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There is no optimal imaging method for the detection of unknown infectious foci in some diseases. This study introduces a novel method in X‐ray imaging of infection foci due to Staphylococcus aureus by developing a contrast agent based on gold nanoparticles (GNPs). GNPs in spherical shape were synthesised by the reduction of tetrachloroauric acid with sodium citrate. Then gentamicin was bound directly to citrate functionalised GNPs and the complex was stabilised by polyethylene glycol. The interaction of gentamicin with GNPs was confirmed by ultraviolet–visible and Fourier transform infrared spectroscopies. The stability of complex was studied in human blood up to 6 h. The stability of conjugate was found to be high in human blood with no aggregation. The biodistribution study showed localisation of gentamicin–GNPs conjugate at the site of Staphylococcal infection. The infection site was properly visualised in X‐ray images in mouse model using the gentamicin–GNPs conjugate as a contrast agent. The results demonstrated that one may consider the potential of new nanodrug as a contrast agent for X‐ray imaging of infection foci in human beings which needs more investigations. [ABSTRACT FROM AUTHOR]

Background To determine the prevalence of community-acquired methicillin-resistant S. aureus (CA-MRSA) and methicillin-sensitive S. aureus (MSSA) nasal abscesses in a lower socioeconomic status urban population over a 5-year period. Methods A retrospective chart review of 29 consecutive patients with nasal abscess cultures performed in the otolaryngology clinic from 2007 to 2012. Results Twenty-nine cases of nasal abscesses were identified. All cultures grew S. aureus; 34.5% were MSSA and 65.5% were CA-MRSA. Comparing CA-MRSA and MSSA, there was no statistically significant increase in prevalence of CA-MRSA over 5 years; and there was no statistical difference comparing gender, year, or age. There was a high rate of erythromycin resistance (15/19) and a low rate of sulfamethoxazole/trimethoprim (2/19) and clindamycin (1/19) resistance in the CA-MRSA cases. Conclusion In this population, the proportion of CA-MRSA nasal abscesses is nearly twice that of MSSA nasal abscesses. The overall prevalence of CA-MRSA appears to be stable over the past 5 years. This may represent a stabilization of CA-MRSA colonization in this community. An awareness of the high proportion of CA-MRSA will allow for the appropriate selection of antibiotic therapy. [ABSTRACT FROM AUTHOR]

Hyper-IgE syndrome (HIES) is a primary immunodeficiency characterized by atopic dermatitis associated with extremely high serum IgE levels and susceptibility to staphylococcal skin abscesses and pneumonia. Recent studies have identified dominant negative mutations in the signal transducer and activator of transcription 3 gene ( STAT3) as a major molecular cause of classical hyper-IgE syndrome, but the molecular mechanisms underlying this syndrome remain unclear. We recently showed that the impaired development of interleukin 17 (IL-17)-producing T helper cells (Th17 cells) due to defective IL-6 and IL-23 signaling in T cells, and the impaired generation of induced regulatory T (iTreg) cells from defective IL-10 signaling in dendritic cells, may account for the immunological abnormalities of hyper-IgE syndrome. These findings open up possibilities for exploring new approaches to the treatment of HIES patients. [ABSTRACT FROM AUTHOR]

Background: This review aims to compare the effectiveness of linezolid to vancomycin for the treatment of Methicillin Resistant Staphylococcus Aureus (MRSA) skin and soft tissue infections (SSTIs) in inpatients. Methods: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and reference lists were searched in March 2007. We included randomized controlled trials that looked at inpatients treated with linezolid versus vancomycin for the treatment of hospital-acquired MRSA SSTIs. Outcome measures were clinical cure (resolution of symptoms and signs) and microbiological cure (eradication of MRSA on wound culture). The validity of the included trials was assessed. The results were combined in meta-analyses, the robustness of which was tested in sensitivity analyses. Results: Four trials were included in this review: three for clinical outcomes (174 participants) and three for microbiological outcomes (439 participants). For clinical outcomes there were non-significant trends in favour of linezolid (RR 0.34; 95% CI 0.04, 2.89; P = 0.32). For microbiological outcomes there was weak evidence of linezolid outperforming vancomycin (RR 0.55; 95% CI 0.30, 1.01; P = 0.05). Sensitivity analyses did not change the conclusions taken from the main analysis. Conclusion: With the current available data no difference could be detected between the two treatments, but a trend towards higher effectiveness of linezolid was observed. More data will be required to determine if linezolid is superior to vancomycin for the treatment of MRSA SSTIs. Further systematic reviews are needed to look at other outcomes (length of hospital stay, safety and tolerability, cost-effectiveness) and at MRSA infections at other sites. [ABSTRACT FROM AUTHOR]

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 primary end-point was any sternal wound infection within 2 months postoperatively. 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. [ABSTRACT FROM AUTHOR]

A 38-year-old woman developed an acute, painful cutaneous eruption on her lower legs, neck, chest and fingers while receiving a number of oral and intravenous antibiotics for left leg cellulitis caused by trauma. Clinically and histopathologically, she was diagnosed with Sweet's syndrome with typical pseudovesicular skin changes in conjunction with erythema nodosum-like lesions on her lower legs. She responded quickly to oral prednisolone. We propose Staphylococcal cellulitis as a cause of Sweet's syndrome. [ABSTRACT FROM AUTHOR]

The reported rate of post-sternotomy mediastinitis is between 0.8 and 2.3%, with up to 79% of cases caused by staphylococci. Mediastinitis is associated with significant morbidity and mortality. Obesity and diabetes are the only risk factors consistently identified. The aims of the present study were to determine the incidence and risk factors for staphylococci post-sternotomy mediastinitis and to audit its management. The clinical records of patients with staphylococcal post-sternotomy mediastinitis between 1 January 1998 and 31 May 2003 were retrospectively reviewed. Information collected included patient demographics, comorbidities, operation type, microbiology findings, surgical and medical management, and outcome. Data collected on cases were compared with data collected in a prospective database of all patients undergoing cardiac surgery. The incidence of staphylococcal post-sternotomy mediastinitis was 1.2% (60 cases in 5176 median sternotomies). Staphylococcus aureus was isolated in 49 (82%) cases and coagulase-negative staphylococci in 11 (18%) cases. Eight (16%) S. aureus isolates were methicillin-resistant. Risk factors associated with mediastinitis were ethnicity, diabetes mellitus, emergency surgery, ejection fraction and length of preoperative hospital stay. In-hospital mortality was 15%. Eighteen per cent of cases were not cured by initial therapy. Staphylococcal mediastinitis is a serious complication with significant rates of relapse and mortality. This audit has lead to an evaluation of our clinical pathways to ensure that prevention and management of surgical site infection is optimized. [ABSTRACT FROM AUTHOR]