APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
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Multicenter Study
Molecular characterization and antibiotic resistance of clinical isolates of methicillin-resistant Staphylococcus aureus obtained from Southeast of Iran (Kerman).
Staphylococcus aureus infections, particularly infections caused by methicillin-resistant S. aureus (MRSA) strains, are emerging as a major public health problem. The aim of this study was to determine the prevalence of MRSA, antibiotic resistance profile and staphylococcal cassette chromosome mec (SCCmec) type of MRSA isolates obtained from clinical samples. Totally, 162 S. aureus isolates were obtained from clinical samples at three university hospitals in Kerman, Iran from March 2011 to February 2012. ⋯ The pvl gene was detected in 3.08% of isolates (two MRSA and three MSSA isolates). REP-PCR typing divided the 92 MRSA isolates into 10 distinct clusters. Our results indicate that vancomycin and linezolid are the most effective antibacterial agents against MRSA isolates and SCCmec type III is predominant in MRSA strains in this area.
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Randomized Controlled Trial Multicenter Study
Local collagen-gentamicin for prevention of sternal wound infections: the LOGIP trial.
In cardiac surgery, sternal wound infection (SWI) continues to be one of the most serious postoperative complications. Coagulase-negative staphylococci (CoNS) have become the most common causative agents of SWI. However, many CoNS species are resistant to routine intravenous antibiotic prophylaxis. 2000 cardiac surgery patients were randomised to routine prophylaxis with intravenous isoxazolyl penicillin alone (control group) or to this prophylaxis combined with application of collagen-gentamicin (260 mg gentamicin) sponges within the sternotomy before wound closure. ⋯ The incidence of any sternal wound infection was 4.3% in the treatment group and 9.0% in the control group (relative risk=0.47; 95% confidence interval 0.33 to 0.68; P<0.001). Local gentamicin reduced the incidence of SWI caused by all major clinically important microbiological agents, including CoNS. Routine use of the described prophylaxis in all adult cardiac surgery patients could be recommended.