Evaluation and use of a rapid Staphylococcus aureus assay by an antimicrobial stewardship program.

Purpose: The performance of a rapid test for methicillin-resistant Staphylococcus aureus (MRSA) in a large community hospital was investigated.

Methods: A prospective observational study was conducted to evaluate an immunochromatographic assay (Alere PBP2a Culture Colony Test, Alere Scarborough, Inc.) for rapid differentiation of MRSA and methicillin-susceptible S.

Evaluation of the BinaxNOW Staphylococcus aureus test for rapid identification of Gram-positive cocci from VersaTREK blood culture bottles.

The ability of the rapid BinaxNOW Staphylococcus aureus (BNSA) immunochromatographic test (Alere Scarborough, Inc., ME) to accurately differentiate S. aureus from coagulase-negative staphylococci (CoNS) and other Gram-positive cocci (GPC) directly from VersaTREK blood culture bottles was evaluated.

Identification and characterization of plasmid-borne erm(T) macrolide resistance in group B and group A Streptococcus.

One hundred and seven group B Streptococcus (GBS) isolates and 344 group A Streptococcus (GAS) isolates were collected between 2005 and 2009 from 2 area hospitals and studied for resistance to erythromycin (ERY) and clindamycin (CLI) and the presence of the erm(T) macrolide resistance gene. The erm(T) gene was found in 5 (8%) of 61 erythromycin nonsusceptible GBS isolates and in 22 (55%) of 40 erythromycin nonsusceptible GAS isolates. The erm(T) gene in all 27 GBS/GAS erm(T) gene-positive isolates was located on a plasmid.

Susceptibility of gram-negative pathogens isolated from patients with complicated intra-abdominal infections in the United States, 2007-2008: results of the Study for Monitoring Antimicrobial Resistance Trends (SMART).

During 2007-2008, 1,036 gram-negative bacilli were isolated from patients with complicated intra-abdominal infections in the United States. Against members of the family Enterobacteriaceae, the most active agents in vitro were ertapenem, imipenem, and amikacin, while the least active agent was ampicillin-sulbactam. Ertapenem and imipenem were active against all extended-spectrum-beta-lactamase (ESBL)-positive Escherichia coli.

Alternative use for spectra MRSA chromogenic agar in detection of methicillin-resistant Staphylococcus aureus from positive blood cultures.

Spectra MRSA agar (Remel, Lenexa, KS), a novel chromogenic medium originally developed to detect methicillin-resistant Staphylococcus aureus (MRSA) from nasal swabs, was evaluated in this multicenter study for the detection of MRSA from positive blood cultures exhibiting Gram-positive cocci upon initial Gram staining.

Novel FKS mutations associated with echinocandin resistance in Candida species.

We studied three clinical isolates of Candida spp. (one C. tropicalis isolate and two C.

First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY Antimicrobial Surveillance Program.

Two strains of Raoultella planticola and one of Raoultella ornithinolytica showing carbapenem resistance were recovered from patients hospitalized in New Jersey and Ohio. All patients had received previous antimicrobial treatment, including carbapenems. These strains harbored bla(KPC-2) and bla(KPC-3).

First report of cfr-mediated resistance to linezolid in human staphylococcal clinical isolates recovered in the United States.

Linezolid resistance has dominantly been mediated by mutations in 23S rRNA or ribosomal protein L4 genes. Recently, cfr has demonstrated the ability to produce a phenotype of resistance to not only oxazolidinones, but also other antimicrobial classes (phenicols, lincosamides, pleuromutilins, and streptogramin A). We describe the first detection of cfr-mediated linezolid resistance in Staphylococcus aureus and Staphylococcus epidermidis recovered from human infection cases monitored during the 2007 LEADER Program.

Prevalence of the erm(T) gene in clinical isolates of erythromycin-resistant group D Streptococcus and Enterococcus.

Among 48 erythromycin-resistant group D streptococci (GDS), 36 had the erm(T) resistance gene. erm(T) was also found in 4 of 31 erythromycin-resistant Enterococcus faecium isolates. This is the first report of the erm(T) gene in U.

Emergence of resistant Acinetobacter baumannii in critically ill patients within an acute care teaching hospital and a long-term acute care hospital.

Background: Acinetobacter baumannii is a gram-negative, coccobacillus found in water and is a significant nosocomial pathogen in hospitals. This report chronicles the appearance in June 2003 of a multidrug-resistant A baumannii (MDR-AB) strain, its dissemination, and interventions used to control it in an acute care hospital (ACH) and long-term acute care facility (LTAC).

Methods: Molecular typing using pulsed-field gel electrophoresis (PFGE) showed that 88 of 99 strains (89%) gave an identical banding designated as clone A.

Regional variations in multidrug resistance among Enterobacteriaceae in the USA and comparative activity of tigecycline, a new glycylcycline antimicrobial.

We report here on the activity of tigecycline and comparators against multidrug-resistant (resistant to >or=3 antimicrobial classes; MDR) Enterobacteriaceae from the USA collected between January 2004 and January 2006 as part of the Tigecycline Evaluation and Surveillance Trial (TEST). Nationally, 131 (5.9%) Escherichia coli, 174 (10.

Identification of an erm(T) gene in strains of inducibly clindamycin-resistant group B Streptococcus.

Five inducibly clindamycin (CLI)-resistant group B Streptococcus (GBS) isolates, all negative for erm(A) and erm(B) genes, were found to contain erm(T), a gene previously reported in erythromycin-resistant animal isolates of Lactobacillus spp. and human isolates of Streptococcus bovis. One additional GBS isolate, constitutively resistant to CLI, was also positive for the erm(T) gene in addition to erm(B).

Rise of Streptococcus pneumoniae isolates containing both erm(B) and mef(E) genes from an adult tertiary care community hospital system.

The emergence of macrolide- and lincosamide-resistant Streptococcus pneumoniae is a worldwide concern. Of particular interest is the increasing prevalence of erythromycin and clindamycin-resistant isolates containing both erm(B) and mef genes. This study determined the prevalence of erythromycin and clindamycin resistance in 596 clinical S.

High rates of erythromycin and clindamycin resistance among OBGYN isolates of group B Streptococcus.

In vitro susceptibility testing on 200 Streptococcus agalactiae strains isolated during a 4-year period from vaginal/rectal specimens demonstrated a very high resistance rate for both erythromycin (54%) and clindamycin (33%). Methylase genes erm(B) and erm(TR) and efflux genes mef(E) and mef(A) were detected. Pulsed-field gel electrophoresis showed evidence of both clonal spread and multiclonal dissemination of resistant strains.

Emergence of levofloxacin-resistant pneumococci in immunocompromised adults after therapy for community-acquired pneumonia.

We describe 4 patients infected with levofloxacin-resistant pneumococci after therapy for community-acquired pneumonia (CAP). The 4 patients had 15 episodes of CAP; Streptococcus pneumoniae was isolated from blood or sputum samples obtained during 14 of the episodes. The underlying medical condition was Bruton agammaglobulinemia in 3 patients and chronic lymphoid leukemia in the other.

In vitro analysis of antifungal impregnated polymethylmethacrylate bone cement.

Fungal infection is a rare but devastating complication of total joint arthroplasty. Many patients require removal of the components and resection arthroplasty for cure; however, revision arthroplasty with medicated polymethylmethacrylate bone cement may be used to salvage the joint. Some studies have documented the efficacy of mixing antibiotics with polymethylmethacrylate, but the efficacy of antifungal drugs when mixed with polymethylmethacrylate is unknown.