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Successful empirical therapy of Staphylococcus aureus infections requires the ability to predict methicillin resistance. Our aim was to identify predictors of methicillin resistance in community-onset (CO) invasive S. aureus infections. Sixteen hospitals across Korea participated in this study from May to December 2012. We prospectively included cases of S. aureus infection in which S. aureus was isolated from sterile clinical specimens ≤72 hours after hospitalization. Clinical and epidemiological data were gathered and compared in methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) cases. Community-associated (CA) infections were defined as in previous studies. In total, there were 786 cases of community-onset S. aureus infection, 102 (13.0%) of which were CA-MRSA. In addition to known risk factors, exposure to 3rd generation cephalosporins in the past 6 months [odds ratio (OR), 1.922; 95% confidence interval (CI), 1.176–3.142] and close contact with chronically ill patients in the past month (OR, 2.647; 95% CI, 1.189–5.891) were independent risk factors for MRSA infection. However, no clinical predictors of CA-MRSA were identified. Methicillin resistance, CO infection, and appropriateness of empirical antibiotics were not significantly related to 30-day mortality. MRSA infection should be suspected in patients recently exposed to 3rd generation cephalosporins or chronically-ill patients. There were no reliable predictors of CA-MRSA infection, and mortality was not affected by methicillin resistance. [ABSTRACT FROM AUTHOR]

Abstract: The presence of fluoroquinolone resistance-associated alterations in topoisomerase II and IV were investigated for 103 nfxC-like type Pseudomonas aeruginosa isolates. The most nfxC-like type isolates (98.1%) possessed the substitution of Ile for Thr-83 in GyrA. A single alteration in GyrA (Thr-83→Ile) was the most frequently detected and the next common alteration was two alterations with Thr-83→Ile in GyrA and Ser-87→Leu in ParC. A novel alteration at position Glin-106 of GyrA, which was suggested to be responsible for fluoroquinolone resistance, was identified. Our study revealed that the alterations in GyrB (Glu-468→Asp) and in ParE (Asp-419→Asn or Glu-459→Asp) play a complementary role in the acquisition of resistance to fluoroquinolone. There was a correlation between the ciprofloxacin MIC and the number of resistance-associated alterations in GyrA, GyrB, ParC and ParE of P. aeruginosa isolates. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to quantify the biofilm formations of various methicillin-resistant Staphylococcus aureus (MRSA) clones (ST1, ST5, ST72, ST89, ST239, and ST254) and to evaluate the in vitro activities of antibiotics. Of 86 MRSA isolates tested, 44 isolates (51.2 %) formed biofilms, including 8 strong biofilm producers (7 isolates of ST72 and 1 isolate of ST89). The planktonic MICs, minimal bactericidal concentrations, and minimum biofilm eradication concentrations (MBECs) of 6 antibiotics (clindamycin, gentamicin, linezolid, vancomycin, daptomycin, and tigecycline) were measured for 8 MRSA isolates. The planktonic isolates were susceptible to all agents, with daptomycin being the most effective, followed by gentamicin and vancomycin. However, clindamycin, linezolid, and tigecycline showed bacteriostatic activity against most of the isolates. The biofilms were resistant to high concentrations of most drugs. However, the MBEC values of daptomycin and tigecycline were lower overall than that of other antibiotics. Microscopy studies verified that daptomycin was the most effective drug used in adhesive biofilms, while gentamicin and tigecycline exhibited some bactericidal efficacy. Our results demonstrated that ST72 and ST89 form strong biofilms that may cause problems in hospital setting, and daptomycin, gentamicin, and tigecycline may be choice therapeutics against biofilm-mediated S. aureus infections. [Copyright &y& Elsevier]