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mrsa bacteremia treatment

Eun Ju Choo, Henry F Chambers
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of health care-associated infections. Vancomycin remains an acceptable treatment option. There has been a welcome increase in the number of agents available for the treatment of MRSA infection. These drugs have certain differentiating attributes and may offer some advantages over vancomycin, but they also have significant limitations. These agents provide some alternative when no other options are available.
December 2016: Infection & Chemotherapy
J Chase McNeil, Sheldon L Kaplan, Jesus G Vallejo
BACKGROUND: Bacteremia is often one factor used in deciding the need for prolonged intravenous antimicrobial therapy in osteoarticular infections (OAI). We examined treatment practices and outcomes of bacteremic S. aureus osteoarticular infections (BOAI) evaluated at Texas Children's Hospital (TCH). METHODS: Cases of acute hematogenous OAI in children with positive blood cultures for S. aureus at TCH from 2011-2014 were reviewed. Orthopedic complications included chronic osteomyelitis, growth arrest, pathologic fracture, avascular necrosis and chronic dislocation...
December 23, 2016: Pediatric Infectious Disease Journal
Shey-Ying Chen, John M Giurini, Adolf W Karchmer
BACKGROUND: Diabetic foot ulcers (DFUs) threaten limbs and prompt hospitalization. After hospitalization, remote-site invasive systemic infection related to DFU (DFU-ISI) may occur. The characteristics of DFU-ISIs and their effect on mortality risk have not been defined. METHODS: We conducted a retrospective cohort study of 819 diabetic patients hospitalized for treatment of 1212 unique DFUs during a 9-year period. We defined the index ulcer as that present at the first (index) DFU admission to our hospital...
November 10, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jessica Branson, Jesus G Vallejo, Anthony R Flores, Kristina G Hulten, Edward O Mason, Sheldon L Kaplan, J Chase McNeil
BACKGROUND: Septic arthritis (SA) and acute osteomyelitis (AO) are among the most common serious bacterial infections of childhood. Knowledge of the microbiology of SA is critical to treatment. Awareness of the presence of attendant AO is also important to guide clinical management. We sought to describe the current microbiology of SA in children as well as describe clinical features associated with coexisting AO. MATERIALS AND METHODS: Patients with SA were identified from the infectious diseases consult service records from 2010-2014...
November 18, 2016: Pediatric Infectious Disease Journal
Rajeev Soman, Neha Gupta, Mitesh Suthar, Jatin Kothari, Alan Almeida, Anjali Shetty, Camilla Rodrigues
BACKGROUND: Central-line-associated blood-stream infection (CLABSI) is a highly consequential nosocomial infection. The most effective management includes the removal of the infected catheter. Retention of the catheter and antibiotic lock therapy (ALT) along with systemic antibiotics may be attempted only if there are unusual extenuating circumstances. CLABSIs due to Gram-negative bacteria (GNB) is more common in our setting and the organisms are often highly resistant. Hence, there is a need to explore the use of novel antimicrobials for catheter lock solutions along with antibiofilm agents...
February 2016: Journal of the Association of Physicians of India
Miki Nagao, Masaki Yamamoto, Yasufumi Matsumura, Isao Yokota, Shunji Takakura, Satoshi Teramukai, Satoshi Ichiyama
PURPOSE: Staphylococcus aureus bacteremia (SAB) is a serious clinical condition associated with high morbidity and mortality. Recent studies have revealed that adherence to evidence-based quality-of-care indicators (QCIs) for the management of SAB could result in reduced mortality. We aimed to determine whether compliance with QCIs was associated with mortality and whether compliance with QCIs predicted the mortality of patients with SAB. METHODS: In a university hospital in Kyoto, Japan, SAB patients, who survived at least 14 days after positive blood cultures were analyzed from 2006 to 2014 to assess their compliance with QCIs and the trend in mortality...
October 5, 2016: Infection
Hideo Shiohira, Masashi Nakamatsu, Yuya Kise, Futoshi Higa, Masao Tateyama, Nobuo Hokama, Yukio Kuniyoshi, Shinichiro Ueda, Katsunori Nakamura, Jiro Fujita
Teicoplanin, a glycopeptide antibiotic for methicillin-resistant Staphylococcus aureus, is recommended for therapeutic drug monitoring during treatment. Maintaining a high trough range of teicoplanin is also recommended for severe infectious disease. However, the optimal dose and interval of treatment for severe renal impairment is unknown. We report a 79-year-old man who received long-term teicoplanin treatment for methicillin-resistant Staphylococcus aureus bacteremia due to postoperative sternal osteomyelitis with renal impairment...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Brendan J McMullan, Asha Bowen, Christopher C Blyth, Sebastiaan Van Hal, Tony M Korman, Jim Buttery, Lesley Voss, Sally Roberts, Celia Cooper, Steven Y C Tong, John Turnidge
Importance: Staphylococcus aureus bacteremia (SAB) in children causes significant morbidity and mortality, but the epidemiology in children is not well characterized. Objective: To describe the epidemiology of SAB in children and adolescents younger than 18 years from Australia and New Zealand. Design, Setting, and Participants: A prospective cohort study, using data from the Australian New Zealand Cooperative on Outcomes in Staphylococcal Sepsis cohort for 1153 children with SAB from birth to less than 18 years in pediatric and general hospitals across Australia and New Zealand, collected between January 1, 2007, and December 31, 2012...
October 1, 2016: JAMA Pediatrics
Yvonne J Burnett, Kelly Echevarria, Kristi A Traugott
OBJECTIVE: To summarize published data regarding the use of ceftaroline as salvage monotherapy for persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. DATA SOURCES: PubMed (January 1980-June 2016) was searched using combinations of the search terms methicillin-resistant Staphylococcus aureus, MRSA, bacteremia, ceftaroline, refractory, and persistent Supplemental references were generated through review of identified literature citations. STUDY SELECTION AND DATA EXTRACTION: Available English-language, full-text articles pertaining to the use of ceftaroline for persistent MRSA bacteremia (MRSAB) were included...
August 12, 2016: Annals of Pharmacotherapy
Sylvain Barreau, Sihem Benaboud, Solen Kernéis, Laurence Moachon, Philippe Blanche, Matthieu Groh, Laurent Massias, Jean-Marc Treluyer, Claire Poyart, Josette Raymond
We report two cases of treatment failure in patients with osteoarticular infection associated with <i>Staphylococcus aureus</i> bacteremia and receiving daptomycin. Using a published population-pharmacokinetic model and daptomycin blood level in these patients, area under the curve (AUC) was calculated and compared to the pharmacological target. For the first patient, treated with 6 mg/kg every 48 hours due to acute renal failure and then every 24 hours, the AUC was 820 mg×h×L<sup>-1</sup>, with a minimal concentration of 23...
November 2016: International Journal of Clinical Pharmacology and Therapeutics
Xufen Hong, Juanxiu Qin, Tianming Li, Yingxin Dai, Yanan Wang, Qian Liu, Lei He, Huiying Lu, Qianqian Gao, Yong Lin, Min Li
The highly successful epidemic of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) ST239 is a growing concern worldwide, due to its progressive adaptation to the highly selective environment of the healthcare system. HA-MRSA ST239 display the reduced virulence and successfully colonize in hospital settings, while the emergent community-associated MRSA (CA-MRSA) maintain full virulence and cause infections in the community environment. Our aim was to investigate what enables S. aureus ST239 to be highly adaptive under hospital circumstances and gradually progress to a series of widespread invasive infections...
2016: Frontiers in Microbiology
Kimberly C Claeys, Evan J Zasowski, Anthony M Casapao, Abdalhamid M Lagnf, Jerod L Nagel, Cynthia T Nguyen, Jessica A Hallesy, Mathew T Compton, Keith S Kaye, Donald P Levine, Susan L Davis, Michael J Rybak
Vancomycin remains the mainstay treatment for methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) despite increased treatment failures. Daptomycin has been shown to improve clinical outcomes in patients with BSIs caused by MRSA isolates with vancomycin MICs of >1 mg/liter, but these studies relied on automated testing systems. We evaluated the outcomes of BSIs caused by MRSA isolates for which vancomycin MICs were determined by standard broth microdilution (BMD). A retrospective, matched cohort of patients with MRSA BSIs treated with vancomycin or daptomycin from January 2010 to March 2015 was completed...
October 2016: Antimicrobial Agents and Chemotherapy
Young Kyung Yoon, Dae Won Park, Jang Wook Sohn, Hyo Youl Kim, Yeon-Sook Kim, Chang-Seop Lee, Mi Suk Lee, Seong-Yeol Ryu, Hee-Chang Jang, Young Ju Choi, Cheol-In Kang, Hee Jung Choi, Seung Soon Lee, Shin Woo Kim, Sang Il Kim, Eu Suk Kim, Jeong Yeon Kim, Kyung Sook Yang, Kyong Ran Peck, Min Ja Kim
BACKGROUND: The purported value of empirical therapy to cover methicillin-resistant Staphylococcus aureus (MRSA) has been debated for decades. The purpose of this study was to evaluate the effects of inappropriate empirical antibiotic therapy on clinical outcomes in patients with healthcare-associated MRSA bacteremia (HA-MRSAB). METHODS: A prospective, multicenter, observational study was conducted in 15 teaching hospitals in the Republic of Korea from February 2010 to July 2011...
July 15, 2016: BMC Infectious Diseases
Yousun Chung, Taek Soo Kim, Young Gi Min, Yun Ji Hong, Jeong Su Park, Sang Mee Hwang, Kyoung-Ho Song, Eu Suk Kim, Kyoung Un Park, Hong Bin Kim, Junghan Song, Eui-Chong Kim
Staphylococci are the leading cause of nosocomial blood stream infections. Fast and accurate identification of staphylococci and confirmation of their methicillin resistance are crucial for immediate treatment with effective antibiotics. A multiplex real-time PCR assay that targets mecA, femA specific for S. aureus, femA specific for S. epidermidis, 16S rRNA for universal bacteria, and 16S rRNA specific for staphylococci was developed and evaluated with 290 clinical blood culture samples containing Gram-positive cocci in clusters (GPCC)...
2016: BioMed Research International
Joseph S Fernandez-Moure, Jeffrey L Van Eps, Lilia Peress, Concepcion Cantu, Randall J Olsen, Leslie Jenkins, Fernando J Cabrera, Ennio Tasciotti, Bradley K Weiner, Brian J Dunkin
BACKGROUND: Surgical energy has been widely implemented because of ease of use, effective hemostasis, and surgical dissection. Studies demonstrate its use to be an independent risk factor for postoperative wound infection. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common bacteria found in postoperative mesh infection. No reports are available on the sequelae of surgical energy use for open ventral hernia repair (oVHR) with mesh. We hypothesized that increasing amounts of surgical energy will result in higher infectious burden after oVHR with composite multifilament polyester mesh (Parietex™ PCO)...
July 7, 2016: Surgical Endoscopy
Masayuki Maeda, Hisashi Shoji, Tetsuro Shirakura, Takahiro Takuma, Kazuhisa Ugajin, Kunihiko Fukuchi, Yoshihito Niki, Keiko Ishino
It is well known that methicillin-resistant Staphylococcus aureus (MRSA) produces many virulence factors, such as hemolysins, leukocidins, proteases, enterotoxins, exfoliative toxins, and immune-modulatory factors. The aim of study was to identify staphylococcal pathogenicity that may affect the prognosis of patients with MRSA bacteremia. We obtained 149 MRSA strains from blood cultures between January 2009 and December 2014 in our institution. We collected information on patient characteristics, laboratory data, staphylococcal toxin genes, and susceptibility of the strain toward anti-MRSA agent and analyzed them as factors contributing to 30-d mortality...
2016: Biological & Pharmaceutical Bulletin
Angélica Cechinel, Denise P Machado, Eduardo Turra, Dariane Pereira, Rodrigo P Dos Santos, Regis G Rosa, Luciano Z Goldani
Background. Polymorphism of the accessory gene regulator group II (agr) in methicillin-resistant Staphylococcus aureus (MRSA) is predictive of vancomycin failure therapy. Nevertheless, the impact of group II agr expression on mortality of patients with severe MRSA infections is not well established. Objective. The goal of our study was to evaluate the association between agr polymorphism and all-cause in-hospital mortality among critically ill patients receiving vancomycin for nosocomial MRSA bacteremia. Methods...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
Bas G J Surewaard, Justin F Deniset, Franz J Zemp, Matthias Amrein, Michael Otto, John Conly, Abdelwahab Omri, Robin M Yates, Paul Kubes
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is reaching epidemic proportions causing morbidity, mortality, and chronic disease due to relapses, suggesting an intracellular reservoir. Using spinning-disk confocal intravital microscopy to track MRSA-GFP in vivo, we identified that within minutes after intravenous infection MRSA is primarily sequestered and killed by intravascular Kupffer cells (KCs) in the liver. However, a minority of the Staphylococci overcome the KC's antimicrobial defenses...
June 27, 2016: Journal of Experimental Medicine
Mao Hagihara, Hideo Kato, Yukihiro Hamada, Jun Hirai, Daisuke Sakanashi, Hiroyuki Suematsu, Naoya Nishiyama, Yusuke Koizumi, Yuka Yamagishi, Katsuhiko Matsuura, Hiroshige Mikamo
The efficacy of arbekacin in patients with MRSA infections is influenced by the peak concentration (Cpeak)/MIC ratio (≧8). A daily arbekacin dose of 4-6 mg/kg is primarily used for the treatment of MRSA infection. However, clinical pharmacokinetic studies of arbekacin that evaluate changes in patients with different infectious diseases have been limited. This study was to evaluate the pharmacokinetics of arbekacin in different infectious diseases and to evaluate its dosing regimens. This work describes a single-centre, retrospective study...
July 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
J Le, Q Dam, M Schweizer, W Thienphrapa, V Nizet, G Sakoulas
Recent studies have demonstrated that anti-staphylococcal beta-lactam antibiotics, like nafcillin, render methicillin-resistant Staphylococcus aureus (MRSA) more susceptible to killing by innate host defense peptides (HDPs), such as cathelicidin LL-37. We compared the effects of growth in 1/4 minimum inhibitory concentration (MIC) of nafcillin or vancomycin on the LL-37 killing of 92 methicillin-susceptible S. aureus (MSSA) isolates. For three randomly selected strains among these, we examined the effects of nafcillin, vancomycin, daptomycin, or linezolid on LL-37 killing and autolysis...
September 2016: European Journal of Clinical Microbiology & Infectious Diseases
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