Přehledový článek interpretuje doporučení pro léčbu stafylokokových infekcí (MRSA) vankomycinem. Základem se stal Konsensus 2009, na který navazuje řada preklinických a klinických studií až do současnosti. Vycházejí z definování prediktorů baktericidní účinnosti vankomycinu, které se liší od antibiotik betalaktamových a aminoglykosidových. Prediktorem účinnosti je vztah AUC0-24/MIC > 400 a Cmin. Praxe vyžaduje doporučení, jak dosáhnout optimální účinnosti a bezpečnosti vankomycinu podaného infuzí intermitentní versus infuze kontinuální nastavením cílových koncentrací v dynamicky se měnících podmínkách. Změny kinetiky a dynamiky antibiotika vlivem patologických kovatriát (SIRS, sepse) i léčby je třeba včas zachytit terapeutickým monitorováním směřujícím k individuální úpravě dávkování.

The review article interprets recommendations for treating methicillin-resistant Staphylococcus aureus (MRSA) infections with vancomycin. These stem from a 2009 consensus followed by numerous preclinical and clinical studies carried out until now. They are based on defining the predictors of the bactericidal activity of vancomycin that are different from those in beta-lactam and aminoglycoside antibiotics. The predictors are AUC0-24/MIC > 400 and Cmin. Practice requires recommendations on how to achieve maximum effectiveness and safety of vancomycin administered by intermittent vs. continuous infusion by attaining target concentrations under dynamically changing conditions. Changes in the kinetics and dynamics of the antibiotic due to pathological covariates (SIRS, sepsis) and treatment should be detected as soon as possible by therapeutic monitoring aimed at individual adjustment of dosage.

• MeSH
• konsensus MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• monitorování léčiv metody   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• stafylokokové infekce * farmakoterapie   MeSH
• vankomycin * aplikace a dávkování   farmakokinetika   farmakologie   krev   škodlivé účinky   toxicita   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• způsoby aplikace léků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Cíl: Ukázat spektrum nemocí, které vyvolávají meticilin-rezistentní kmeny Staphylococcus aureus (MRSA). Posoudit účinnost postupů, které mohou vést k vyléčení infekce MRSA, případně k eradikaci kolonizace. Metody. Klinická studie sledující průběh infekce či kolonizace MRSA u pacientů hospitalizovaných na infekční klinice FN Na Bulovce v době 1.1. 2004-31. 8. 2005. Do studie jsou zahrnuty i výsledky ambulantního sledování těchto pacientů. Výsledky. Do studie bylo zařazeno 59 pacientů; v 22 případech se jednalo o infekci a v 37 případech o kolonizaci MRSA. U 14 pacientů byla zjištěna kolonizace v několika anatomických lokalitách současně, u 15 pacientů byla kromě infekce MRSA zjištěna ještě kolonizace v jiné lokalizaci. Z infekcí byly nejčastější infekce měkkých tkání (Ux), nejčastějším místem kolonizace byla nosní sliznice (14x) a kožní defekty (8x). V léčbě lehkých infekcí se dobře osvědčil kotrimoxazol, v léčbě nazální kolonizace mupirocin ve formě masti (Bactroban ung). Při šestiměsíčním ambulantním sledování 25 MRSA-pozitivních pacientů jsme zjistili vymizení kmene MRSA u 7 osob (28 %). Závěr. U významné části MRSA-pozitivních pacientů dochází po léčbě nebo i spontánně k vymizení kmene MRSA. Vývoj kolonizace MRSA je možné sledovat pomocí ambulantní dispenzarizace.

Purpose: To present the range of diseases produced by a methicilhn-resistant strain of Staphylococcus aureus (MRSA). To assess the efficacy of procedures likely to cure MRSA infections and possibly to eradicate colonization. Methods: Clinical trial studying the course of MRSA infections or colonization of in-patients, treated at the Department of Infectious Diseases of the Teaching Hospital Na Bulovce e, Prague, between 1 January 2004 and 31 August 2005. The trial also took into account the results of these patients' follow-up as out-patients. Results: Included in the trial were 59 patients - 22 presenting MRSA infections and 37 MRSA colonization. In 14 patients we found simultaneous colonization in several anatomical sites, while in 15 patients we saw, in addition to the MRSA infection, colonization at another site. .Among the infections most frequent were infections of soft tissues (11), while colonization occured chiefly in the nasal mucosa (14) and in skin defects (8). In the treatment of mild infections we had good results with co-trimoxazole, in the treatment of coIonizations mupirocine in the form of ointment (Bactroban ung.). During a six-month follow-up of 25 MRSA-positive patients at our Out-patient Dpt. we saw the disappearance of the MRSA strain in 7 subjects (28 %). Conclusion: In a significant proportion of MRSA-positive patients the MRSA strain disappears either after treatment or spontaneously. The development of MRSA colonization may be studied in out-patient follow-ups.

• MeSH
• antibakteriální látky MeSH
• chloramfenikol terapeutické užití   MeSH
• kombinace léků trimethoprim a sulfamethoxazol terapeutické užití   MeSH
• lidé MeSH
• mupirocin terapeutické užití   MeSH
• prospektivní studie MeSH
• rezistence na methicilin MeSH
• Staphylococcus aureus patogenita   účinky léků   MeSH
• vankomycin terapeutické užití   MeSH
• Check Tag
• lidé MeSH

• Klíčová slova
• aktivní surveiliance, VRE kolonizace,
• MeSH
• bakteriální léková rezistence MeSH
• bakteriologické techniky využití   MeSH
• Enterococcus faecium * izolace a purifikace   patogenita   účinky léků   MeSH
• hematologické nádory * komplikace   mikrobiologie   MeSH
• infekce spojené se zdravotní péčí * komplikace   mikrobiologie   prevence a kontrola   MeSH
• kontrola infekce metody   organizace a řízení   MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * genetika   patogenita   účinky léků   MeSH
• rezistence na vankomycin * MeSH
• Check Tag
• lidé MeSH

PURPOSE OF THE STUDY Septic arthritis is an infection of joints caused by a pathogenic microorganism. Septic arthritis has a mortality rate of 11-40% when it's not treated properly. The mortality rate with methicillin-sensitive Staphylococcus aureus (MSSA)is 5-7%, while the rate with methicillin-resistant Staphylococcus aureus (MRSA)is 13-20%. The aim of this study is to evaluate the effects of intraarticular vancomycin and teicoplanin on joint cartilage in in vivo settings and its utility in routine MRSA treatment. MATERIALS AND METHODS In our study, 35 male Sprague-Dawley rats aged 28 days were used. Rats were obtained from the Regenerative and Restorative Medicine Research Center (REMER) of Istanbul Medipol University. Rats were randomly divided into 5 groups each containing 7 rats. Joint injections were administered with isoflurane analgesia every day at 6 am. Three rats (15 rats) from each group were sacrified in seventh day and evaluated immunohistologically to evaluate acute healing in articular cartilage. All remaining rats were sacrificed on day 28 and their knees were evaluated by immunohistochemical examination. RESULTS In our study, there were no complications in any rat during injection and the study period. Hematoxylin eosin (H & E) histological staining for evaluating cartilage healing and healing levels did not show statistically significant differences between the groups at first week (p > 0.05). Matrix metalloproteinase-13 (MMP-13) staining did not show any statistically significant difference between the groups. (p > 0.05). DISCUSSION MRSAseptic arthritis, diagnosed for the first time in 1960, has recently been responsible for 6-22% of all septic arthritis and is increasing day by day. The use of systemic vancomycin or teicoplanin is the first-line treatment method in MRSA septic arthritis. Serum levels reach the desired level, especially with intravenous infusion dose. On the other hand, it has been shown that intraarticular concentration does not reach a sufficient level in studies conducted. The use of intraarticular antibiotics during treatment can lead to more effective and early disease control by turning this negative situation into favor of the patient. As a result, intraarticular vancomycin and teicoplanin maximale tolerable and maintenance doses can be safely used beside surgery and intravenous antibiotics to increase efficacy of treatment, reduction of recurrence rates and reduction of mortality in MRSAseptic arthritis. CONCLUSIONS Intraarticular vancomycin and teicoplanin maximale tolerable and maintenance doses can be safely used beside surgery and intravenous antibiotics to increase efficacy of treatment, reduction of recurrence rates and reduction of mortality in MRSA septic arthritis. Key words:arthritis, infectious; methicillin-resistant Staphylococcus aureus; mortality.

• MeSH
• antibakteriální látky aplikace a dávkování   MeSH
• hojení ran účinky léků   MeSH
• infekční artritida farmakoterapie   patologie   MeSH
• injekce intraartikulární MeSH
• kloubní chrupavka účinky léků   patologie   MeSH
• krysa rodu rattus MeSH
• methicilin rezistentní Staphylococcus aureus izolace a purifikace   MeSH
• modely nemocí na zvířatech MeSH
• náhodné rozdělení MeSH
• potkani Sprague-Dawley MeSH
• stafylokokové infekce farmakoterapie   patologie   MeSH
• teikoplanin aplikace a dávkování   MeSH
• vankomycin aplikace a dávkování   MeSH
• zadní končetina účinky léků   mikrobiologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

• MeSH
• analýza nákladů a výnosů MeSH
• ekonomika farmaceutická MeSH
• financování organizované MeSH
• interpretace statistických dat MeSH
• klinické zkoušky jako téma MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus účinky léků   MeSH
• náklady a analýza nákladů MeSH
• oxazolidinony ekonomika   MeSH
• retrospektivní studie MeSH
• stafylokokové infekce ekonomika   farmakoterapie   MeSH
• statistika jako téma MeSH
• teikoplanin ekonomika   MeSH
• vankomycin ekonomika   MeSH
• Check Tag
• lidé MeSH

Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa are major causes of hospital-acquired infections and sepsis. Due to increasing antibiotic resistance, new treatments are needed. Mesenchymal stem cells (MSCs) have antimicrobial effects, which can be enhanced by preconditioning with antibiotics. This study investigated using antibiotics to strengthen MSCs against MRSA and P. aeruginosa. MSCs were preconditioned with linezolid, vancomycin, meropenem, or cephalosporin. Optimal antibiotic concentrations were determined by assessing MSC survival. Antimicrobial effects were measured by minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and antimicrobial peptide (AMP) gene expression. Optimal antibiotic concentrations for preconditioning MSCs without reducing viability were 1 μg/mL for linezolid, meropenem, and cephalosporin and 2 μg/mL for vancomycin. In MIC assays, MSCs preconditioned with linezolid, vancomycin, meropenem, or cephalosporin inhibited MRSA or P. aeruginosa growth at lower concentrations than non-preconditioned MSCs (p ≤ 0.001). In MBC assays, preconditioned MSCs showed enhanced bacterial clearance compared to non-preconditioned MSCs, especially when linezolid and vancomycin were used against MRSA (p ≤ 0.05). Preconditioned MSCs showed increased expression of genes encoding the antimicrobial peptide genes hepcidin and LL-37 compared to non-preconditioned MSCs. The highest hepcidin expression was seen with linezolid and vancomycin preconditioning (p ≤ 0.001). The highest LL-37 expression was with linezolid preconditioning (p ≤ 0.001). MSCs' preconditioning with linezolid, vancomycin, meropenem, or cephalosporin at optimal concentrations enhances their antimicrobial effects against MRSA and P. aeruginosa without compromising viability. This suggests preconditioned MSCs could be an effective adjuvant treatment for antibiotic-resistant infections. The mechanism may involve upregulation of AMP genes.

• MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• antimikrobiální peptidy MeSH
• cefalosporiny farmakologie   MeSH
• hepcidiny farmakologie   terapeutické užití   MeSH
• lidé MeSH
• linezolid farmakologie   terapeutické užití   MeSH
• meropenem farmakologie   terapeutické užití   MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• mezenchymální kmenové buňky * MeSH
• mikrobiální testy citlivosti MeSH
• Pseudomonas aeruginosa genetika   MeSH
• stafylokokové infekce * mikrobiologie   MeSH
• vankomycin MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

A series of twenty-one salicylanilide N-alkylcarbamates was assessed for novel antibacterial characteristics against three clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and S. aureus ATCC 29213 as the reference and quality control strain. The minimum inhibitory concentration was determined by the broth dilution micro-method with subsequent subcultivation of aliquots to assess minimum bactericidal concentration. The bactericidal kinetics was established by time-kill assay. Ampicillin, ciprofloxacin and vancomycin were used as reference antibacterial drugs. All the tested compounds exhibited highly potent anti-MRSA activity (⩽ 0.008-4 μg/mL) comparable or up to 250× higher than that of vancomycin, the standard in the treatment of serious MRSA infections. 4-Chloro-2-(3,4-dichlorophenylcarbamoyl)phenyl butylcarbamate and 4-chloro-2-(3,4-dichlorophenylcarbamoyl)phenyl ethylcarbamate were the most active compounds. In most cases, compounds provided reliable bacteriostatic activity, except for 4-chloro-2-(4-chlorophenylcarbamoyl)phenyl decylcarbamate exhibiting bactericidal effect at 8h (for clinical isolate of MRSA 63718) and at 24h (for clinical isolates of MRSA SA 630 and MRSA SA 3202) at 4× MIC. Structure-activity relationships are discussed.

• MeSH
• antibakteriální látky farmakologie   MeSH
• buněčné linie MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus účinky léků   MeSH
• mikrobiální testy citlivosti MeSH
• salicylanilidy farmakologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVES: Staphylococcus aureus (SA) represents one of the most important microorganism that is part of the normal microflora of humans, but in certain conditions can cause very serious infections. Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a wide spectrum of nosocomial and community associated infections worldwide. The aim of this study was to determine community acquired MRSA (CA-MRSA), as well as the frequency of Panton-Valentine leukocidin (PVL) genes and staphylococcal cassette chromosome mec (SCCmec) types in isolates obtained from outpatients in the region of 700,000 people (Canton Sarajevo, Bosnia and Herzegovina) Methods: Our investigation included phenotypic and genotypic markers such as antimicrobial resistance, pulsed-field gel electrophoresis (PFGE), SCC typing, and PVL detection. RESULTS: Antimicrobial susceptibility: all MRSA isolates were resistant to the β-lactam antibiotics tested, and all isolates were susceptible to trimethoprim sulphamethoxazole, rifampicin, fusidic acid, linezolid, and vancomycin. After the PFGE analysis, the isolates were grouped into five similarity groups: A-E. The largest number of isolates belonged to one of two groups: C - 60% and D - 27%. In both groups C and D, SCCmec type IV was predominant (60% and 88.8%, respectively). A total of 24% of the isolates had positive expression of PVL genes, while 76% showed a statistically significantly greater negative expression of PVL genes. CONCLUSIONS: Using combination techniques, we were able to investigate the origin and genetic background of the strains. PFGE analysis revealed two large, genetically related groups of strains consisting of 87 isolates. Our results suggest failure to apply the screening policy, and a lack of knowledge about multiresistant MRSA strains. This study showed the local epidemiological situation which should be the basis of antimicrobial empiric therapy for non-hospitalized patients.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriální proteiny MeSH
• bakteriální toxiny genetika   MeSH
• chromozomy MeSH
• exotoxiny genetika   MeSH
• infekce získané v komunitě epidemiologie   mikrobiologie   MeSH
• leukocidiny genetika   MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus účinky léků   genetika   izolace a purifikace   MeSH
• methicilin MeSH
• mikrobiální testy citlivosti MeSH
• proteiny vázající penicilin MeSH
• stafylokokové infekce epidemiologie   mikrobiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Bosna a Hercegovina MeSH

Antimicrobial resistance remains a global issue, hindering the control of bacterial infections. This study examined the antimicrobial properties of 2,3-N,N-diphenyl quinoxaline derivatives against Gram-positive, Gram-negative, and Mycobacterium species. Two quinoxaline derivatives (compounds 25 and 31) exhibited significant activity against most strains of Staphylococcus aureus, Enterococcus faecium, and Enterococcus faecalis tested, with MIC values ranging from 0.25 to 1 mg/L. These compounds also showed effective antibacterial activity against methicillin-resistant S. aureus (MRSA) and vancomycin-resistant E. faecium/E. faecalis (VRE) strains. They demonstrated comparable or superior activity to four current antibiotics (vancomycin, teicoplanin, daptomycin, and linezolid) against a wide range of clinically relevant isolates. Additionally, they were more effective in preventing S. aureus and E. faecalis biofilm formation compared to several other antibiotics. In summary, these two quinoxaline derivatives have potential as new antibacterial agents.

• MeSH
• antibakteriální látky * farmakologie   MeSH
• biofilmy * účinky léků   růst a vývoj   MeSH
• chinoxaliny * farmakologie   MeSH
• Enterococcus faecalis * účinky léků   MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * účinky léků   MeSH
• mikrobiální testy citlivosti * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Staphylococcus aureus infection is associated with hospitals and caused mortality in hospitalized patients. These biofilm-forming bacteria are associated with chronic infections in patients. OBJECTIVES: To investigate the biofilm forming ability of multidrug resistant bacteria associated with hospital environment and analyze anti-biofilm compounds from the natural sources. METHODS: The hospital wastewater sample was used for the isolation of drug resistant S. aureus strains. The biofilm producing ability was analyzed and the isolated S. aureus strains were tested for antibiotic susceptibility patterns against various antibiotics. To screen suitable antibacterial agent, essential oil was extracted from Teucrium polium by hydrodistillation method and the compounds were determined by GC-MS analysis. The antimicrobial potential of essential oil was studied against S. aureus strains by disc diffusion method and biofilm inhibition property of essential oil was analyzed. The synergistic activity of essential oil was also analyzed. RESULTS: A total of 13 S. aureus strains were isolated and almost all bacterial strains showed biofilm forming ability. Most of the isolated S. aureus strains showed resistance to ampicillin, cefoxitin, ciprofloxacin, erythromycin, gentamicin, chloramphenicol and vancomycin. The extracted essential oil showed pale yellow in colour with pleasant odour and the yield was about 0.9%. Twenty-two compounds were detected in GC-MS analysis which shared about 96% of the total determined chemical composition. The major compounds determined were α-pinene (5.3%), linalool (16.2%), caryophyllene (10.04%), germacrene D (37.2%), and β-eudesmol (6.1%). The extracted essential oil showed antibacterial activity and the zone of inhibition varied from 15 ± 1 to 21 ± 2 mm against S. aureus strains. The essential oil showed antibiofilm activity and synergistic activity against S. aureus strains. CONCLUSIONS: This study analyzed biofilm forming ability of drug resistant S. aureus strains isolated from the hospital wastewater. The isolated bacterial strains showed resistance against various tested antibiotics. The essential oil extracted from T. polium showed antibacterial and anti-biofilm activity.

• MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• bakteriální léková rezistence MeSH
• lidé MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• mikrobiální testy citlivosti MeSH
• perzistentní infekce MeSH
• stafylokokové infekce * farmakoterapie   MeSH
• Staphylococcus aureus MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH