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Methicillin-resistant Staphylococcus aureus (MRSA) colonization increases infection risk in both patients and healthy individuals. Decolonization therapy has been proven to reduce S. aureus infections, but data on the effectiveness of individual decolonization strategies in community-onset MRSA carriage are scarce. The aim of this narrative review was to summarize the evidence on strategies for the elimination of MRSA colonization in community-onset MRSA carriers. PubMed database was searched for studies on MRSA eradication, from inception to July 2023. Topical therapy is proven to be effective in nasal-only carriage and in temporary load reduction. Mupirocin nasal ointment in combination with chlorhexidine body wash is highly effective in nasal-only MRSA carriers in the community as well. In patients with extra-nasal colonization, addition of orally administered antibiotics likely increases success rates compared with topical therapy alone. Studies on systemic treatment of extra-nasal MRSA decolonization are subject to a high heterogeneity of antimicrobial agents, treatment duration, and control groups. The majority of evidence supports the use of a combination of topical therapy with rifampin and another antimicrobial agent. Decolonization treatment with probiotics is a promising novel non-antibiotic strategy. However, achieving long-term decolonization is more likely in countries with low MRSA prevalence, given the risk of recolonization in a context of high MRSA prevalence. The decision to pursue community-onset MRSA eradication treatment in the individual patient should be based on the combination of the treatment objective (short-term bacterial load reduction in health care settings vs. long-term eradication in community settings), and the likelihood of successful decolonization. The latter is influenced by both individual risk factors for treatment failure, and the risk of recolonization. The addition of a combination of systemic antibiotics is rational for extra-nasal long-term decolonization. To determine the most effective systemic antimicrobial agents in MRSA decolonization, more research is needed. [ABSTRACT FROM AUTHOR]

Bacterial resistance, a global public health concern prioritized by the World Health Organization, is particularly alarming in Staphylococcus aureus and Escherichia coli. Urgently addressing this, the search for new antibiotics has turned to plant essential oils. Our study focused essential oils derived from Colombian plants Croton killipianus, Croton smithianus, Croton leptostachyus, Croton hondensis, and Croton gossypiifolius. We performed antimicrobial susceptibility tests targeting Staphylococcus aureus, methicillin-resistant Staphylococus aureus, sensitive Escherichia coli, and ampicillin- and streptomycin-resistant Escherichia coli. Simultaneosly, citotoxic assays and chemical analysis were carried out. The essential oil derived from C. hondensis demonstrated superior inhibitory efficacy, effectively targeting methicillin-resistant S. aureus, susceptible S. aureus, and both sensitive and ampicillin- and streptomycin-resistant strains of E. coli. Furthermore, it exhibited notable potential for protective activity in Chinese hamster ovary cells. C. killipianus manifested inhibitory effects against MRSA and susceptible S. aureus, whereas C. smithianus specifically affected susceptible strains of S. aureus. Chemical analysis of the essential oils revealed rich content in phenolic compounds, flavonoids, tannins, and steroids. Gas-coupled mass spectrometry identified key compounds like γ-muurolene, α-humulene, (E)-caryophyllene, α-copaene, curcumene, and (E)-nerolidol. These findings underscore C. hondensis, C. killipianus, and C. smithianus as potential natural sources for antibacterial agent development. [ABSTRACT FROM AUTHOR]

The delineation of the complex biosynthesis of the potent antibiotic mupirocin, which consists of a mixture of pseudomonic acids (PAs) isolated from Pseudomonas fluorescens NCIMB 10586, presents significant challenges, and the timing and mechanisms of several key transformations remain elusive. Particularly intriguing are the steps that process the linear backbone from the initial polyketide assembly phase to generate the first cyclic intermediate PA‐B. These include epoxidation as well as incorporation of the tetrahydropyran (THP) ring and fatty acid side chain required for biological activity. Herein, we show that the mini‐module MmpE performs a rare online (ACP‐substrate) epoxidation and is integrated ('in‐cis') into the polyketide synthase via a docking domain. A linear polyketide fragment with six asymmetric centres was synthesised using a convergent approach and used to demonstrate substrate flux via an atypical KS0 and a previously unannotated ACP (MmpE_ACP). MmpE_ACP‐bound synthetic substrates were critical in demonstrating successful epoxidation in vitro by the purified MmpE oxidoreductase domain. Alongside feeding studies, these results confirm the timing as well as chain length dependence of this selective epoxidation. These mechanistic studies pinpoint the location and nature of the polyketide substrate prior to the key formation of the THP ring and esterification that generate PA‐B. [ABSTRACT FROM AUTHOR]

Background/Objectives: Biofilm-associated infections, particularly those involving Candida auris and Staphylococcus aureus, pose significant challenges in clinical settings due to their resilience and resistance to conventional treatments. This study aimed to synthesize novel triazole derivatives containing a piperazine ring via click chemistry and evaluate their efficacy in disrupting biofilms formed by these pathogens. Methods: Triazole derivatives were synthesized using click chemistry techniques. The antimicrobial activity of the compounds was tested against planktonic cells of C. auris and S. aureus in single and dual-species culture conditions. Biofilm disruption efficacy was assessed, alongside the evaluation of physicochemical properties, oral bioavailability potential, and toxicity profiles. Results: The compound T3 demonstrated potent antimicrobial activity against planktonic cells of C. auris and S. aureus in both single and dual-species cultures. T3 exhibited significant efficacy in reducing microbial viability within biofilms formed by these pathogens. Physicochemical analyses revealed favorable solubility and permeability profiles, supporting its potential for oral bioavailability. Toxicity assessments showed a non-toxic profile, highlighting a promising safety margin for further development. Conclusions: This study underscores the anti-biofilm properties of novel triazole-piperazine derivatives, particularly T3, against single and dual-species biofilms of C. auris and S. aureus. These findings position T3 as a promising candidate for developing therapies targeting polymicrobial infections and provide a foundation for future research into alternative strategies for combating biofilm-associated infections. [ABSTRACT FROM AUTHOR]

Purpose: To explore antimicrobial resistance profiles and mupA gene characterization of Staphylococcus epidermidis recovered from facial skin of healthy females in Shanghai, China. Patients and Methods: In this study, we collected facial skin samples from 107 healthy females in Shanghai, China, and S. epidermidis isolation was performed. The minimal inhibitory concentrations of 10 antibiotics were determined for the S. epidermidis isolates using the agar dilution method. High-level mupirocin-resistant isolates were subjected to whole-genome sequencing and bioinformatics analysis. A total of 94 un-duplicated S. epidermidis isolates were obtained from 107 facial skin samples. Results: Antimicrobial susceptibility tests revealed that 23.4% of the 94 S. epidermidis isolates were resistant to oxacillin and positive for the mecA gene, which could be cauterized as methicillin-resistant S. epidermidis (MRSE). Resistance rates for erythromycin, clindamycin, tetracycline, ciprofloxacin, and gentamicin were 8.5%, 11.7%, 10.6%, 12.8%, and 1.1%, respectively. For mupirocin, the rates of low- and high-level resistance were 3.2% (3/94) and 11.7% (11/94), respectively. Resistance to vancomycin or linezolid was not observed. High-level mupirocin resistance in facial skin isolates is mediated by mupA. WGS and SNP-based phylogenetic analyses revealed diverse phylogenies among the 11 mupA-positive S. epidermidis isolates. Additionally, various resistance and virulence genes were identified in mupA-positive isolates. A new hybrid plasmid carrying mupA genes was found in two S. epidermidis isolates. Conclusion: We observed a considerable level of antimicrobial resistance to several antibiotics and the prevalence of abundant and diverse resistance and virulence genes in the facial skin-origin S. epidermidis isolates. This may pose a potential risk for both public health and S. epidermidis infection. [ABSTRACT FROM AUTHOR]

Background: Due to rising antibiotic-resistant microorganisms, there is a pressing need to screen approved drugs for repurposing and to develop new antibiotics for controlling infections. Current in vitro and ex vivo models have mostly been unsuccessful in establishing in vivo relevance. In this study, we developed a stringent ex vivo-burned porcine skin model with high in vivo relevance to screen topical antimicrobials. Methods: A 3 cm-diameter thermal injury was created on non-sterilized porcine skin using a pressure-monitored and temperature-controlled burn device. Commensals were determined pre- and post-burn. The burn wound was inoculated with a target pathogen, and efficacies of Silvadene, Flammacerium, Sulfamylon, and Mupirocin were determined. The in vivo relevance of this platform was evaluated by comparing the ex vivo treatment effects to available in vivo treatment outcomes (from our laboratory and published reports) against selective burn pathogens. Results: Approximately 1% of the commensals survived the skin burn, and these commensals in the burn wounds affected the treatment outcomes in the ex vivo screening platform. When tested against six pathogens, both Silvadene and Flammacerium treatment exhibited ~1–3 log reduction in viable counts. Sulfamylon and Mupirocin exhibited higher efficacy than both Silvadene and Flammacerium against Pseudomonas and Staphylococcus, respectively. The ex vivo treatment outcomes of Silvadene and Flammacerium against Pseudomonas were highly comparable to the outcomes of the in vivo (rats). Conclusions: The ex vivo model developed in our lab is a stringent and effective platform for antimicrobial activity screening. The outcome obtained from this ex vivo model is highly relevant to in vivo. [ABSTRACT FROM AUTHOR]

Background: This study aimed to develop and evaluate an antibacterial cream emulsion containing mupirocin using Cocamidopropyl betaine (CAPB) as an emulsifier. Mupirocin, a topical antibiotic effective against Staphylococcus aureus (including methicillin-resistant strains), was formulated into a cream to enhance its topical delivery. Materials and Methods: Mupirocin cream emulsion formulations were developed with varying concentrations of CAPB, PEG-400, and glycerol monostearate. The cream formulations were mainly evaluated for in vitro diffusion tests, antibacterial activity tests, and stability studies. Result and Discussion: CAPB produced a stable cream emulsion formulation (F7) at 30% concentration and 2% PEG-400. The formulation (F7) exhibited sustained drug release over 3.5 hours in the diffusion test. The formulation F7 showed a higher zone of inhibition, 32.16±2.2 mm, than the marketed mupirocin cream, 29.56±1.35 mm, for the Staphylococcus aureus strain. The prepared cream formulation F7 was found stable over 90 days at different temperature conditions (8±2°C, 25±2°C and 40±2°C). Conclusion: The study concludes that CAPB effectively enhances mupirocin cream solubility and antibacterial properties, making it a promising option for treating bacterial skin infections.

Abstract Severe cutaneous injuries may not heal spontaneously and may necessitate the use of supplementary therapeutic methods. Electrospun nanofibers possess high porosity and specific surface area, which provide the necessary microenvironment for wound healing. Here in, the nanofibers of Soluplus-soy protein isolate (Sol-SPI) containing mupirocin (Mp) were fabricated via electrospinning for wound treatment. The fabricated nanofibers exhibited water absorption capacities of about 300.83 ± 29.72% and water vapor permeability values of about 821.8 ± 49.12 g/m2 day. The Sol/SPI/Mp nanofibers showed an in vitro degradability of 33.73 ± 3.55% after 5 days. The ultimate tensile strength, elastic modulus, and elongation of the Sol/SPI/Mp nanofibers were measured as 3.61 ± 0.29 MPa, 39.15 ± 5.08 MPa, and 59.11 ± 1.94%, respectively. Additionally, 85.90 ± 6.02% of Mp loaded in the nanofibers was released in 5 days in vitro, and by applying the Mp-loaded nanofibers, 93.06 ± 5.40% and 90.40 ± 5.66% of S. aureus and E. coli bacteria were killed, respectively. Human keratinocyte cells (HaCat) demonstrated notable biocompatibility with the prepared nanofibers. Furthermore, compare to other groups, Sol-SPI-Mp nanofibers caused the fastest re-epithelialization and wound healing in a rat model. The findings of this study present a novel nanofiber-based wound dressing that accelerates the healing of severe skin wounds with the risk of infection.

Jing Sun,1 Tracy Lu,1 Yan Dang,1 Zigang Xu,2 Ying Liu2 1Medical & Scientific Affairs, Haleon (Formerly GSK Consumer Healthcare), Shanghai, People’s Republic of China; 2Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, National Center for Children‘s Health, Beijing, People’s Republic of ChinaCorrespondence: Ying Liu, Department of Dermatology, Beijing Children’s Hospital, Capital Medical University, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, National Center for Children’s Health, Beijing, People’s Republic of China, Email ying_lemon@aliyun.comAbstract: Mupirocin, an antibiotic produced by Pseudomonas fluorescens, is mainly used for the topical treatment of various skin and soft tissue infections caused by Staphylococcus (including methicillin-resistant Staphylococcus aureus) and Streptococcus around the world for decades. Nevertheless, the clinical application scope of mupirocin varies in different countries due to differences in their medical policies, prescription types, and drug resistance. According to the experience of Chinese doctors in the past few years, mupirocin presented low drug resistance rates, and could be used as a treatment option for various primary infections and secondary infections, with antibacterial effects in a broad application. In this review, we summarized the experience of mupirocin used in the Chinese population and discussed its clinical value to provide novel insights and inspiration for physicians.Keywords: experience, mupirocin, skin diseases, infectious

AbstractBackgroundObjectivesMethodsResultsConclusionThroat carriage of methicillin-resistant Staphylococcus aureus (MRSA) has previously been associated with lower decolonisation treatment success rates.To characterise decolonisation treatment and outcome in Danish MRSA throat carriers.This retrospective population-based cohort study included MRSA throat carriers between July, 2018 and June, 2019, in the Capital Region of Denmark. Logistic regression analysis was performed to assess variables associated with becoming MRSA free.Of 178 patients included, 129 (72%) were MRSA free by the end of the study. Overall, 78 (44%) of patients became MRSA free following a treatment attempt. Twenty-six (15%) patients became MRSA free without treatment and 25 (14%) became MRSA free unrelated to a treatment attempt. The success rate of the first decolonisation treatment, mainly nasal mupirocin and chlorhexidine body wash, was 23%. Systemic clindamycin was given in 52 cases and had a success rate of 52%. Logistic regression showed that residing in a household with three to four additional MRSA carriers was negatively associated with becoming MRSA free, although not significant after adjustment. Having MRSA in a clinical sample prior to decolonisation was associated with a lower chance of becoming MRSA free after adjustment. Topical decolonisation treatment was associated with a lower probability of becoming MRSA free.In this Danish cohort of MRSA throat carriers, the overall success rate of decolonisation treatment was 44% and for systemic clindamycin 52%. A higher number of household MRSA carriers and a previous clinical MRSA infection were associated with a lower chance of becoming MRSA free. [ABSTRACT FROM AUTHOR]

Backgrounds: The aim of the current study was to develop a distinctive nanolipid formulation, namely, nanostructured lipid carrier (NLC), which would deliver an antibacterial medication such as mupirocin (MP). Additionally, cinnamon essential oil (CEO), which is reported to exhibit antibacterial activity, was utilized in the development process in an attempt to improve the influence of MP. Methods: As a consequence, different MP–NLC formulations were developed using the central composite design (CCD) approach. One optimized formula was selected and incorporated within the pre-formulated gel matrix, providing the MP–NLC-gel formula for efficient topical application. MP–NLC-gel was assessed for its physical characteristics to check its suitability for topical application and evaluated for its in vitro drug release over 6 h. Furthermore, it studied the formulation for its stability at different conditions; 25°C ± 2°C and at 4°C ± 3°C for 6 months. Finally, the formulation was examined for its antibacterial performance against gram-positive and -negative bacteria. Results: The developed topical NLC-gel formulation demonstrated pH 5.8, viscosity 14,510 cP, and spreadability 58.1 mm, which were seemed to be satisfactory properties for successful topical application. The drug was released successfully for over 6 h with 52.9%. Additionally, it was stable in both storage conditions for 6 months since it displayed non-significant variations in its evaluated characteristics compared to those of fresh preparation. Ultimately, the developed gel formulation could inhibit the growth of different bacterial strains, especially gram-negative strains. Conclusion: To sum up, these findings would demonstrate the efficiency of NLC prepared with CEO and incorporating MP to be a promising antibacterial lipid nanocarrier. [ABSTRACT FROM AUTHOR]

Wound healing is a complex process triggered by skin injury, and has increased attention on chronic wounds due to serious health problems and decline in life quality. The development of a biohybrid formulation using a synergistic technique involves a promising strategy for addressing various pathological manifestations of chronic wounds. This research aims to investigate the efficacy of beta-cyclodextrin (BCD) and sodium borohydride as a reducing agent in development of biohybrid collagen-based silver nanoparticles through a chemical reduction method with mupirocin (Col-AgNP-MUP). The Col-AgNP-MUP was developed and optimized to determine the best-reducing agent employing response surface methodology with critical quality attributes. The optimized formulation was characterized and demonstrated for its in-vitro cytotoxicity using a 3T3-L1 fibroblast cell line. The formulation, developed through chemical reduction method with BCD. The UV-vis spectroscopy exhibits a λmax at 402 nm and compatibility through Fourier transform Infrared spectroscopy (FTIR) studied. The particle size, polydispersity index (PDI), zeta potential(ZP) and entrapment efficiency(EE) were determined to be 188.4 nm, 0.176, 36.7 mV and 85.21 % respectively. The X-ray diffraction (XRD) indicates an amorphous peak owing to collagen matrix. Atomic force microscopy (AFM) and High-Resolution Transmission electron microscopy (HR-TEM) confirm a spherical shape of particles. In-vitro drug release studies showed efficacy at pH 7.4, suitable for the increased pH of chronic wounds. The in-vitro biocompatibility investigations demonstrated the Col-AgNP-MUP did not cause any toxicity. The study paves the work for developing a novel anti bacterial wound dressing. [ABSTRACT FROM AUTHOR]

Severe cutaneous injuries may not heal spontaneously and may necessitate the use of supplementary therapeutic methods. Electrospun nanofibers possess high porosity and specific surface area, which provide the necessary microenvironment for wound healing. Here in, the nanofibers of Soluplus-soy protein isolate (Sol-SPI) containing mupirocin (Mp) were fabricated via electrospinning for wound treatment. The fabricated nanofibers exhibited water absorption capacities of about 300.83 ± 29.72% and water vapor permeability values of about 821.8 ± 49.12 g/m2 day. The Sol/SPI/Mp nanofibers showed an in vitro degradability of 33.73 ± 3.55% after 5 days. The ultimate tensile strength, elastic modulus, and elongation of the Sol/SPI/Mp nanofibers were measured as 3.61 ± 0.29 MPa, 39.15 ± 5.08 MPa, and 59.11 ± 1.94%, respectively. Additionally, 85.90 ± 6.02% of Mp loaded in the nanofibers was released in 5 days in vitro, and by applying the Mp-loaded nanofibers, 93.06 ± 5.40% and 90.40 ± 5.66% of S. aureus and E. coli bacteria were killed, respectively. Human keratinocyte cells (HaCat) demonstrated notable biocompatibility with the prepared nanofibers. Furthermore, compare to other groups, Sol-SPI-Mp nanofibers caused the fastest re-epithelialization and wound healing in a rat model. The findings of this study present a novel nanofiber-based wound dressing that accelerates the healing of severe skin wounds with the risk of infection. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus aureus is an important pathogen that causes mild to invasive infections in hospitals and the community. Although methicillinsusceptible Staphylococcus aureus (MSSA) isolates continue to cause different infections, there is no data on the genetic backgrounds of the MSSA colonizing or causing infections in Kuwait hospitals. This study aimed to investigate MSSA isolated from patients admitted to Kuwait hospitals for antibiotic resistance and genetic backgrounds to understand their clonal composition. Methods: Consecutive MSSA isolates were collected from single patients during two surveillance periods in 2016 and 2021 in 13 public hospitals. The isolates were characterized using antibiogram, staphylococcal protein A (spa) typing, DNA microarray analysis, and multilocus sequence typing (MLST) using standard protocols. Results: A total of 446 MSSA was cultured from different clinical samples in 2016 (n  =  240) and 2021 (n  =  206). All isolates were susceptible to vancomycin [minimum inhibitory concentration (MIC) ≤  2  mg/L], teicoplanin (MIC ≤2  mg/L), linezolid (MIC ≤4  mg/L), ceftaroline (MIC ≤2  mg/L), rifampicin, and mupirocin but were resistant to erythromycin (21.3%), clindamycin (14.0%), gentamicin (3.8%), kanamycin (10.5%), fusidic acid (27.0%), tetracycline (6.9%), trimethoprim (23.1%), and ciprofloxacin (35.2%). Molecular typing identified 155 spa types, dominated by t127 (15.0%), t084 (5.4%), t3841 (5.4%), t267 (2.4%), t442 (2.2%), t091 (2.2%), t021 (2.2%), and t003 (2.2%); 31 clonal complexes (CCs); and 56 sequence types (STs). The majority of the isolates (n  =  265; 59.4%) belonged to CC1 (20.6%), CC15 (10.9%), CC22 (5.1%), CC30 (7.6%), CC361 (10.1%), and CC398 (4.7%). Discussion: The MSSA isolates belonged to diverse genetic backgrounds dominated by CC1, CC15, CC22, CC30, CC361, and CC398. The distribution of MSSA clones in 2016 and 2021 showed the stability of these clones over time. The study provides the first comprehensive data on the clonal distribution of MSSA in Kuwait hospitals. [ABSTRACT FROM AUTHOR]

Background: Bacterial pathogens such as Staphylococcus aureus colonize body surfaces of part of the human population, which represents a critical risk factor for skin disorders and invasive infections. However, such pathogens do not belong to the human core microbiomes. Beneficial commensal bacteria can often prevent the invasion and persistence of such pathogens by using molecular strategies that are only superficially understood. We recently reported that the commensal bacterium Staphylococcus lugdunensis produces the novel antibiotic lugdunin, which eradicates S. aureus from the nasal microbiomes of hospitalized patients. However, it has remained unclear if S. lugdunensis may affect S. aureus carriage in the general population and which external factors might promote S. lugdunensis carriage to enhance its S. aureus-eliminating capacity. Results: We could cultivate S. lugdunensis from the noses of 6.3% of healthy human volunteers. In addition, S. lugdunensis DNA could be identified in metagenomes of many culture-negative nasal samples indicating that cultivation success depends on a specific bacterial threshold density. Healthy S. lugdunensis carriers had a 5.2-fold lower propensity to be colonized by S. aureus indicating that lugdunin can eliminate S. aureus also in healthy humans. S. lugdunensis-positive microbiomes were dominated by either Staphylococcus epidermidis, Corynebacterium species, or Dolosigranulum pigrum. These and further bacterial commensals, whose abundance was positively associated with S. lugdunensis, promoted S. lugdunensis growth in co-culture. Such mutualistic interactions depended on the production of iron-scavenging siderophores by supportive commensals and on the capacity of S. lugdunensis to import siderophores. EJt4aqYa_PFzdC4ihACHg3 Video Abstract Conclusions: These findings underscore the importance of microbiome homeostasis for eliminating pathogen colonization. Elucidating mechanisms that drive microbiome interactions will become crucial for microbiome-precision editing approaches. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus pseudintermedius and S. aureus are important pathogens in dogs. This study established carrier rates, strain diversity and antimicrobial resistance of these bacteria among healthy dogs in Tanzania. Results: Based on cultures of mouth and perineal swabs, 11.3% and 50.3% of 151 healthy dogs were carriers of S. aureus and S. pseudintermedius, respectively. Only four dogs (3%) carried meticillin‐resistant S. aureus (MRSA), while none of the S. pseudintermedius strains were meticillin‐resistant. 12 of 19 S. aureus strains tested were resistant to penicillin G, and resistance to enrofloxacin and tetracycline was also commonly detected. The most common resistances in 103 S. pseudintermedius strains tested were to penicillin G (28.2%) and tetracycline (22.3%). S. pseudintermedius strains showed 65 different random amplified polymorphic DNA (RAPD) fingerprints, and S. aureus strains belonged to eight different spa types, including two novel types (t18988 and t18989). MRSA strains carried SCCmec type V. Conclusions and Clinical Relevance: Healthy dogs in Tanzania were carriers of MRSA at low frequency, and half of the dogs carried S. pseudintermedius with high strain diversity. [ABSTRACT FROM AUTHOR]

Background: Wound management is an extremely important clinical and societal concern. Research into the delayed healing process is progressing rapidly, as indicated by novel therapy strategies, such as nano-drug therapy, which is not conventional. Mupirocin is a commonly used antibiotic in wound healing. However, various novel delivery methods have been developed to improve patient compliance, reduce bacterial resistance, and boost mupirocin delivery. Therefore, this pilot study was conducted with the aim of evaluating the effectiveness of mupirocin nanomicelles in insulin-based gel in the management of open skin wounds in Iraqi participants. Materials & methods: A randomized case-control, clinical trial pilot study including 40 skin-wounded patients was conducted in a private surgery clinic in Al-Zubair-Basrah, Iraq. The patients were randomly assigned to two treatment groups (20 male & 20 female patients each): mupirocin nanomicelles in insulin-based gel (2%), and mupirocin gel (2%). They were followed for 5 days. The percentage of wound contraction (% Wound Contraction) was measured and the wound areas were photographed. Results: On day 5 of treatment, all cases treated with mupirocin nanomicells in insulin-based gel showed complete healing (% Wound Contraction = 100) without signs of infection, compared to the mupirocin-treated group (% Wound Contraction = 90.8±1.04) with four cases of infections (p = 0.001). The majority of wounds were located in the arms. Conclusion: The findings suggested that mupirocin nanomicells in insulin-based gel could have applications in the future, as it can promote improved acute wound healing in various regions of the body, percentage of wound contraction, and infection-free status. [ABSTRACT FROM AUTHOR]

Chronic non‐healing wounds pose significant challenges due to an elevated inflammatory response caused in part by bacterial contamination (Physiol Rev. 2019;99:665). These wounds lead to billions being spent in the health care system worldwide (N Engl J Med. 2017;376:2367, Int J Pharm. 2014;463:119). We studied the in‐vitro and in‐vivo antimicrobial effects of a multimodal wound matrix (MWM) against two common wound pathogens, Methicillin‐Resistant Staphylococcus aureus (MRSA USA300) and Pseudomonas aeruginosa ATCC 27312 (PA27312) (Int Wound J. 2019;16:634). The in‐vitro study conducted was a zone of inhibition test with the two microbes at 104 Log CFU/mL inoculated on Tryptic soy agar with 5% sheep blood (TSAII) plates. Treatments used were MWM, Mupirocin (Positive control for MRSA), Silver Sulfadiazine (Positive Control for PA), Petrolatum and Sterile Saline (both serving as Negative Controls). Treatments were allowed to diffuse into the agar for 3 h and then were incubated for 24 h at 37°C. The in‐vivo study utilized a deep dermal porcine wound model (22 × 22 × 3 mm) created on six animals. Three animals were inoculated with MRSA USA300 and the other three with PA27312 with each allowing a 72‐h biofilm formation. After 72 h, baseline wounds were assessed for bacterial concentration and all remaining wounds were treated with either MWM alone, Silver Treatment or Untreated Control. Wounds were assessed on days 4, 8 and 12 after treatment application for microbiological analysis. In‐vitro, MWM exhibited significant inhibition of MRSA USA300 and PA27312 growth when compared to negative controls (p ≤ 0.05). Likewise, in‐vivo, the MWM‐treated wounds exhibited a significant (p ≤ 0.05) bacterial reduction compared to all other treatment groups, especially on days 8 and 12 for both pathogens. MWM demonstrated promise in addressing colonized wounds with biofilms. Additional studies on MWM's benefits and comparisons with existing treatments are warranted to optimize wound care strategies (Adv Wound Care. 2021;10:281). [ABSTRACT FROM AUTHOR]

Background: Staphylococcus aureus is a ubiquitous organism that normally colonizes the human body and causes food poisoning. This study aimed to determine the rate of nasal carriage of S. aureus among food handlers in Sana'a restaurants in, Yemen and performed an antibacterial susceptibility test. Methods: This cross-sectional study was carried out among healthy food handlers from November 2022 to March 2023. Approximately 024 nasal swabs were collected and S. aureus was isolated and identified according to standard bacteriological procedures. Moreover, the antibacterial susceptibility pattern was determined using the disc diffusion method. Additionally, the required data were obtained by using the pretested questionnaire. Results: Of 420 nasal swabs, 78 (18.6%) food handlers were S. aureus nasal carriers. The prevalence rate of S. aureus was significantly higher among subjects aged >30 years (23.1%), males (18.8%), and uneducated subjects (25%). Additionally, a higher rate of S. aureus nasal carriers was observed among food handlers who worked as cooks (19.4%), had less than 2 years of experience (20.5%), and had low hygiene (29%). The S. aureus isolates were sensitive to ciprofloxacin (71.8%), vancomycin (76.9%), and amoxicillin-clavulanic acid (61%). Conversely, the isolated S. aureus was resistant to oxacillin (69.2%) and methicillin (66.7%). Conclusion: These data stress that food handlers with a high S. aureus nasal carrier rate may pose significant risks to consumers. Therefore, creating restaurant policies and rules is necessary to provide safe and healthy food to consumers. [ABSTRACT FROM AUTHOR]

By combining mechanical treatment of aluminium alloy with subsequent surface modification using micro-arc oxidation (MAO) technology, zinc oxide (ZnO) oxide coatings were prepared, which achieved enhanced hydrophobic properties, excellent antibacterial activity and corrosion resistance. The coatings were oxidised at different MAO discharge intensities using different frequencies. All surfaces were subjected to determination of wettability, corrosion resistance and chemical stability at 1, 7, 14, and 28 days and antibacterial activity of the coatings against the bacterial population of Staphylococcus aureus, Escherichia coli with an evaluation of population inhibition after 24 h. The surfaces mechanically modified by blasting showed a hydrophobic character; their subsequent oxidation by MAO contributed to a significant increase in hydrophobic properties. The sample with the highest Zn content (1.1 wt%), prepared at an MAO source frequency of 222 Hz, i.e. at the most intense plasma discharge, showed the most significant chemical stability in simulated body fluid (SBF) and distilled water and showed the highest antibacterial activity after 24 h. Thus, blasting of aluminium alloy surfaces and their subsequent MAO in alkaline electrolyte allows to obtain oxide coatings with antibacterial, hydrophobic and corrosion-resistant properties with the possibility of their use on surfaces with potential occurrence of harmful bacteria. • Oxide layers on aluminium alloy were prepared in alkaline electrolyte. • Frequencies of 49, 95 and 222 Hz, blasting and MAO technology combination were used. • Mechanically modified layers and MAO coatings achieved hydrophobic properties. • ZnO-doped MAO coatings had antibacterial properties and higher corrosion resistance. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal myiasis is a rare condition, with few reports available on the subject. Surgical management is recommended in some cases. In this study, we present the case of a 7-day-old male neonate with larvae in his scrotum who underwent surgery. Case presentation: A full-term 7-day-old male infant (Aryan race) was referred to a children's hospital. On the sixth day after birth, three 3–4 mm long larvae crawled out from his scrotum, with the number increasing over time. He was given intravenous antibiotics and topical mupirocin to combat secondary infections. The surgical treatment involved two steps: first, the larvae were extracted, and then the infection site was washed with betadine and hydrogen peroxide to help remove any possible remaining larvae. Conclusion: Scrotal myiasis is a rare disease that occurs in infants and requires immediate treatment. Surgical treatment is effective in removing dead or decaying larvae from a deep-seated location and washing the infection site to prevent secondary infection. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is a new update on the resistance profile, Macrolide–Lincosamide–Streptogramin B resistance mechanisms and biofilm formation in the Staphylococcus aureus isolated from health care workers (HCWs) nasal carriage at a children's teaching hospital in Babol (Northern Iran). Results: A total of 143 non-repetitive nasal swab samples were collected from volunteers, where 53.8% (n; 77/143) were HCWs, 33.6% (n; 48/143) medical students, and 12.6% (n; 18/143) resident students. The prevalence of nasal carriers of S. aureus was 22.4% (n; 32/143), among them, 40.6% (n; 13/32) were identified as methicillin-resistant Staphylococcus aureus (MRSA(carriers. Antimicrobial susceptibility testing showed that erythromycin (68.8%, n; 22/32) and ciprofloxacin (15.6%, n; 5/32) had the highest and lowest resistance rate, respectively. The frequency of resistance genes in the strains was as follows; ermC (n; 17/32, 53.1%), ermA (n; 11/32, 34.4%), ermB (n; 6/32, 18.7%), ereA (n; 3/32, 9.4%). Moreover, 50.0% (n; 16/32), 28.1% (n; 9/32) and 21.8% (n; 7/32) of isolates were strongly, weakly and moderately biofilm producer, respectively. Macrolides-lincosamides-streptogramins B (MLSB) antibiotic resistance among S. aureus isolates from HCWs nasal carriage have found significant prevalence rates throughout the globe. It is crucial to remember that the development of biofilms and MLS B antibiotic resistance are both dynamic processes. [ABSTRACT FROM AUTHOR]

The application properties such as foam property, electrolyte tolerance, antibacterial activity and antistatic performance of the mixed systems of a novel Gemini quaternary ammonium salt with quadra‐cationic sites (TC‐GS) and sodium fatty alcohol polyoxyethylene ether carboxylate (AE9CNa) at various molar fraction of TC‐GS (αTC‐GS), were investigated systematically. Results show that TC‐GS/AE9CNa mixed systems with different ratios form a homogeneous and transparent solution, which exhibits excellent foam stability and antibacterial activity. The foam volume of the mixed system remains nearly constant from 400 s to 1000 s, and even when TC‐GS is 10 mg/L in the mixed systems, the antibacterial rates against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) for 2 min. are all exceeded 99 %. The mixed systems of TC‐GS/AE9CNa at various αTC‐GS also demonstrate the superior electrolyte tolerance, their maximum tolerance of NaCl, CaCl2 and MgCl2 is severally beyond 270 g/L, 180 g/L and 180 g/L. In addition, both TC‐GS solution and the mixed systems have good antistatic properties, which can reduce the surface resistance of polyester fabric to ≤1010 Ω. [ABSTRACT FROM AUTHOR]

Introduction: Staphylococcus aureus is an identified pathogen involved in the recurrence of symptoms in patients with chronic rhinosinusitis with nasal polyps. We investigated the effectiveness of a topical ointment of mupirocin applied in the nasal vestibule in lessening symptom recurrence and improving the efficiency of functional endoscopic sinus surgery. Materials and Methods: Patients with chronic rhinosinusitis, nasal polyps, and a positive nostril culture for Staphylococcus aureus were included in a clinical trial. The right nostril was determined as the intervention group (applying mupirocin ointment) and the left as the control group (applying vitamin A ointment). Lund-Mackay radiological scores and Lund-Kennedy endoscopic scores were examined at the time of diagnosis and six months later. Results: Among 60 patients with chronic rhinosinusitis with nasal polyps, 91.6% were positive for nostril Staphylococcus aureus. Comparing the average of the diagnostic radiological and endoscopic scores with the follow-up values in both groups indicated a significant improvement after surgery (Pvalue= 0.001, 0.001). However, there was no significant difference in the radiological and endoscopic score improvements between the study and control groups (P-value > 0.56, 0.74). Conclusion: Nasal mupirocin administration following endoscopic sinus surgery cannot significantly prevent symptom recurrence in chronic rhinosinusitis with nasal polyps. [ABSTRACT FROM AUTHOR]

Chitosan-based biomaterials are being investigated for their unique properties that support skin regeneration and wound healing. This study focused on the preparation and characterization of a mupirocin (Mup)-loaded PEGylated chitosan (CS-PEG) nanoparticulate film (NF) [CBNF]. The CBNF was characterized using FTIR spectroscopy and SEM analysis. The results demonstrated that CBNF was successfully incorporated into the composites, as shown by functional group modification through FTIR analysis. Additionally, the SEM micrograph revealed the deposition of nanoparticles (<200 nm) on the surface of transparent CBNF. The film has higher water absorption (≥1700%) and moderate water retention ability within 6 h. Furthermore, histological findings showed significant development, with re-epithelialization and granulation of tissues after 19 days, indicating the healing efficiency of CNBF. These results suggest that drug-loaded films could be an effective carrier and delivery agent for Mup-like anti-inflammatory drugs. [ABSTRACT FROM AUTHOR]

The present study is to develop and evaluate an ethosomal gel formulation of ciprofloxacin. It aims to provide a topical treatment for many bacterial infections that affect the skin. Administration of medications topically having the facility of delivering a high concentration of the drug to the skin than would be possible with systemic therapy. Topical administration of drugs is better for local action and the efficiency of the topically administered drug is increased with liposome, proliposomes and ethosomes. Recently, it was found that ethosomal carriers were phospholipid vesicular systems having relatively high concentrations of alcohol, enhances dermal and transdermal delivery of both lipophilic as well as hydrophilic molecules. Ciprofloxacin hydrochloride is a second-generation antibiotic and a BCS class II drug. Ethosomes were formulated using phospholipid, cholesterol, ethanol, polyethylene glycol and purified water by cold method. Ethosomes were evaluated for vesicle size, shape, optical microscopy, entrapment efficiency and in-vitro release study. F4 have better drug entrapment efficiency than the other formulation. The best formulation (F4) was used to prepare gel by using carbopol 934 as a gelling agent. The ethosomes were entrapped in gel matrix of carbopol 980 in different concentration 0.5%, 1.00% and 2% w/w. FT-IR studies revealed no interaction between the drug and excipients. The formulated gel formulation was evaluated with parameter pH, viscosity, spreadability, in-vitro release test, wash ability, extrudability study and stability studies. The formulation EGF2 have better in-vitro drug release profile which contains carbopol 980 concentration 1%w/w. the stability studies performed (EGF2) at refrigeration temperature (4.0±0.2°C), at room temperature (25-28±2°C) and 45±1°C for 45days. These ethosomes were unstable at higher temperature like 45.2°C. Percent efficiency of ethosomes also decrease at higher temperature like 4502°C. The present work also focuses on making the formulation more pharmaceutically acceptable. [ABSTRACT FROM AUTHOR]

Nano-mupirocin is a PEGylated nano-liposomal formulation of the antibiotic mupirocin, undergoing evaluation for treating infectious diseases and intratumor bacteria. Intratumoral microbiota play an important role in the regulation of tumor progression and therapeutic efficacy. However, antibiotic use to target intratumoral bacteria should be performed in a way that will not affect the gut microbiota, found to enable the efficacy of cancer treatments. Nano-mupirocin may offer such a selective treatment. Herein, we demonstrate the ability of Nano-mupirocin to successfully target tumor-residing Fusobacterium nucleatum without an immediate effect on the gut microbiome. In-depth characterization of this novel formulation was performed, and the main findings include: (i). the pharmacokinetic analysis of mupirocin administered as Nano-mupirocin vs mupirocin lithium (free drug) demonstrated that most of the Nano-mupirocin in plasma is liposome associated; (ii). microbiome analysis of rat feces showed no significant short-term difference between Nano-mupirocin, mupirocin lithium and controls; (iii). Nano-mupirocin was active against intratumoral F. nucleatum , a tumor promoting bacteria that accumulates in tumors of the AT3 mice model of breast cancer. These data suggest the ability of Nano-mupirocin to target tumor residing and promoting bacteria. Nano-mupirocin may offer a selective tumor-targeting antibiotic. Herein, we demonstrate the ability of Nano-mupirocin to successfully target tumor-residing Fusobacterium nucleatum without an immediate effect on the gut microbiome. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: Biofilms significantly contribute to the persistence and antibiotic resistance of Staphylococcus aureus infections. However, the regulatory mechanisms governing biofilm formation of S. aureus remain not fully elucidated. This study aimed to investigate the function of the S. aureus lineage-specific two-component system, desKR, in biofilm regulation and pathogenicity. Methods: Bioinformatic analysis was conducted to assess the prevalence of desKR across various S. aureus lineages and to examine its structural features. The impact of desKR on S. aureus pathogenicity was evaluated using in vivo mouse models, including skin abscess, bloodstream infection, and nasal colonization models. Crystal violet staining and confocal laser scanning microscopy were utilized to examine the impact of desKR on S. aureus biofilm formation. Mechanistic insights into desKR-mediated biofilm regulation were investigated by quantifying polysaccharide intercellular adhesin (PIA) production, extracellular DNA (eDNA) release, autolysis assays, and RT-qPCR. Results: The prevalence of desKR varied among different S. aureus lineages, with notably low carriage rates in ST398 and ST59 lineages. Deletion of desKR in NCTC8325 strain resulted in decreased susceptibility to β-lactam and glycopeptide antibiotics. Although desKR did not significantly affect acute pathogenicity, the ΔdesKR mutant exhibited significantly reduced nasal colonization and biofilm-forming ability. Overexpression of desKR in naturally desKR-lacking strains (ST398 and ST59) enhanced biofilm formation, suggesting a lineage-independent effect. Phenotypic assays further revealed that the ΔdesKR mutant showed reduced PIA production, decreased eDNA release, and lower autolysis rates. RT-qPCR indicated significant downregulation of icaA, icaD, icaB, and icaC genes, along with upregulation of icaR, whereas autolysis-related genes remained unchanged. Conclusion: The desKR two-component system positively regulates S. aureus biofilm formation in a lineage-independent manner, primarily by modulating PIA synthesis via the ica operon. These findings provide new insights into the molecular mechanisms of biofilm formation in S. aureus and highlight desKR as a potential target for therapeutic strategies aimed at combating biofilm-associated infections. [ABSTRACT FROM AUTHOR]

ImportanceUniversal nasal mupirocin plus chlorhexidine gluconate (CHG) bathing in intensive care units (ICUs) prevents methicillin-resistant Staphylococcus aureus (MRSA) infections and all-cause bloodstream infections. Antibiotic resistance to mupirocin has raised questions about whether an antiseptic could be advantageous for ICU decolonization.ObjectiveTo compare the effectiveness of iodophor vs mupirocin for universal ICU nasal decolonization in combination with CHG bathing.Design, setting, and participantsTwo-group noninferiority, pragmatic, cluster-randomized trial conducted in US community hospitals, all of which used mupirocin-CHG for universal decolonization in ICUs at baseline. Adult ICU patients in 137 randomized hospitals during baseline (May 1, 2015-April 30, 2017) and intervention (November 1, 2017-April 30, 2019) were included.InterventionUniversal decolonization involving switching to iodophor-CHG (intervention) or continuing mupirocin-CHG (baseline).Main outcomes and measuresICU-attributable S aureus clinical cultures (primary outcome), MRSA clinical cultures, and all-cause bloodstream infections were evaluated using proportional hazard models to assess differences from baseline to intervention periods between the strategies. Results were also compared with a 2009-2011 trial of mupirocin-CHG vs no decolonization in the same hospital network. The prespecified noninferiority margin for the primary outcome was 10%.ResultsAmong the 801 668 admissions in 233 ICUs, the participants' mean (SD) age was 63.4 (17.2) years, 46.3% were female, and the mean (SD) ICU length of stay was 4.8 (4.7) days. Hazard ratios (HRs) for S aureus clinical isolates in the intervention vs baseline periods were 1.17 for iodophor-CHG (raw rate: 5.0 vs 4.3/1000 ICU-attributable days) and 0.99 for mupirocin-CHG (raw rate: 4.1 vs 4.0/1000 ICU-attributable days) (HR difference in differences significantly lower by 18.4% [95% CI, 10.7%-26.6%] for mupirocin-CHG, P

Allergic contact dermatitis is a rare cause of emergency room visits. However, it can progress to life-threatening conditions such as urticaria and angioedema. In this report, we describe a case that developed severe allergic contact dermatitis around the eye applying an eyelash dye containing p-Phenylenediamine. A 21-year-old female patient was admitted to the emergency department with the complaint of swelling and redness around both eyes. Swelling and redness started 3 days ago with permanent eyelash dye (containing p-Phenylenediamine) application in the beauty center. Clinically, periocular edema and rash was suspected to be an allergic reaction to a substance contained in the eyelash dye. For allergic contact dermatitis, 40 mg methylprednisolone, 45.5 mg pheniramine maleate, IV bolus was administered. The vesicular rash was thought to be a herpes lesion. She was discharged from the emergency department, with an initial dose of 16 mg methyl prednisolone (discontinued by reducing the dose), 500 mg oral valacyclovir twice a day, mupirocin cream on twice a day and oral levocetrizine 5 mg once daily. It was observed that the patient's lesions and redness regressed after 2 weeks. The effects of cosmetic products, which are the agents that come into contact with the skin most often, may differ individually. Agents included in cosmetic products, such as in our case, may cause severe contact dermatitis that requires treatment. Beauticians should also be informed about PPD. Patients who have had allergic reactions due to the use of PPD-containing dyes should use PPD-free cosmetic products. [ABSTRACT FROM AUTHOR]

Abstract Background Nasal carriage of Staphylococcus aureus is a risk factor for surgical site infections (SSI) in orthopaedic surgery. The efficacy of decolonisation for S. aureus on reducing the risk of SSI is uncertain in this speciality. The objective was to evaluate the impact of a nasal screening strategy of S. aureus and targeted decolonisation on the risk of S. aureus SSI. Methods A retrospective pre-post and here-elsewhere study was conducted between January 2014 and June 2020 in 2 adult orthopaedic surgical sites (North and South) of a French university hospital. Decolonisation with Mupirocin and Chlorhexidine was conducted in S. aureus carriers starting February 2017 in the South site (intervention group). Scheduled surgical procedures for hip, knee arthroplasties, and osteosyntheses were included and monitored for one year. The rates of S. aureus SSI in the intervention group were compared to a historical control group (South site) and a North control group. The risk factors for S. aureus SSI were analysed by logistic regression. Results A total of 5,348 surgical procedures was included, 100 SSI of which 30 monomicrobial S. aureus SSI were identified. The preoperative screening result was available for 60% (1,382/2,305) of the intervention group patients. Among these screenings, 25.3% (349/1,382) were positive for S. aureus and the efficacy of the decolonisation was 91.6% (98/107). The rate of S. aureus SSI in the intervention group (0.3%, 7/2,305) was not significantly different from the historical control group (0.5%, 9/1926) but differed significantly from the North control group (1.3%, 14/1,117). After adjustment, the risk factors of S. aureus SSI occurrence were the body mass index (ORaper unit, 1.05; 95%CI, 1.0-1.1), the Charlson comorbidity index (ORaper point, 1.34; 95%CI, 1.0–1.8) and operative time (ORaper minute, 1.01; 95%CI, 1.00–1.02). Having benefited from S. aureus screening/decolonisation was a protective factor (ORa, 0.24; 95%CI, 0.08–0.73). Conclusions Despite the low number of SSI, nasal screening and targeted decolonisation of S. aureus were associated with a reduction in S. aureus SSI.

This study was directed to prepare poly (lactic acid) curcumin (Cur)-based nanofibers using the electrospinning method and their evaluation potentially in the presence of titanium dioxide (TiO2) nanoparticles as bioactive wound dressings. The interactions between components, crystallinity nature, and presence of Cur-TiO2 in the prepared nanofibers were demonstrated by Fourier transform infrared spectroscopy, X-ray diffraction, and energy-dispersive X-ray spectroscopy. Furthermore, scanning electron microscopy images revealed that the existence of Cur-TiO2 in the system caused a decrease in the nanofiber diameters from 264 ± 29 to 210 ± 18 nm, and the significant influence of TiO2 on the hydrophilicity of nanofibers was proved by the water contact angle test. Based on the cytotoxicity studies, TiO2-containing nanofibers were biocompatible and did not reduce the viability of the cultured fibroblast cells. Moreover, it was found that the cell proliferation and level of cell adhesion increased in the presence of Cur-TiO2, and the highest amount of cell growth occurred on scaffolds containing TiO2, according to fluorescent staining. Finally, the antibacterial activities of the samples against Gram-negative and Gram-positive bacteria, named Escherichia coli and Staphylococcus aureus, respectively, were analyzed, which confirmed that the addition of Cur-TiO2 caused bacterial resistance, resulting in their desired potential for being employed in wound dressing applications. [ABSTRACT FROM AUTHOR]