Annals of Clinical Microbiology and Antimicrobials - Latest Comments

Nature is better than...Doctors

pietro aragona — 2012-05-11T10:34:26Z

Could we use Lucilia cuprina to eat G-bactera or yeasts like Candida on diabetic wounds,for example,on feet's fingers to avoid cutting? Do you know if there is a team studing this problem? Could we work better with veterinaries to understand if animals "use" maggots to repair their wounds? Several years ago,when I worked in a general laboratory and microbiology, I remember we found eggs of cowflies on feet's fingers wounds of a neurological rested man and we thougt:" what a durty way to manage this man had the family" but, on the contrary, could be a natural way to solve the problem, of course, changig the fly!Thank you for your attention. MD P.A.

2 correction for small Errors in Table 1

Mohamed Hamid — 2011-07-19T11:03:38Z

B.5.1
Table 1. Raw 1: 1, 2, 3, 4, 5, 6, 6, 8, etc
Should be: 1, 2, 3, 4, 5, 6, 7, 8, etc

Raw 1: Resistance to antimicrobial agents (¿g ml-1):
Shoul be: Antimicrobial agents (¿g ml-1):

Email adress changed

Mohamed O Ahmed — 2011-07-19T11:02:44Z

The E-mail adress of the corresponding author has changed to a.mo@live.com

Daptomycin resistant Staphylococcus epidermidis: an emerging threat?

Metaxia Papanikolaou — 2011-02-25T19:58:31Z

Daptomycin-resistant Staphylococcus epidermidis: an emerging threat?
M.N. Papanikolaou1, P. Drimousis1, M. Balla1, T. Papavasilopoulou1, J. Deves1, A. Xanthaki2, A. Tsirigga2, S.P. Karatzas1
Intensive Care Unit1 and Microbiology Department2
Hippokrateion General Hospital, Athens, Greece
We read with interest the case report by Dr. Duah, regarding the activity of daptomycin against Staph epidermidis causing native-valve endocarditis [1]. As Dr Duah points out, daptomycin seems to be a promising alternative, if vancomycin has failed to control the infection.
Although resistance of several gram positive cocci to daptomycin, like enterococcus and Staphylococcus aureus, is unfortunately established [2,3,4], there was not such evidence concerning Stapylococcus epidermidis until recently. Two such cases of critically ill patients were registered in our ICU .
Patient #1. A 87 year old man, who had undergone a colectomy for colon cancer, was admitted in the ICU, after being reoperated due to an anastomosic rupture. The patient was in septic shock. Blood and trauma cultures were obtained and daptomycin was prescribed empirically on postoperative day 3. The next day, daptomycin resistant Staph epidermidis (MIC= 8 μg/mL) was isolated from the trauma exudate. Daptomycin was discontinued and replaced by tigegycline. The patient did well and was extubated 3 days later.
Patient #2. A 19 year old woman was admitted in the ICU on Feb 5th 2010, after an incident of ventricular fibrillation due to cardiomyopathy, resulting to hypoxemic encephalopathy. Due to her prolonged hospitalization, recurrent catheter- related blood stream infections by Gram-positive pathogens, mainly Staph epidermidis, have been recorded. Among other antimicrobials, she was given daptomycin at least 5 times during her 11 month-stay. Daptomycin resistant Staph epidermidis (MIC= 3 μg/mL) was isolated from a blood culture, obtained on Jan 18th, after ten days administration of this particular drug. Daptomycin was discontinued, but the patient had clinically improved.
The MIC of ≥ 3.0 μg/mL is three dilutions above the proposed breakpoint for non-susceptible of 1.0 μg/mL (E-test methodology, AB BIODISK) and clearly above the MIC at which the 90% isolates tested are inhibited of 0.5 μg/mL for MRSA found in prior studies [3]. It is surprising, that for patient #1, resistance developed while on therapy with daptomycin for the first time, and only 2 days after its initiation. Daptomycin resistance of MRSA and Enterococcus has been noted since 2005 [2,3,4]. Resistance of Staph epidermidis to daptomycin has not been reported to our knowledge, though linezolid resistant Staphylococcus epidermidis has been susceptible for a recent endemic outbreak in two Spanish ICUs [5,6] .
The emergence of daptomycin resistant Staph epidermidis, and particularly during the last month, is a rather alarming situation, narrowing therapeutic options for coagulase negative Staph epidermidis. Prolonged and repeated exposure to the drug is certainly a leading cause of resistance emergence. Routine testing for daptomycin susceptibility is not a current strategy. Disk diffusion method is not recommended and an E-test must be used alternatevily. However, daptomycin susceptibility testing may be considered for gram positive cocci infections in high risk critically ill patients.

1. Duah M. : Daptomycin for methicillin-resistant Staphylococcus epidermidis native-valve endocarditis: a case report. Annals of Clinical Microbiology and Antimicrobials 2010, 9:9
2. Sabol K, Lewis JS, Owens A, Cadena J, Jorgensen JH: Emergence of Daptomycin Resistance in Enterococcus faecium during Daptomycin Therapy. Antimicrobial agents and Chemotherapy. Apr 2005, 1664-5
3. Skiest D: Treatment Failure Resulting from Resistance of Stahylococcus aureus to Daptomycin. Journal of Clinical Microbiology, Feb 2006, 655-6.
4. Hayden MK, Rezai K, Hayes RA, Lolans K, Quinn JP, Weinstein RA: Development of Daptomycin Resistance In Vibo in Methicillin –Resistant Staphylococcus Aureus. Journal of Clinical Microbiology, Oct 2005, 5285-7.
5. Trevino M, Martinez- Lamas L, Romero- Jung PA, Giraldez JM, Alvarez- Escudero J, Regueiro BJ: Endemic linezolid –resistant Staphylococcus epidermidis in a critical care unit. Eur J Clin Microbiol Infect Dis, 2009 May; 28(5):527-33
6. Seral C, Saenz Y, Algarate S, Duran E, Luque P, Torres C, Castillo FJ: Nososcomial outbreak of methicillin- and linezolid- resistant Staphylococcus epidermidis associated with catheter-related infections in intensive care unit patients. Int J Med Microbiol. 2011 Jan 12 [Epub ahead of print]

Author's corrections and clarifications

Niyaz Ahmed — 2008-02-04T15:04:48Z

This review article is followup of a previous review (Carroll IM, Khan AA and Ahmed N. Infect Genet Evol. 2004, 4:81-90) from us/our collaborators and therefore, should be taken as an update. We missed citing the reference inadvertently, which is now being incorporated as an erratum along with some minor changes that we missed by oversight at the time of final submission. This version indeed entails a fair use of the previous topics, with an intention to bring a derivative update which is publicly accessible, with some value addition. As H. pylori infection is a topic of wider public interest we reproduced much of the previous discussion with an intention to benefit wider audience, especially the patients and the students and those living in developing countries who can not purchase a non-open access article.

The corrected abstract of the article may please be read as follows:

Abstract:

The human gastric pathogen Helicobacter pylori is linked to chronic gastritis, peptic ulcer disease, gastric carcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma. It infects over 50% of the worlds' population, however, only a small subset of infected people experience the diseases mentioned above. Associations of the virulence factors to the outcome of infection remain enigmatic years after the genome sequences were deciphered. Infection with strains of Helicobacter pylori that carry the cytotoxin-associated antigen A (cagA) gene is associated with gastric carcinoma. Recent studies revealed mechanisms through which the cagA protein triggers oncopathogenic activities. Other candidate genes such as some members of the so-called plasticity region cluster are also implicated to be associated with carcinoma of stomach. Study of the evolution of polymorphisms and sequence variation in H. pylori populations on a global basis has provided a window into the history of human population migration and co-evolution of this pathogen with its host. Possible symbiotic relationships were debated since the discovery of this pathogen. However, this debate has been further intensified as some studies reveal that H. pylori infection may be beneficial in some humans in some particular geographical/clinical settings. This assumption is based on increased incidence of gastro-oesophageal reflux disease (GERD), Barrett's oesophagus and adenocarcinoma of the oesophagus following H. pylori eradication in some countries. The contribution of comparative genomics to our understanding of the genome plasticity and diversity of H. pylori and its pathophysiological importance to human healthcare is discussed. This review is written with a fair interest to reproduce through open access channel a follow up and update of our previous detailed discussions on the subject (Carroll IM, Khan AA and Ahmed N. Infect Genet Evol. 2004, 4:81-90).

We apologise for any confusion.

Niyaz Ahmed, Leonardo Sechi

Erratum: Ertapenem Susceptibility of Extended Spectrum Beta-lactamase Producing Organisms

Rupal Mody — 2007-11-18T07:50:31Z

To the editor-

An error was made in reporting the ertapenem MIC for the E.coli and K.pneumoniae isolates as posted in our original article published Jun 6, 2007 (ACMA 2007, 6:6). We recorded the mean and range of the MIC, however in reporting the mean we neglected to take into account the fact that the MIC is not linear, but instead exponential in nature. This issue is addressed by reporting the MIC 50/90 (ie the median and 90th percentile for the MICs in which the MICs of organisms are 50% and 90% below these values). The MIC 50/90 for the E.coli isolates (range 0.006-0.5 ug/ml) is 0.032/0.125 ug/ml. The MIC 50/90 for the K.pneumoniae isolates (range 0.006-2 ug/ml) is 0.047/0.19 ug/ml. Since the MIC 90 is below the critical breakpoint, the organisms are still considered susceptible to ertapenem as was asserted in our original article.

We thank the astute comments made by Dr.Leonard Mada (CJAS Timis, Romanian National Health Insurance, Timis County) which led to this erratum.

Rupal M. Mody, MD

Daniel P. Erwin

Kimberly A. Moran, MD

Contradiction to the author's conclution

Kirsten Lyche Baastad — 2007-08-08T18:26:50Z

The author’s conclusion has to be contradicted. The contamination was made possible because of the failed preservation. The only way to ensure microbiological quality of sealed containers with water solution is to preserve the solution, particularly when sterilization or aseptic preparation are not applicable as is the case for this product. More extensive general hygiene, as the producer was imposed, would not solve the problem. Microorganisms are ubiquitous.

At the starting point, the Dent-O-Sept solution had excellent anti-microbial properties, as showed by the authors. That is in contradiction of the fact that the swabs were contaminated. The preservation properties in the finished preparation must have been more or less lost during storage. Proportionally it was a small amount of moisturizing liquid in the containers compared to the amount of swab brush in the product. Inhibition of the preserving agent could occur by absorption, chemical reaction, pH-change etc. The preserving agent, benzoic acid, is only active in solutions with pH below 4,5. Maybe for instance the glue over time would raise the pH in the solution and as a consequence inactivate the preserving agent.

The producer of the Dent-O-Sept swab was instructed to meet the requirements of ‘Medical device Class 1, which includes most non-invasive medical devices according to the European Council Directive 93/42/EEC’. However, this directive is not applicable to containers with water solutions. For such products, quality should be provided by application of the principles established in The European Pharmacopoeia (or USP) and guidelines for production e.g. the EU Guidelines for Good Manufacturing Practice (GMP).

Your paper regarding P. falciparum

Javid Ahmad — 2006-09-15T18:19:51Z

Your paper is having a valuable information in the related field. I hope in our country where malaria is sometimes taking epidemic state, your study and clinical experience will help in dealing with such a big health problem over here.

Invasive pulmanary aspergillosis and acute leukemia

Ridvan Ali — 2006-09-15T18:19:29Z

The case report of Ridvan Ali and colleagues is well described and has educational value. Also it is important in the management of leukemia cases, and it will have contributions to literature.

Correction to Table 3

Nteimam Jonathan — 2006-07-27T10:47:11Z

Table 3 NPA 5months - 5years (n = 27). Cell culture sensitivity 2/4(50), not 4/4(50).