Methicillin resistant Staphylococcal aureus (MRSA) enterocolitis is characterized by high fever, abdominal distension, and watery diarrhea that leads to severe dehydration, shock, a sharp decrease in the white cell counts and sometimes multiple organ failure. Clinically, it can be an another cause of nosocomial diarrhea. If MRSA enteritis is suspected from the clinical symptoms, prompt treatment and strict prophylactic measures including vancomycin, are most important for its management. We recently observed a case of MRSA enterocolitis as a nosocomial infection in a patient with acute pancreatitis. This patient showed uncontrolled massive diarrhea, fever, and multiple organ failure. We report a case of MRSA enterocolitis with a review of literatures.
Cross Infection/diagnosis/*microbiology ; Diarrhea/etiology/*microbiology ; Enterocolitis/complications/diagnosis/*microbiology ; Humans ; Male ; *Methicillin Resistance ; Middle Aged ; *Staphylococcal Infections/diagnosis

OBJECTIVETo study the proteomic change in lymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion.

METHODSTwenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 degrees C), rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0 x 10(8) CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its extracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy.

RESULTSAbout 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 proteins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate kinase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously.

CONCLUSIONSThere is obvious proteomic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.

Animals ; Burns ; metabolism ; microbiology ; Lymphocytes ; metabolism ; Male ; Proteome ; Rabbits ; Staphylococcal Infections ; etiology ; metabolism

Panton-Valentine leukocidin (PVL)-positive USA300 clone has been the most successful community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone spreading in North America. In contrast, PVL-negative ST72-CA-MRSA has been predominant in Korea, and there has been no report of infections by the USA300 strain except only one case report of perianal infection. Here, we describe the first case of pneumonia caused by the USA300 strain following pandemic influenza A (H1N1) in Korea. A 50-year-old man was admitted with fever and cough and chest radiograph showed pneumonic consolidation at the right lower lung zone. He received a ventilator support because of respiratory failure. PCR for pandemic influenza A (H1N1) in nasopharyngeal swab was positive, and culture of sputum and endotracheal aspirate grew MRSA. Typing of the isolate revealed that it was PVL-positive, ST 8-MRSA-SCCmec type IV. The analysis of the PFGE patterns showed that this isolate was the same pulsotype as the USA300 strain.
Community-Acquired Infections/*etiology/microbiology ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human/*complications ; Male ; *Methicillin-Resistant Staphylococcus aureus/classification/isolation & purification ; Middle Aged ; Pneumonia, Staphylococcal/*etiology/microbiology ; Republic of Korea ; Staphylococcal Infections/*etiology/microbiology

Child ; Community-Acquired Infections ; complications ; microbiology ; Epidural Abscess ; diagnostic imaging ; etiology ; microbiology ; Female ; Humans ; Magnetic Resonance Imaging ; Methicillin-Resistant Staphylococcus aureus ; pathogenicity ; Staphylococcal Infections ; complications ; microbiology

Necrotizing fasciitis (NF) is a deep infection of the subcutaneous tissue that progressively destroys fascia and fat; it is associated with systemic toxicity, a fulminant course, and high mortality. NF most frequently develops from trauma that compromises skin integrity, and is more common in patients with predisposing medical conditions such as diabetes mellitus, atherosclerosis, alcoholism, renal disease, liver disease, immunosuppression, malignancy, or corticosteroid use. Most often, NF is caused by polymicrobial pathogens including aerobic and anaerobic bacteria. NF caused by Staphylococcus aureus as a single pathogen, however, is rare. Here we report a case of NF that developed in a healthy woman after an isolated shoulder sprain that occurred without breaking a skin barrier, and was caused by Staphylococcus aureus as a single pathogen.
*Arm ; Coagulase/metabolism ; Fasciitis, Necrotizing/*etiology/microbiology/pathology/surgery ; Female ; Humans ; Middle Aged ; Shoulder Joint/*injuries ; Sprains and Strains/*complications ; Staphylococcal Infections/*etiology/microbiology ; Staphylococcus aureus/enzymology/isolation & purification

OBJECTIVE: To study the risk factors and interaction of nasal septal perforation (NSP) in rats. METHOD: Animals (n=120) that underwent unilateral nasal obstruction using Merocel nasal packing or gelfoam with/without standard staphylococcus aureus inoculation were observed for the formation of NSP at 2, 3, 5, and 7 days after operation by endoscope system. Following sacrifice at 7 days, the obtained nasal secretions were prepared for bacterial culture. Experimental interventions were compared with normal controls (n=10). RESULT: Perforation of nasal septum was observed in 80% of the animals accepted nasal obstruction using Merocel nasal packing with standard staphylococcus aureus inoculation in 3 days (P < 0.01), while in 70% of those using abacterial Merocel nasal packing in 5 days (P < 0.05) and no significant difference than that of before (P > 0.05). There was a weak region in anteroinferior nasal septum in rats, which the almost NSPs located in. The position of NSP does not overlap Merocel. CONCLUSION The interaction of risk factors contributes to NSP. The occurrence of NSP mainly depends on the construction of nasal septum, while dysaemia is also necessary. Obstruction of nasal drainage and infection promote the development of NSP.
Animals ; Causality ; Disease Models, Animal ; Male ; Nasal Obstruction ; microbiology ; pathology ; Nasal Septal Perforation ; etiology ; Nasal Septum ; anatomy & histology ; Rats ; Rats, Sprague-Dawley ; Risk Factors ; Staphylococcal Infections ; pathology

No abstract available.
Adult ; Embolism/*complications/diagnosis/microbiology ; Eye Infections, Bacterial/*complications/diagnosis/microbiology ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Macula Lutea/drug effects/*pathology ; Male ; Retinal Perforations/diagnosis/*etiology ; Sepsis/*complications/diagnosis ; Staphylococcal Infections/*complications/diagnosis ; Staphylococcus aureus/isolation & purification

OBJECTIVE: To analyze the factors and biological characteristics of infection after cochlear implantation so as to control the risk factors and improve the treatment of postoperative infection. METHOD: A retrospective study was conducted to analyze the clinical data of 316 patients receiving cochlear implantation from July 2001 to October 2011. RESULT: Postoperative infection was found in five of the 316 cases and one transferred case. The six cases recovered after clinical therapy without explantation. One case underwent explantation due to recurrent meningitis after implantation of 8 years later. CONCLUSION The pathogens of infection after cochlear implantation are staphylococcus aureus, pseudomonas aeruginosa, etc. The key infectious factor is the formation of bacterial biofilm, which can be removal by chemical agents to control the postoperative infection, especially the flap infection. It is not necessary to remove the artificial cochlea when the postoperative infection occurs. Positive perioperative interventions and postoperative infection control can improve the outcome of cochlear implantation.
Adolescent ; Aged ; Biofilms ; growth & development ; Cochlea ; Cochlear Implantation ; adverse effects ; Humans ; Postoperative Complications ; microbiology ; Pseudomonas Infections ; etiology ; Pseudomonas aeruginosa ; physiology ; Retrospective Studies ; Risk Factors ; Staphylococcal Infections ; etiology ; Staphylococcus aureus ; physiology

OBJECTIVE: To investigate the risk factors of methicillin-resistant Staphylococcus aureus(MRSA) enterocolitis after gastrointestinal surgery. METHODS: Clinical and pathological data of 17 cases with MRSA enteritis after gastrointestinal surgery from March 2015 to March 2017 at Department of General Surgery of Affiliated Drum Tower Hospital were retrospectively analyzed. INCLUSION CRITERIA: (1) age of 18 to 80 years;(2) with history of gastrointestinal surgery; (3) diarrhea symptoms within 7 days after gastrointestinal surgery; (4) use of antibiotics before diarrhea; (5) fecal smear showing a large number of gram positive cocci; (6) fecal culture suggested the presence of MRSA; (7) application of antibiotic therapy against MRSA was effective. EXCLUSION CRITERIA: (1)clostridium difficile toxin positive; (2) toxic shock syndrome caused by food poisoning. According to gender, age, and inpatient ward, 1:2 pairing was performed, and 34 patients with non-MRSA enteritis from the hospitalized cases in the same ward were selected as the control group for retrospective case-control study. There were no significant differences in the gender, age, and constitution index between two groups (all P>0.05), indicating that the two groups were comparable. The χ² test was used to perform univariate analysis on 11 factors, including the nature of the primary disease, colorectal surgery, emergency surgery, use of multiple antibiotics, preoperative bowel preparation, perioperative hormone, intraoperative intraperitoneal chemotherapy, perioperative nasogastric tube, diabetes history, intensive care unit stay, and previous infectious disease hospitalization, and then multivariate logistic regression analysis was performed. RESULTS: MRSA enteritis occurred 3 to 5 days after surgery in all the 17 cases, and 4 cases developed septic shock rapidly. Univariate analysis showed that the operation site (colorectal surgery) (χ²=4.747, P=0.029) and use of two antibiotics before MRSA enteritis (χ²=3.959, P=0.047) were associated with MRSA enteritis after gastrointestinal surgery. Multivariate logistic regression analysis revealed that colorectal surgery was the only independent risk factor for MRSA enteritis after gastrointestinal surgery(OR=5.526, 95%CI: 1.350-22.602,P=0.017), while the use of two antibiotics was not (OR=0.204, 95%CI:0.051-0.819, P=0.025). CONCLUSIONS MRSA enteritis has a rapid onset, and a high incidence of septic shock, which requires immediate attention. Colorectal surgery is an independent risk factor for MRSA enteritis.
Anti-Bacterial Agents ; Case-Control Studies ; Colorectal Surgery ; adverse effects ; Digestive System Surgical Procedures ; adverse effects ; Enterocolitis ; etiology ; microbiology ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Risk Factors ; Staphylococcal Infections ; etiology

BACKGROUNDGram-positive bacteria such as Staphylococcus aureus have been a common cause of infection among liver transplant (LT) recipients in recent decades. The understanding of local epidemiology and its evolving trends with regard to pathogenic spectra and antibiotic susceptibility is beneficial to prophylactic and empiric treatment for LT recipients. This study aimed to investigate etiology, timing, antibiotic susceptibility and risk factors for multidrug resistant (MDR) Gram-positive coccal bacteremia after LT.

METHODSA cohort analysis of prospectively recorded data was performed to investigate etiologies, timing, antibiotic susceptibility and risk factors for MDR Gram-positive coccal bacteremia in 475 LT recipients.

RESULTSIn 475 LT recipients in the first six months after LT, there were a total of 98 episodes of bacteremia caused by Gram-positive cocci in 82 (17%) patients. Seventy-five (77%) bacteremic episodes occurred in the first post-LT month. The most frequent Gram-positive cocci were methicillin-resistant coagulase-negative staphylococcus (CoNS, 46 isolates), methicillin-resistant Staphylococcus aureus (MRSA, 13) and enterococcus (34, E. faecium 30, E. faecalis 4). In all Gram-positive bacteremic isolates, 59 of 98 (60%) were MDR. Gram-positive coccal bacteremia and MDR Gram-positive coccal bacteremia predominantly occurred in patients with acute severe exacerbation of chronic hepatitis B and with fulminant/subfulminant hepatitis. Four independent risk factors for development of bacteremia caused by MDR Gram-positive coccus were: LT candidates with encephalopathy grades II - IV (P = 0.013, OR: 16.253, 95%CI: 1.822 - 144.995), pre-LT use of empirical antibiotics (P = 0.018, OR: 1.029, 95%CI: 1.002 - 1.057), post-LT urinary tract infections (P < 0.001, OR: 20.340, 95%CI: 4.135 - 100.048) and abdominal infection (P = 0.004, OR: 2.820, 95%CI: 1.122 - 10.114). The main infectious manifestations were coinfections due to gram-positive cocci and gram-negative bacilli.

CONCLUSIONSMethicillin-resistant CoNS and enterococci are predominant pathogens among LT recipients with Gram-positive coccal bacteremia. Occurrences of Gram-positive coccal bacteremia may be associated with the severity of illness in the perioperative stage.

Anti-Bacterial Agents ; pharmacology ; Bacteremia ; etiology ; microbiology ; Coagulase ; metabolism ; Drug Resistance, Multiple, Bacterial ; Enterococcus ; drug effects ; enzymology ; physiology ; Gram-Positive Bacterial Infections ; enzymology ; microbiology ; transmission ; Humans ; Liver Diseases ; microbiology ; Liver Transplantation ; adverse effects ; Risk Factors ; Staphylococcal Infections ; enzymology ; microbiology ; transmission ; Staphylococcus ; drug effects ; enzymology ; physiology