scholarly journals Ceftaroline in the treatment of methicillin-resistant and daptomycin-non-susceptible Staphylococcus aureus bacteremia and infective endocarditis in end-stage renal disease

2013 ◽  
Vol 1 (4) ◽  
pp. 53
Author(s):  
Kristen Fuhrmann ◽  
Richard Winn ◽  
Paula McKenzie ◽  
Mamoun Bashir
Keyword(s):  
Staphylococcus Aureus ◽  
Case Reports ◽  
Kinetic Properties ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia ◽  
Stage Renal Disease ◽  
End Stage ◽  
Vitro Data ◽  
In Vitro Data

As bacteria evolve and become resistant to preferred antibiotics, we often have toresort to alternative, second-line agents for treatment. This case highlights a growingtrend being observed among methicillin-resistant Staphylococcus aureus (MRSA)isolates, in which the minimum inhibitory concentration breakpoints start to increaseand traditional therapy fails. When clinicians are faced with a difficult to treat infectionand constrained by declining renal function, drug allergies, or clinical scenario, it maybe prudent to use therapy that is supported by only in vitro data, animal models, andstrong case reports. Combining knowledge of the drug’s kinetic properties, mechanismof action, safety, and adverse effect profile, and literature to support its use helpedguide our decision in treating a patient with persistent MRSA bacteremia and infectiveendocarditis.

Methicillin-Resistant Staphylococcus aureus Bacteremia in Patients With End-Stage Renal Disease in Taiwan: Distinguishing Between Community-Associated and Healthcare-Associated Strains

2009 ◽  
Vol 30 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Chung-Chih Lin ◽  
Jiun-Ling Wang ◽  
Chi-Ying Lin ◽  
Shey-Ying Chen ◽  
Jann-Tay Wang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Medical Center ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia ◽  
Mrsa Strains ◽  
Stage Renal Disease ◽  
End Stage ◽  
Healthcare Associated

We reviewed genotyping and medical records of 53 patients with end-stage renal disease and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in a medical center in Taiwan. In multivariate analysis, hospitalization within the previous year was independently negatively associated with infection with community-associated MRSA strains, and an increased number of years of dialysis predicted the recovery of patients infected with community-associated MRSA strains.

scholarly journals Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure

2019 ◽  
Vol 6 ◽  
pp. 204993611988650 ◽  
Author(s):  
Joseph Patrik Hornak ◽  
Seher Anjum ◽  
David Reynoso
Keyword(s):  
Staphylococcus Aureus ◽  
Combination Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Treatment Options ◽  
Source Control ◽  
Optimal Timing ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia ◽  
Persistent Bacteremia

Background: Methicillin-resistant Staphylococcus aureus bacteremia (MRSA-B) may fail to improve with standard monotherapy, particularly in patients with multifocal infection, incomplete source control, or persistent bacteremia. Synergy observed in vitro between ceftaroline (CPT) and daptomycin (DAP) or vancomycin (VAN) may translate into clinical benefit. Here, we describe our experience with DAP/CPT and VAN/CPT for complicated MRSA-B after monotherapy failure. Methods: Single-center, retrospective review of consecutive patients treated with DAP/CPT or VAN/CPT for MRSA-B after monotherapy failure from 1 January 2016 to 30 November 2018. Results: We identified 11 instances of combination therapy in 10 patients (DAP/CPT = 6, VAN/CPT = 5) with 1 patient receiving VAN/CPT followed by DAP/CPT. Rates of multifocal infection, incomplete source control, persistent bacteremia, and infective endocarditis were high (100%, 80%, 60%, and 60%, respectively). Combination therapy was initiated most commonly for persistent bacteremia (60%). When patients were persistently bacteremic, median preceding duration was 13 days and median time to clearance was 3 days. Total microbiologic cure rate was 100%. There were zero instances of bacteremia relapse at 30 days (30D) or 60 days (60D). All-cause 30D and 60D mortality rates were 11.1% and 33.3%, respectively. Conclusions: Combination therapy demonstrated success in diverse cases of refractory MRSA-B, including instances of persistent bacteremia paired with incomplete source control. Optimal timing and therapeutic cadence for combination therapy remain unclear. Our findings suggest that DAP/CPT and VAN/CPT can be considered for complicated MRSA bacteremia when other treatment options fail or are unavailable. We propose persistent bacteremia with incomplete source control to be a clinical niche particularly worthy of further investigation.

scholarly journals Anti-Clumping Factor A Immunoglobulin Reduces the Duration of Methicillin-Resistant Staphylococcus aureus Bacteremia in an Experimental Model of Infective Endocarditis

2003 ◽  
Vol 47 (11) ◽  
pp. 3400-3406 ◽  
Author(s):  
John Vernachio ◽  
Arnold S. Bayer ◽  
Thuan Le ◽  
Yin-Li Chai ◽  
Bradley Prater ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Combination Therapy ◽  
Rabbit Model ◽  
Human Fibrinogen ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia ◽  
Fibrinogen Binding ◽  
Human Polymorphonuclear Leukocytes

ABSTRACT SA-IGIV is a human polyclonal immunoglobulin containing elevated levels of antibodies specific for the fibrinogen-binding MSCRAMM protein clumping factor A (ClfA). In vitro, SA-IGIV specifically recognized ClfA that was expressed on the surface of Staphylococcus aureus and inhibited bacterial adherence to immobilized human fibrinogen by >95%. Moreover, SA-IGIV efficiently opsonized ClfA-coated fluorescent beads and facilitated phagocytosis by human polymorphonuclear leukocytes. To determine its potential therapeutic efficacy, SA-IGIV was evaluated in combination with vancomycin in a rabbit model of catheter-induced aortic valve infective endocarditis (IE) caused by methicillin-resistant S. aureus (MRSA). The combination therapy was more effective than vancomycin alone in sterilizing all valvular vegetations when used therapeutically during early (12-h) IE. The combination therapy resulted in clearance of bacteremia that was significantly faster than that of vancomycin alone in animals with well-established (24-h) IE. Therefore, in both early and well-established MRSA IE, the addition of SA-IGIV to a standard antibiotic regimen (vancomycin) increased bacterial clearance from the bloodstream and/or vegetations.

scholarly journals β-Lactams Enhance Vancomycin Activity against Methicillin-Resistant Staphylococcus aureus Bacteremia Compared to Vancomycin Alone

2013 ◽  
Vol 58 (1) ◽  
pp. 102-109 ◽  
Author(s):  
Thomas J. Dilworth ◽  
Omar Ibrahim ◽  
Pamela Hall ◽  
Jora Sliwinski ◽  
Carla Walraven ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Synergistic Activity ◽  
Methicillin Resistant ◽  
Content Type ◽  
Staphylococcus Aureus Bacteremia ◽  
High Incidence ◽  
The Difference ◽  
Initiation Of Therapy ◽  
The Impact

ABSTRACTVancomycin (VAN) is often used to treat methicillin-resistantStaphylococcus aureus(MRSA) bacteremia despite a high incidence of microbiological failure. Recentin vitroanalyses of β-lactams in combination with VAN demonstrated synergistic activity against MRSA. The goal of this study was to examine the impact of combination therapy with VAN and a β-lactam (Combo) on the microbiological eradication of MRSA bacteremia compared to VAN alone. This was a retrospective cohort study of patients with MRSA bacteremia who received Combo therapy or VAN alone. Microbiological eradication of MRSA, defined as a negative blood culture obtained after initiation of therapy, was used to evaluate the efficacy of each regimen. A total of 80 patients were included: 50 patients in the Combo group and 30 patients in the VAN-alone group. Microbiological eradication was achieved in 48 patients (96%) in the Combo group compared to 24 patients (80%) in the VAN-alone group (P= 0.021). In a multivariable model, the Combo treatment had a higher likelihood of achieving microbiological eradication (adjusted odds ratio, 11.24; 95% confidence interval, 1.7 to 144.3;P= 0.01). In patients with infective endocarditis (n= 22), 11/11 (100%) who received Combo therapy achieved microbiological eradication compared to 9/11 (81.8%) treated with VAN alone, but the difference was not statistically significant (P= 0.20). Patients with MRSA bacteremia who received Combo therapy were more likely to experience microbiological eradication of MRSA than patients who received VAN alone.

Neutrophil Extracellular Traps Enhance Staphylococcus Aureus Vegetation Formation through Interaction with Platelets in Infective Endocarditis

2019 ◽  
Vol 119 (05) ◽  
pp. 786-796 ◽  
Author(s):  
Chih-Chieh Hsu ◽  
Ron-Bin Hsu ◽  
Ryosuke Ohniwa ◽  
Jeng-Wei Chen ◽  
Chang-Tsu Yuan ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Synergistic Effects ◽  
Neutrophil Extracellular Traps ◽  
Dnase I ◽  
Extracellular Traps ◽  
Vitro Data ◽  
In Vitro Data ◽  
Vegetation Formation

AbstractThe mechanisms or host factors involved in septic thrombus or vegetation formation in Staphylococcus aureus-induced infective endocarditis (IE) are unclear. Using an experimental endocarditis rat model, here we demonstrated that S. aureus HG001-induced vegetation was composed of bacterial floes encased in aggregated platelets and surrounded by neutrophil extracellular traps (NETs). In vitro data demonstrated that platelets contribute to both biofilm and NET formation. Prophylactic administration of DNase I significantly reduced the size of vegetation induced by methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains, even though MRSA and MSSA isolates express different biofilm phenotypes and NET-induction abilities in the presence of platelets. Moreover, delivery of both DNase I and daptomycin prophylactically and therapeutically produced synergistic effects by reducing vegetation size and bacterial numbers on damaged valve tissues in MRSA-induced IE. Together, these data suggest that NETs contribute to vegetation formation in S. aureus endocarditis and DNase I has the potential to control S. aureus-induced IE in the clinic.

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