Methicillin-Resistant Staphylococcus aureus: Comparison of Susceptibility Testing Methods and Analysis of mecA-Positive Susceptible Strains

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for an increasing number of serious nosocomial and community-acquired infections. Phenotypic heterogeneous drug resistance (heteroresistance) to antistaphylococcal beta-lactams affects the results of susceptibility testing. The present study compared the MRSA-Screen latex agglutination test (Denka Seiken Co., Ltd., Tokyo, Japan) for detection of PBP 2a with agar dilution, the VITEK-1 and VITEK-2 systems (bioMérieux, St. Louis, Mo.), and the oxacillin agar screen test for detection of MRSA, with PCR for the mecA gene used as the "gold standard" assay. Analysis of 107 methicillin-susceptible S. aureus (MSSA) isolates and 203 MRSA isolates revealed that the MRSA-Screen latex agglutination test is superior to any single phenotype-based susceptibility testing method, with a sensitivity of 100% and a specificity of 99.1%. Only one isolate that lacked mecA was weakly positive by the MRSA-Screen latex agglutination test. This isolate was phenotypically susceptible to oxacillin and did not contain the mecA gene by Southern blot hybridization. The oxacillin agar screen test, the VITEK-1 system, the VITEK-2 system, and agar dilution showed sensitivities of 99.0, 99.0, 99.5, and 99%, respectively, and specificities of 98.1, 100, 97.2, and 100%, respectively. The differences in sensitivity or specificity were not statistically significant. Oxacillin bactericidal assays showed that mecA- and PBP 2a-positive S. aureus isolates that are susceptible to antistaphylococcal beta-lactams by conventional methods are functionally resistant to oxacillin. We conclude that the accuracy of the MRSA-Screen latex agglutination method for detection of PBP 2a approaches the accuracy of PCR and is more accurate than any susceptibility testing method used alone for the detection of MRSA.     

Mucosal bromodomain-containing protein 4 mediates aeroallergen-induced inflammation and remodeling

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Biodegradation study of crop residues as affected by exogenous inorganic nitrogen and fungal inoculants

The comparative decomposition of chickpea residue, and chopped and unchopped wheat straw was investigated in pits for 120 days. Microbial biomass, humus, C/N ratio, pH, Electrical conductivity (EC), dehydrogenase, alkaline phosphatase, cellulase, xylanase, total phenol and soluble protein were determined to assess their response to the addition of inorganic nitrogen and mixed fungal inoculum of Aspergillus nidulans, Phanerochaete chrysosporium and Trichoderma viride. The evaluation of physico-chemical parameters (organic matter, organic carbon, N, C/N, pH, EC, microbial biomass) revealed that by supplementing unchopped wheat straw with 1% urea and mixed fungal inoculum, a lowest C/N ratio of 10.7, lowest biomass of 9.54 and highest humus content of 13% can be achieved within 3 months. Germination of Lepidium sativum (cress seeds) showed a germination index >60%, in this treatment. The enzyme assay for dehydrogenase indicated highest microbial activity in uninoculated treatments compared to fungal inoculated counterparts, in the second month sampling (active phase of composting). However, cellulase and xylanase activity showed an upward trend during curing phase of composting. Chickpea residue compost, though resulted in a C/N ratio of 17.3, but its germination index was less than 60%. The rapid quality tests conducted for H2S, NH3, NO3 and starch confirmed the stability and maturity of finished compost prepared from wheat straw through microbial inoculants.     

Oesophageal foreign body in four month old infant

A 4 month old male infant was brought with only strong suspicion of foreign body ingestion without any symptomatology. X-ray examination revealed foreign body at cricopharyngeus, which was managed successfully emphasizing the fact that a strong suspicion and relevant radiography is the key to early and successful management.     

Waardenburg syndrome Type II

Two rare cases of Waardenburg type II are reported. First case had three main features of WS-profound SN hearing loss, hetrochromia iris and white forelock of hair. Second case had moderate SNHL and depigmentation of hair. Key words: Hetrochromia iris, white forelock hair.