogether, current survey provides a snapshot of the characteristics of S. aureus strains isolated from patients. Our observations highlighted type III as predominant coa type among multidrug-resistant MDR strains indicating low heterogeneity of these isolates. Our study also indicates the importance of continuous monitoring of the genotypes of MDR-MRSA isolates to prevent nosocomial outbreaks and the spread of MDR isolates.

Topics: Anti-Bacterial Agents; Cross-Sectional Studies; Drug Resistance, Multiple, Bacterial; Humans; Iran; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Multilocus Sequence Typing; Mupirocin; Staphylococcal Infections; Staphylococcus aureus; Tigecycline; Vancomycin-Resistant Staphylococcus aureus; Wounds and Injuries

An ideal wound dressing should exhibit good biocompatibility, minimize pain and infection, absorb excess exudates, and maintain a moist environment. However, few clinical products meet all these needs. Therefore, the aim of this study was to fabricate a multifunctional double layer nanofibrous scaffolds (DLS) as a potential material for wound dressing.. The scaffold was formed from mupirocin and lidocaine hydrochloride homogeneously incorporated into polycaprolactone as the first layer of scaffolds and chitosan as the second layer of scaffolds nanofibers through electrospinning. The fabricated nanofibrous scaffolds were characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, thermogravimetric analysis, differential scanning calorimetry, and measurement of swelling ratio, contact angle, drug release, and mechanical properties. Furthermore, antibacterial assessment, live/dead cell assays, and MTT assays were used to investigate the antibacterial activity and cytotoxicity of the nanofibrous scaffolds.. The morphology of the nanofibrous scaffolds was studied by scanning electron microscopy, showing successful nanofibrous scaffolds. Fourier transform infrared spectroscopy demonstrated the successful incorporation of the material used to produce the produced nanofibrous scaffolds. Thermal studies with thermogravimetric analysis and differential scanning calorimetry indicated that the DLS had high thermal stability. The DLS also showed good in vitro characteristics in terms of improved swelling ratio and contact angle. The mechanical results revealed that the DLS had an improved tensile strength of 3.88 MPa compared with the second layer of scaffold (2.81 MPa). The release of drugs from the scaffold showed different profiles for the two drugs. Lidocaine hydrochlo ride exhibited an initial burst release (66% release within an hour); however, mupirocin exhibited only a 5% release. Furthermore, the DLS nanofibers displayed highly effective antibacterial activities against. The fabricated DLS exhibited excellent hydrophilicity, cytocompatibility, sustained drug release, and antibacterial activity, which are favorable qualities for its use as a multifunctional material for wound dressing applications.

Topics: Anti-Bacterial Agents; Bacteria; Bandages; Cell Death; Chitosan; Drug Liberation; Fibroblasts; Humans; Lidocaine; Microbial Sensitivity Tests; Mupirocin; Nanofibers; Particle Size; Polyesters; Porosity; Spectroscopy, Fourier Transform Infrared; Temperature; Tissue Scaffolds; Water; Wounds and Injuries

Burn wound infections are often difficult to treat due to the presence of multidrug-resistant bacterial strains and biofilms. Currently, mupirocin is used to eradicate methicillin-resistant Staphylococcus aureus (MRSA) from colonized persons; however, mupirocin resistance is also emerging. Since we consider antimicrobial peptides to be promising candidates for the development of novel anti-infective agents, we studied the antibacterial activities of a set of synthetic peptides against different strains of S. aureus, including mupirocin-resistant MRSA strains. The peptides were derived from P60.4Ac, a peptide based on the human cathelicidin LL-37. The results showed that peptide 10 (P10) was the only peptide more efficient than P60.4Ac, which is better than LL-37, in killing MRSA strain LUH14616. All three peptides displayed good antibiofilm activities. However, both P10 and P60.4Ac were more efficient than LL-37 in eliminating biofilm-associated bacteria. No toxic effects of these three peptides on human epidermal models were detected, as observed morphologically and by staining for mitochondrial activity. In addition, P60.4Ac and P10, but not LL-37, eradicated MRSA LUH14616 and the mupirocin-resistant MRSA strain LUH15051 from thermally wounded human skin equivalents (HSE). Interestingly, P60.4Ac and P10, but not mupirocin, eradicated LUH15051 from the HSEs. None of the peptides affected the excretion of interleukin 8 (IL-8) by thermally wounded HSEs upon MRSA exposure. In conclusion, the synthetic peptides P60.4Ac and P10 appear to be attractive candidates for the development of novel local therapies to treat patients with burn wounds infected with multidrug-resistant bacteria.

Topics: Amino Acid Sequence; Anti-Bacterial Agents; Antimicrobial Cationic Peptides; Biofilms; Burns, Electric; Cathelicidins; Epidermis; Epithelial Cells; Fibroblasts; Humans; Interleukin-8; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Mitochondria; Models, Biological; Molecular Sequence Data; Mupirocin; Skin, Artificial; Solid-Phase Synthesis Techniques; Wounds and Injuries

This work was conducted to study the prophylactic efficacy of 2 topical antibiotic ointments (mupirocin and nitrofurazone) against wound infection in experimental contaminated crush wounds.. Male Wistar rats underwent two 2-cm incisions at the back side and randomized into 3 groups--placebo (n = 14), mupirocin (n = 14), and nitrofurazone (n = 14)--and infected with either Staphylococcus aureus or S. pyogenes. All wound edges were crushed for 5 seconds with hemostats to simulate crush injury before inoculation of the microorganisms. Half of the wounds were sutured and the other half left open. These wounds were treated 3 times daily for 6 days with topical mupirocin, nitrofurazone, or petrolatum (as placebo). At the end of 6 days, excisional biopsies were taken from wound edges and histopathologic assessments were made based on neutrophilic infiltration, edema formation, myofibroblastic proliferation, and granulation tissue formation. For the microbiologic assessments, quantitative tissue cultures were made.. In S. aureus-inoculated wounds, mupirocin showed higher antibacterial activity against bacterial colonization and reduced infection rates compared to placebo groups. The same effect was observed for the infection rates in S. pyogenes-inoculated wounds. In S. pyogenes-inoculated open wounds, nitrofurazone showed higher antibacterial activity against infection, but this effect was not observed in closed wounds. In S. pyogenes- and S. aureus-infected wounds, mupirocin treatment significantly lowered infection rates compared to nitrofurazone treatment. Histopathologic examination showed higher myofibroblastic proliferation and higher volume of granulation tissue in the nitrofurazone groups compared to the mupirocin groups.. Topical mupirocin application was effective against crush wound infections inoculated with S. pyogenes and S. aureus. Nitrofurazone provides better granulation tissue formation, but did not effectively prevent bacterial colonization and infection in crush contaminated wounds.

Topics: Administration, Topical; Animals; Anti-Bacterial Agents; Male; Mupirocin; Nitrofurazone; Rats; Rats, Wistar; Staphylococcal Skin Infections; Treatment Outcome; Wound Infection; Wounds and Injuries

We report the largest documented healthcare-associated outbreak of Panton-Valentine leucocidin-positive meticillin-resistant Staphylococcus aureus (PVL(+) MRSA) in Europe. Six index patients from three long-term care facilities (LTCFs) were screened positive for PVL(+) MRSA in 2004 on admission to a community hospital in Germany. The purpose of this prospective study was to describe the prevalence of PVL(+) MRSA in the LTCFs before and after infection control interventions. Screening for MRSA with or without PVL was performed in all three LTCFs in 2004 [453 residents, 240 healthcare workers (HCWs)] and 2005 (440 residents, 192 HCWs). Swabs from anterior nares and wounds, if applicable, were collected. Colonised residents and staff were treated with mupirocin nasal ointment and topical antiseptics, and staff were provided with hygiene education. Total MRSA carrier rate of residents and HCWs in 2004 was 11.3% (PVL(+) MRSA 9.1%, PVL(-) MRSA 2.2%). There were comparable carrier rates between residents and HCWs in each LTCF. All PVL(+) MRSA isolates were of clonal origin (MLST 22) representing a novel spa sequence type t310. A decrease in total MRSA prevalence (from 11.3 to 5.5%) and PVL(+) MRSA (from 9.1 to 3.3%) was observed in 2005. The rate of PVL(-) MRSA remained unaffected. No symptomatic skin infections were noted among residents or HCWs. In this outbreak incomplete control of PVL(+) MRSA presumably resulted from difficult and delayed detection and decolonisation of carriers, incomplete compliance with control measures and lack of enforcement by public health authorities.

Topics: Administration, Intranasal; Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Toxins; Carrier State; Cross Infection; Disease Outbreaks; Exotoxins; Female; Germany; Guideline Adherence; Health Personnel; Humans; Infection Control; Leukocidins; Male; Methicillin Resistance; Middle Aged; Mupirocin; Nose; Patients; Staphylococcal Infections; Staphylococcus aureus; Wounds and Injuries