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MRSA therapy

Nicola Steinhaus, Mohammed Al-Talib, Prudence Ive, Tom Boyles, Colleen Bamford, Mary-Ann Davies, Marc Mendelson, Sean Wasserman
OBJECTIVES: Limited evidence exists on the management and outcomes of Staphylococcus aureus bacteraemia (SAB) in resource-limited settings. The aim of this study was to describe a cohort of South African patients with SAB, and explore the factors associated with complicated infection and death. METHOD: A prospective observational study of patients over the age of 13 years admitted to a South African referral hospital with SAB. RESULTS: One hundred SAB infection episodes occurring in 98 patients were included...
June 13, 2018: International Journal of Infectious Diseases: IJID
Nieves M Coronado-Álvarez, Diego Parra, Jorge Parra-Ruiz
INTRODUCTION: Over recent years we have witnessed an increase in the resistance of microorganisms to the available antimicrobials and a decrease in the number of new antimicrobials. Fosfomycin is a safe and cheap broad-spectrum antibiotic which has shown very promising results in combination therapy, mainly against gram-negative microorganisms. Little is known, however, about its clinical efficacy against gram-positive microorganisms. METHODS: We performed a retrospective review of all patients with severe gram-positive infections who received fosfomycin as part of their treatment from 2011 to 2017...
June 12, 2018: Enfermedades Infecciosas y Microbiología Clínica
Yu-Feng Zhou, Yan Q Xiong, Meng-Ting Tao, Liang Li, Ming-Xiao Bu, Jian Sun, Xiao-Ping Liao, Ya-Hong Liu
Objectives: The chloramphenicol/florfenicol resistance gene cfr, which mediates cross-resistance to linezolid and other classes of antimicrobial agents, represents a global therapeutic challenge due to its dissemination among MDR nosocomial pathogens, including MRSA. This study aimed to compare the efficacy of the linezolid/rifampicin combination in a murine pneumonia model caused by cfr-positive and cfr-negative clinical MRSA strains. Methods: Synergistic activity between linezolid and rifampicin was evaluated by chequerboard and time-kill assays...
April 20, 2018: Journal of Antimicrobial Chemotherapy
Andras Farkas, Joseph Sassine, Joseph P Mathew, Christine Stavropoulos, Ron Stern, George Mckinley
Objectives: There is growing evidence that patients with community-onset pneumonia and recent healthcare exposure are not at equally high risk of infection with MDR organisms. An individualized approach is necessary with regard to risk assessment and choice of antibiotics. Methods: We reviewed the records of 102 patients admitted for community-onset pneumonia, before and after the implementation of a revised risk assessment programme for MDR organisms using the drug resistance in pneumonia (DRIP) score...
June 11, 2018: Journal of Antimicrobial Chemotherapy
Adrienne G Randolph, Ruifei Xu, Tanya Novak, Margaret M Newhams, Juliane Bubeck Wardenburg, Scott L Weiss, Ronald C Sanders, Neal J Thomas, Mark W Hall, Keiko M Tarquinio, Natalie Cvijanovich, Rainer G Gedeit, Edward J Truemper, Barry Markovitz, Mary E Hartman, Kate G Ackerman, John S Giuliano, Steven L Shein, Kristin Moffitt
Background: Respiratory coinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza-MRSA respiratory coinfection and evaluated antibiotic use. Methods: We prospectively enrolled children (<18 years) with influenza infection and acute respiratory failure across 34 pediatric intensive care units Nov 2008 to May 2016...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
C Dustin Waters, Joshua Caraccio
Vancomycin is a commonly prescribed empiric antibiotic used when methicillin-resistant Staphylococcus aureus (MRSA) infection is suspected. In this study, we aimed to determine the rate of culture-positive infection requiring vancomycin therapy.
June 12, 2018: Infection Control and Hospital Epidemiology
Guillaume Butler-Laporte, Matthew P Cheng, Emily G McDonald, Todd C Lee
BACKGROUND: Consideration to add empiric MRSA therapy with vancomycin is a common clinical dilemma. However, vancomycin overuse has important adverse events. MRSA colonization screening is commonly performed for infection control. We hypothesized that in cases of S. aureus bacteremia, a score based on patient level factors and MRSA colonization could predict the risk of MRSA infection and inform the need for empiric coverage. METHODS: Using modern machine learning statistical methods (LASSO regression and random forests), we designed a predictive score for MRSA infection based on patient level characteristics, and MRSA colonization as measured by screening done 30 days before infection (30-Day criteria), or at any time before infection (Ever-Positive criteria)...
June 11, 2018: BMC Infectious Diseases
Samreen Jatana, Craig R Homer, Maria Madajka, András K Ponti, Amrita Kabi, Francis Papay, Christine McDonald
Multidrug-resistant bacterial strains are a rapidly emerging healthcare threat; therefore it is critical to develop new therapies to combat these organisms. Prior antibacterial strategies directly target pathogen growth or viability. Host-directed strategies to increase antimicrobial defenses may be an effective alternative to antibiotics and reduce development of resistant strains. In this study, we demonstrated the efficacy of a pyrimidine synthesis inhibitor, N-phosphonacetyl-L-aspartate (PALA), to enhance clearance of methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Acinetobacter baumannii strains by primary human dermal fibroblasts in vitro...
June 7, 2018: Scientific Reports
Zhuo Ma, Erica Lasek-Nesselquist, Jackson Lu, Ryan Schneider, Riddhi Shah, George Oliva, Janice Pata, Kathleen McDonough, Manjunath P Pai, Warren E Rose, George Sakoulas, Meenakshi Malik
The extensive use of daptomycin (DAP) for treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the last decade has led to the emergence of DAP non-susceptible (DNS) Staphylococcus aureus strains. A better understanding of the molecular changes underlying DAP-non-susceptibility is required for early diagnosis and intervention with alternate combination therapies. The phenotypic changes associated with DNS strains have been well established. However, the genotypic changes-especially the kinetics of expression of the genes responsible for DAP-non-susceptibility are not well understood...
2018: PloS One
Krishan Yadav, Kathryn N Suh, Debra Eagles, John MacIsaac, Darmyn Ritchie, Jordan Bernick, Venkatesh Thiruganasambandamoorthy, George Wells, Ian G Stiell
INTRODUCTION: Current guideline recommendations for optimal management of non-purulent skin and soft tissue infections (SSTIs) are based on expert consensus. There is a lack of evidence to guide emergency physicians regarding selection of patients for oral versus intravenous antibiotic therapy. The primary objective was to identify predictors associated with oral antibiotic treatment failure. METHODS: We performed a health records review of adults (age ≥18 years) with non-purulent SSTIs treated at two tertiary care emergency departments (EDs)...
June 5, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Liang Li, Wessam Abdelhady, Niles P Donegan, Kati Seidl, Ambrose Cheung, Yu-Feng Zhou, Michael R Yeaman, Arnold S Bayer, Yan Q Xiong
Persistent MRSA bacteremia (PB) represents an important subset of S. aureus endovascular infections. In this study, we investigated potential genetic mechanisms underlying the persistent outcomes. Compared to resolving bacteremia (RB) isolates (negative blood cultures within 2-4 days of therapy), PB strains (positive blood cultures after ≥ 7 days of therapy) had significantly: i) earlier-onset activation of key virulence regulons and structural genes (e.g., sigB, sarA, sae and cap5); ii) higher expression of purine biosynthesis genes (e...
June 2, 2018: Journal of Infectious Diseases
Yi Wang, Weiqiang Yan, Shanshan Fu, Shoukui Hu, Yan Wang, Jianguo Xu, Changyun Ye
Staphylococcus aureus ( S. aureus ), including methicillin-resistant S. aureus (MRSA), is one of the most important human pathogens, which is responsible for bacteremia, soft-tissue infections, and food poisoning. Hence, multiple cross displacement amplification (MCDA) is employed to detect all S. aureus strains, and differentiates MRSA from methicillin-sensitive S. aureus . Multiplex MCDA (m-MCDA), which targets the nuc gene ( S. aureus -specific gene) and mecA gene (encoding penicillin-binding protein-2'), could detect S...
2018: Frontiers in Microbiology
Yos Adi Prakoso, Chylen Setiyo Rini, Roeswandono Wirjaatmadja
The tropical area has a lot of herbal medicines such as Aloe vera (AV), Ananas comosus (AC), and Sansevieria masoniana (SM). All the three have a unique potential effect as an antibacterial and wound-healing promoter. The aim of this study is to explore the role of AV, AC, and SM on the skin wound infected with methicillin-resistant Staphylococcus aureus (MRSA). Forty-five adult female Sprague Dawley rats weighing 250-300 grams were divided into 5 groups. All the groups were exposed to two round full-thickness punch biopsy and infected with MRSA...
2018: Advances in Pharmacological Sciences
Weifeng Yang, Jueling Liu, Biljana Blažeković, Yanan Sun, Shuhua Ma, Chuanyun Ren, Sanda Vladimir-Knežević, Chaohua Li, Yajun Xing, Guijie Tian, Yi Wang
BACKGROUND: Combining conventional drugs and traditional medicine may represent a useful approach to combating antibiotic resistance, which has become a serious threat to global public health. This study aimed to evaluate the potential synergistic interactions between Tanreqing (TRQ) injection, a commercial traditional Chinese medicine formula used for the treatment of upper respiratory tract infection, and selected antibiotics used against methicillin-resistant Staphylococcus aureus (MRSA)...
May 30, 2018: BMC Complementary and Alternative Medicine
Nivedita B Singh, Juwon Yim, Seyedehameneh Jahanbakhsh, George Sakoulas, Michael J Rybak
OBJECTIVE: Development of antimicrobial resistance during monotherapy of complicated methicillin-resistant Staphylococcus aureus bacteremia is problematic due to cross-resistance between vancomycin (VAN) and daptomycin, the only approved agents for this condition. Our objective was to demonstrate that development of resistance under conditions of suboptimal VAN (200 mg q 12 h) exposure in S. aureus can be attenuated by addition of cefazolin (CFZ). METHODS: Two strains of S...
April 7, 2018: Diagnostic Microbiology and Infectious Disease
Naomi Maeda, Hideharu Hagiya, Tsuyoshi Takiuchi, Shinsuke Kusakabe, Tetsuo Maeda, Keigo Kimura, Sayuri Iwai, Keisuke Kawasaki, Yumiko Hori, Eiichi Morii, Yuzuru Kanakura, Tadashi Kimura, Kazunori Tomono
Staphylococcus aureus as a pathogen in human gestational membranes, a rather rare phenomenon, has recently been the focus of several researches. S. aureus forms biofilms on these membranes and potentially causes chorioamnionitis in pregnant women. We report a case of persistent methicillin-resistant S. aureus (MRSA) bacteremia owing to placental infection, causing chorioamnionitis and preterm birth. A 29-year-old Japanese woman at the 27th gestational week was diagnosed with acute promyelocytic leukemia and underwent all-trans retinoic acid therapy...
May 24, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Claire C Triffault-Fillit, Tristan T Ferry, Frédéric F Laurent, Pierre P Pradat, Céline C Dupieux, Anne A Conrad, Agathe A Becker, Sébastien S Lustig, Michel-Henry Mh Fessy, Christian C Chidiac, Florent F Valour
OBJECTIVES: The high microbiological diversity encountered in prosthetic joint infection (PJI) makes the choice of empirical antimicrobial therapies challenging, especially in case of implant retention or one-stage exchange. Despite the risk of dysbiosis and toxicity, the combination of vancomycin with a broad-spectrum beta-lactam is currently recommended in all cases, even if Gram-negative bacilli (GNB) might be less represented in late PJI. In this context, this study aimed to describe the microbiological epidemiology of PJI according to the chronology of infection...
May 24, 2018: Clinical Microbiology and Infection
K Szymanek-Majchrzak, A Mlynarczyk, M Bilinska, M Rownicki, K Majchrzak, A Chmura, A Kwiatkowski, M Durlik, D Deborska-Materkowska, L Paczek, G Mlynarczyk
INTRODUCTION: Staphylococcus aureus infection, and health care-associated-methicillin resistant S aureus (HA-MRSA) in particular, is a serious risk for patients treated with organ transplantation. The frequent combined resistance of these bacteria to macrolides, lincosamides, and streptogramin-B (MLS-B) limits the use of these drugs in therapy. AIM: Evaluation of the mechanism of MLS-B resistance among HA-MRSA strains derived from patients treated in surgical-transplantation wards, over a 24-year period, and assessment of correlation of clindamycin use and resistance phenotype...
April 27, 2018: Transplantation Proceedings
Y M Wi, J Y Rhee, C I Kang, D R Chung, J H Song, K R Peck
We investigated the clinical predictors of methicillin-resistance and their impact on mortality in 371 patients with Staphylococcus aureus bacteraemia identified from two prospective multi-centre studies. Methicillin resistant S. aureus (MRSA) accounted for 42.2% of community-onset and 74.5% of hospital-onset cases. No significant clinical difference was found between patients infected with MRSA vs. methicillin-sensitive S. aureus (MSSA), except that the former were more likely to have had hospital-onset bacteraemia and received antibiotics in the preceding 90 days...
May 21, 2018: Epidemiology and Infection
Kuzma Jerzy, Hombhanje Francis
Background: Chronic osteomyelitis is a catastrophic sequel of delayed diagnosis of acute osteomyelitis. Objectives: The objectives of the study were to determine bacterial flora and antibiotic sensitivity, and to evaluate the outcome of an aggressive surgical approach to chronic osteomyelitis. Methods: This is a single surgeon, prospective cohort study on 30 consecutive patients with clinically and radiologically diagnosed chronic osteomyelitis presented to a hospital...
2018: Open Orthopaedics Journal
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