Nasiru Abdullahi Department of Medical Microbiology and Parasitology, National Hospital, Abuja, PMB 425 Garki, Abuja 900 001 Nigeria Source of Support: None, Conflict of Interest: None Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of both health care- and community- associated infections worldwide and do present therapeutic challenges to beta-lactam antibiotics and other antibiotics due to the development of multidrug resistance. Aim: This study was carried out to determine the prevalence and antibiotic susceptibility profile of MRSA among patients at National Hospital Abuja with a view to providing information that will guide rational choice of antimicrobial agents in the empirical therapy of its infections. Materials and Methods: Between April 2014 and August 2015, clinical samples of patients submitted to Medical Microbiology laboratory of the hospital were processed and all Staphylococcus aureus isolates recovered, using standard laboratory methods. They were subjected to antibiotic susceptibility testing using the modified Kirby Bauer disc diffusion technique with zones of inhibition interpreted according to the Clinical and Laboratory Standard Institute (CLSI) guidelines. Methicillin resistance was determined using cefoxitin disc diffusion. All (100%) the MRSA isolates were susceptible to vancomycin, 88 (90.7%) to imipenem and 71 (73.2%) to clindamycin. Other clinical data of the patients were gathered along for analysis. All (100%) the MRSA isolates were resistant to penicillin, 85(88.0%) to tetracycline, 61 (62.9%) to ciprofloxacin, 58 (60.0%) to erythromycin and 52 (53.6%) to gentamycin. The MRSA strains showed higher resistance rate than MSSA strains to all tested antibiotics. Based on prediction from glide scores and ability to reduce Et Br MIC, two of the ten derivatives S3- [4-((E)-2-(diethylcarbamoyl)vinyl)-2-methoxyphenyl acetate] and S6- [(E)-methyl 3-(4-((p-tolylcarbamoyl)methoxy)-3-methoxyphenyl)acrylate] were chosen as putative efflux pump inhibitors (EPI's). Time dependent accumulation studies revealed that S6 caused enhanced Et Br accumulation relative to standard Nor A efflux inhibitor reserpine, in clinical isolate of MRSA (CIMRSA) and in Nor A overexpressed strain of 3.2 log decline in CIMRSA cell counts relative to CPX treatment alone. Of the two potent derivatives, S6 probably acts through Nor A whereas S3 might exert its effect through pump other than Nor A. I want to order valtrex Zoloft dizzy Regimen. The study was terminated after the enrollment of 21 subjects due to the recognition of ciprofloxacin resistance in 10 of 21 new MRSA isolates during the. Learn to identify and treat common skin infections caused by the staph bacteria, including impetigo and abscesses. May 3, 2018. The clinical significance of silent mutations with respect to ciprofloxacin resistance in MRSA Chih-Cheng Lai,1 Chi-Chung Chen,2,3 Ying-Chen. 1Department of Clinical Sciences, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK2Co MPLEX, (Centre for Mathematics and Physics in the Life Sciences and Experimental Biology), University College London, Gower Street, London WC1E 6BT, UK We investigated the evolution of an MRSA population from a large, acute-care teaching hospital in London, UK over a 10 year period. MRSA incidence and antibiotic prescribing were correlated with changes in resistance genes and prevalence of clonal groups. Clones that were multidrug resistant were selected for, and CC22 became dominant once it acquired a wide range of extra resistance genes. CC22 MRSA was also the fittest clone in an independent growth assay and a competition assay, and had a greater ability to survive desiccation. No individual isolate was fully drug resistant, and there was evidence of substantial horizontal gene transfer (HGT) as well as resistance gene loss within the clonal groups. The exception was fluoroquinolone resistance, which was rarely lost by any of the dominant hospital clones, suggesting that this resistance contributes to selection and survival of HA-MRSA. In support of this, a decrease in hospital-wide ciprofloxacin (a fluoroquinolone) prescribing was strongly associated with an overall decrease in MRSA infection. but carry different sets of mobile genetic elements (MGEs) and therefore different combinations of antibiotic resistances. A 57-year-old man presents with pain and swelling in his leg. There is no purulence, fluctuance, or weeping skin. With the growing concern for community-associated methicillin-resistant Staphylococcus aureus infection (MRSA), more and more patients are receiving empiric coverage for MRSA for all skin infections. On exam, his right lower extremity is warm, erythematous, and swollen to the midcalf. There are exceptional circumstances where other organisms must be considered; but for the most part, those situations are rare. Labs are: WBC, 12,000; Na, 134; K, 5.2; BUN, 20; creatinine, 1.4. Is this coverage for MRSA in patients with cellulitis a new myth in evolution? Arthur Jeng and colleagues, all patients admitted to one hospital over a 3-year period with diffuse cellulitis were studied (Medicine 2010;7-26). The study was a randomized, double-blind, placebo-controlled trial. They concluded that trimethoprim-sulfamethoxazole and clindamycin were better than cephalexin. Cellulitis is almost always caused by group A streptococcus. Myth: Cellulitis treatment should include MRSA coverage. A total of 179 patients were enrolled in the study; all patients had serologic studies for exposure to streptococci and what antibiotics they received, and outcomes were recorded. The experimental group received trimethoprim-sulfamethoxazole and cephalexin, while the control group received cephalexin plus placebo. However, more than 50% of patients in this study had abscesses or ulcers – clinical criteria that increase the possibility of MRSA. Trimethoprim-sulfamethoxazole can cause serious skin reactions and hyperkalemia (especially in the elderly and those with renal impairment), and the drug has a marked drug interaction with warfarin, leading to high risk of excessive anticoagulation. Almost all patients with positive antibodies to streptococci responded to beta-lactam antibiotics (97%). The addition of vancomycin is reserved for patients with purulence/evidence of abscess or exudate. A recent study looked at whether additional community-associated MRSA coverage with trimethoprim-sulfamethoxazole in addition to beta-lactam therapy for cellulitis showed any benefit over therapy with only a beta-lactam (Clin. There was no difference in outcome between the two groups, with the conclusion that addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to a better outcome than cephalexin alone in patients with nonpurulent cellulitis. Alan Tice looked at whether cephalexin, trimethoprim-sulfamethoxazole, or clindamycin was superior for the treatment of outpatient cellulitis (Am. The most commonly used oral antibiotic for the coverage of community-associated MRSA is trimethoprim-sulfamethoxazole. These risks of TMP-sulfa use make it extremely important to have clear and worthwhile indications for its use. Ciprofloxacin for mrsa Things to remember about living with MRSA, Staph Skin Infections and MRSA Treatments - Verywell Health Inderal 30 mg MRSA - methicillin-resistant Staphylococcus aureus - is a bacteria that causes hospital-acquired infection and is resistant to all of the penicillin-type antibiotics frequently used in hospitals. Ciprofloxacin use is major contributor to MRSA spread in.. The clinical significance of silent mutations with respect to ciproflo IDR. Updated information on MRSA infections - Clinical Advisor. Jun 11, 2018. All 100% the MRSA isolates were resistant to penicillin, 8588.0% to tetracycline, 61 62.9% to ciprofloxacin, 58 60.0% to erythromycin and. Thirty-seven patients with methicillin-resistant Staphylococcus aureus infections and/or colonization were treated with oral ciprofloxacin 750 mg twice a day. Clinical cure or improvement of infections occurred in 91% of the patients, and bacteriologic cure occurred in 60%. Ciprofloxacin therapy. Oct 15, 2013. Among the fluoroquinolones, maximum resistance in MRSA was seen to ciprofloxacin 92.5%, followed by ofloxacin 80.4%. None of the S.