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MRSA bacteremia

Elizabeth A Neuner, Andrea M Pallotta, Simon W Lam, David Stowe, Steven M Gordon, Gary W Procop, Sandra S Richter
OBJECTIVE To describe the impact of rapid diagnostic microarray technology and antimicrobial stewardship for patients with Gram-positive blood cultures. DESIGN Retrospective pre-intervention/post-intervention study. SETTING A 1,200-bed academic medical center. PATIENTS Inpatients with blood cultures positive for Staphylococcus aureus, Enterococcus faecalis, E. faecium, Streptococcus pneumoniae, S. pyogenes, S. agalactiae, S. anginosus, Streptococcus spp., and Listeria monocytogenes during the 6 months before and after implementation of Verigene Gram-positive blood culture microarray (BC-GP) with an antimicrobial stewardship intervention...
November 2016: Infection Control and Hospital Epidemiology
Nicolás M Vázquez, Graciela Fiorilli, Paulo A Cáceres Guido, Silvia Moreno
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is resistant to different commonly used antibiotics, stressing the need for further strategies to treat this human pathogen with worldwide prevalence. The use of phytochemicals within the current pharmacology is a promising approach to enhance the antimicrobial activity of common antibiotics in the battle against these bacteria. PURPOSE: The purpose of this study was to determine the antimicrobial effectiveness of carnosic acid, the major constituent of Rosmarinus officinalis L...
November 15, 2016: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Bryce T Fukunaga, Wesley K Sumida, Deborah A Taira, James W Davis, Todd B Seto
Methicillin-resistant Staphylococcus aureus (MRSA) results in almost half of all deaths caused by antibiotic resistant organisms. Current evidence suggests that MRSA infections are associated with antibiotic use. This study examined state-level data to determine whether outpatient antibiotic use was associated with hospital-acquired MRSA (HA-MRSA) infections. The 2013 Centers for Disease Control and Prevention (CDC) Healthcare-Associated Infections Progress Report was used to obtain HA-MRSA infection rates...
October 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Guillaume Butler-Laporte, Matthew P Cheng, Alexandre P Cheng, Emily G McDonald, Todd C Lee
BACKGROUND: Bloodstream infections with Staphylococcus aureus are clinically significant and are often treated with empiric methicillin resistance (MRSA) coverage. However, vancomycin has associated harms. We hypothesized that MRSA screening correlated with resistance in S. aureus bacteremia and could help determine empiric vancomycin requirement. METHODS: We reviewed consecutive S. aureus bacteremias over a five-year period at two tertiary care hospitals. MRSA colonization was evaluated in three ways: as tested within 30 days of bacteremia (30-Day criteria), as tested within 30 days but accounting for any prior positive results (ever positive criteria), or if the patient was known positive with patients with unknown MRSA status being labeled negative (known positive criteria)...
October 10, 2016: Antimicrobial Agents and Chemotherapy
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
George Sakoulas, Joshua Olson, Juwon Yim, Niedita B Singh, Monika Kumaraswamy, Diana T Quach, Michael J Rybak, Joseph Pogliano, Victor Nizet
BACKGROUND: Ertapenem and cefazolin were used in combination to successfully clear refractory methicillin-susceptible Staphylcoccus aureus (MSSA) bacteremia. In addition, recent work has demonstrated acitivity of combination beta-lactam therapy from different classes against MRSA. METHODS: Ertapenem plus cefazolin combination was evaluated for synergy in vitro and in vivo in a murine skin infection model using an index MSSA bloodstream isolate from a patient in whom persistent bacteremia was cleared with this combination, and against a cadre of well-described research strains and clinical strains of MSSA and MRSA...
August 29, 2016: Antimicrobial Agents and Chemotherapy
Yuliya Zboromyrska, Cristina De la Calle, Marcelo Soto, Laura Sampietro-Colom, Alex Soriano, Míriam José Alvarez-Martínez, Manel Almela, Francesc Marco, Ruth Arjona, Nazaret Cobos-Trigueros, Laura Morata, José Mensa, José Antonio Martínez, Aurea Mira, Jordi Vila
Catheter-related bacteremia (CRB) is an important cause of morbidity and mortality among hospitalized patients, being staphylococci the main etiologic agents. The objective of this study was to assess the use of a PCR-based assay for detection of staphylococci directly from blood obtained through the catheter to diagnose CRB caused by these microorganisms and to perform a cost-effectiveness analysis. A total of 92 patients with suspected CRB were included in the study. Samples were obtained through the catheter...
2016: PloS One
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
Dominique Missiakas, Olaf Schneewind
Staphylococcus aureus, a commensal of the human nasopharynx and skin, also causes invasive disease, most frequently skin and soft tissue infections. Invasive disease caused by drug-resistant strains, designated MRSA (methicillin-resistant S. aureus), is associated with failure of antibiotic therapy and elevated mortality. Here we review polysaccharide-conjugate and subunit vaccines that were designed to prevent S. aureus infection in patients at risk of bacteremia or surgical wound infection but failed to reach their clinical endpoints...
August 22, 2016: Journal of Experimental Medicine
Sumanth Gandra, Nestor Mojica, Eili Y Klein, Ashvin Ashok, Vidya Nerurkar, Mamta Kumari, Uma Ramesh, Sunanda Dey, Viral Vadwai, Bibhu R Das, Ramanan Laxminarayan
OBJECTIVE: There have been no long-term studies on trends in antibiotic resistance (ABR) on a national scale in India. Using a private laboratory network, the ABR patterns of organisms most commonly associated with bacteremia, obtained from patients across India between 2008 and 2014, were examined. METHODS: A retrospective study of patient blood cultures collected over a 7-year period (January 1, 2008-December 31, 2014) was conducted. Data on the microorganism(s) identified and their antimicrobial susceptibility were obtained from SRL Diagnostics (Mumbai, India)...
September 2016: International Journal of Infectious Diseases: IJID
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
S Hewagama, T Spelman, M Woolley, J McLeod, D Gordon, L Einsiedel
BACKGROUND: The Central Australian Indigenous population has a high incidence of Staphylococcus aureus bacteremia (SAB) but little is known about the local molecular epidemiology. METHODS: Prospective observational study of bacteremic and nasal colonizing S.aureus isolates between June 2006 to June 2010. All isolates underwent single nucleotide polymorphism (SNP) genotyping and testing for the presence of the Panton-Valentine Leucocidin (pvl) gene. RESULTS: Invasive isolates (n = 97) were predominantly ST93 (26...
2016: BMC Infectious Diseases
Virginia R Roth, Tara Longpre, Doug Coyle, Kathryn N Suh, Monica Taljaard, Katherine A Muldoon, Karamchand Ramotar, Alan Forster
BACKGROUND: The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission. METHODS: The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission...
2016: PloS One
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...
2016: BMC Infectious Diseases
Dafna Yahav, Hila Shaked, Elad Goldberg, Sharief Yassin, Noa Eliakim-Raz, Mical Paul, Jihad Bishara, Leonard Leibovici
INTRODUCTION: Changes in the epidemiology of Staphylococcus aureus bacteremia (SAB) have been described in recent decades. Decreased mortality has been reported over time, mostly from countries with low methicillin resistance rates. We aimed to describe time trends in SAB in a tertiary center with high methicillin resistance rates. METHODS: We retrospectively analyzed 1692 patients with SAB, and compared between three time periods: 1988-1994 (342 patients), 1998-2004 (597 patients) and 2005-2010 (753 patients)...
July 13, 2016: Infection
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
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