scholarly journals Methicillin resistant Staphylococcus aureus - importance of appropriate empirical therapy in serious infections

2021 ◽  
Vol 9 (1) ◽  
pp. 56
Author(s):  
Pavan Kumar Nanchary Reddy ◽  
Anand Sutar ◽  
Sambit Sahu ◽  
Bini Thampi ◽  
Neha Keswani ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Empirical Therapy ◽  
World Health ◽  
Multi Drug Resistance ◽  
Methicillin Resistant ◽  
Healthcare Settings ◽  
Global Priority ◽  
Serious Infections ◽  
The World

India has been titled the capital of antimicrobial resistance in the world with the centre for disease dynamics, economics and policy (CDDEP) predicting two million deaths in India by 2050. As per the World Health Organisation’s global priority pathogen list of 2017, methicillin resistant Staphylococcus aureus (MRSA) has been classified as a ‘high priority’ pathogen due to its association with increased mortality rate, rising prevalence of resistance and increased burden on healthcare settings. A recent report by Indian Council of Medical Research signifies the exponential rise in the prevalence of MRSA in India, from 29% in 2009 to 39% in 2018. Serious MRSA infections are commonly associated with poor clinical outcomes coupled with increased hospitalisation stay and cost. Therefore, early identification and appropriate empiric treatment of MRSA plays a crucial role in healthcare settings. However, the constant rise in multi-drug resistance to the currently available anti-MRSA agents as well as their compromised safety profile limits its clinical use to manage severe MRSA infections. This review article explores the implications of severe MRSA infections and inappropriate empirical therapy on the clinical as well as economic outcomes. In addition, it also highlights limitations of the currently available anti-MRSA agents and the need for newer agents to manage multi drug resistant (MDR) gram positive infections.

Genomic Epidemiology of Invasive Methicillin-Resistant Staphylococcus aureus Infections Among Hospitalized Individuals in Ontario, Canada

2020 ◽  
Vol 222 (12) ◽  
pp. 2071-2081 ◽  
Author(s):  
Jennifer L Guthrie ◽  
Sarah Teatero ◽  
Sotaro Hirai ◽  
Alex Fortuna ◽  
Daniel Rosen ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Demographic Data ◽  
Public Health Practice ◽  
Acid Resistance ◽  
Fold Increase ◽  
High Genetic Diversity ◽  
Methicillin Resistant ◽  
Genomic Epidemiology ◽  
Healthcare Settings

Abstract Background Prevention and control of methicillin-resistant Staphylococcus aureus (MRSA) infections remain challenging. In-depth surveillance integrating patient and isolate data can provide evidence to better inform infection control and public health practice. Methods We analyzed MRSA cases diagnosed in 2010 (n = 212) and 2016 (n = 214) by hospitals in Ontario, Canada. Case-level clinical and demographic data were integrated with isolate characteristics, including antimicrobial resistance (AMR), classic genotyping, and whole-genome sequencing results. Results Community-associated MRSA (epidemiologically defined) increased significantly from 23.6% in 2010 to 43.0% in 2016 (P < .001). The MRSA population structure changed over time, with a 1.5× increase in clonal complex (CC)8 strains and a concomitant decrease in CC5. The clonal shift was reflected in AMR patterns, with a decrease in erythromycin (86.7% to 78.4%, P = .036) and clindamycin resistance (84.3% to 47.9%, P < .001) and a >2-fold increase in fusidic acid resistance (9.0% to 22.5%, P < .001). Isolates within both CC5 and CC8 were relatively genetically diverse. We identified 6 small genomic clusters—3 potentially related to transmission in healthcare settings. Conclusions Community-associated MRSA is increasing among hospitalized individuals in Ontario. Clonal shifting from CC5 to CC8 has impacted AMR. We identified a relatively high genetic diversity and limited genomic clustering within these dominant CCs.

scholarly journals Methicillin-Resistant Staphylococci and Macrococci at the Interface of Human and Animal Health

Toxins ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 61
Author(s):  
Karsten Becker
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Animal Health ◽  
Methicillin Resistant ◽  
Global Impact ◽  
The World

The global impact of methicillin-resistant Staphylococcus aureus (MRSA) clonal lineages on human and animal health continues, even considering the decreasing MRSA rates in some parts of the world [...]

scholarly journals Antibacterial and anti-biofilm activities of crude extracts of Lawsonia inermis against Methicillin Resistant Staphylococcus aureus

2016 ◽  
Vol 9 (6) ◽  
pp. 263 ◽  
Author(s):  
Triveni A G ◽  
Suresh Kumar Mendem ◽  
Channapa T Shivannavar ◽  
Subhaschandra M Gaddad
Keyword(s):  
Staphylococcus Aureus ◽  
Antibacterial Activity ◽  
Ethyl Acetate ◽  
Petroleum Ether ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multi Drug Resistance ◽  
Lawsonia Inermis ◽  
Biofilm Inhibition ◽  
Methicillin Resistant ◽  
Crude Extracts

 Objective:The continuous rise in the prevalence of multi drug resistance pathogens globally is threatening the treatment and management of infectious diseases. Ethno medicine plays a key role in the exploration for novel bioactive compounds. The present study evaluates the antibacterial and antibiofilm activities of the crude extracts of Lawsonia inermis against clinical isolates of methicillin resistant Staphylococcus aureus (MRSA).Materials and methods: Shade dried and finely powdered leaves of the plant were extracted by maceration method using six solvents methanol, acetone, ethyl acetate, chloroform, petroleum ether and n-hexane. Antibacterial and antibiofilm activities of the extracts against MDR MRSA by agar cup diffusion and tube method respectively.Results: Methanol extract showed the highest antibacterial activity of 18mm compared to other extracts. Similarly, petroleum ether extract showed highest biofilm inhibition of 84.7%. Other solvent extracts also exhibited significant biofilm inhibition [n-Hexane-83.6%, Ethyl acetate -79.5%, Chloroform-79.2%, Acetone -77% and Methanol-77%].Conclusion: The leaf extracts of L. inermis have shown promising biofilm inhibitory activity and good antibacterial activity, which can be explored for the development of new drugs for the MDR pathogens. Keywords: Antibioticacivity, Antibiofilm activity, L.inermis, MRSA

scholarly journals Pediatric pharmaceutical care with anti-infective medication in a patient with acute hematogenous osteomyelitis caused by methicillin-resistant Staphylococcus aureus

2020 ◽  
Vol 34 ◽  
pp. 205873842092571
Author(s):  
Chanmei Lv ◽  
Jiantao Lv ◽  
Yue Liu ◽  
Qifeng Liu ◽  
Dongna Zou
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
First Line ◽  
Methicillin Resistant ◽  
First Report ◽  
First Line Therapy ◽  
Acute Hematogenous Osteomyelitis ◽  
Serious Infections ◽  
Daily Dose ◽  
Red Man Syndrome

The infection of the bone marrow system caused by methicillin-resistant Staphylococcus aureus (MRSA) leads to a variety of common diseases which usually occur in children under the age of 12. Vancomycin (VCM) is the first-line therapy for MRSA-caused serious infections such as bacteremia, infective endocarditis, osteomyelitis, meningitis, pneumonia, and severe skin and soft-tissue infection (e.g. necrotizing fasciitis) with a recommended dosage of 15–20 μg/mL. In this study, we first report a case of a child with MRSA-caused osteomyelitis who was successfully cured by VCM at a concentration of 4.86 μg/mL. VCM’s clinical daily dose of more than 4 g was of concern in light of recent evidence suggesting the increased risks of nephrotoxicity and red man syndrome when Cmin ⩾15 μg/mL and doses ⩾10 mg/kg in children. As far as we know, this is the first report on the lower dose of VCM in children with MRSA osteomyelitis.

scholarly journals Vancomycin-Associated Leukocytoclastic Vasculitis

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Makhawadee Pongruangporn ◽  
David J. Ritchie ◽  
Dongsi Lu ◽  
Jonas Marschall
Keyword(s):  
Staphylococcus Aureus ◽  
Skin Biopsy ◽  
Drug Administration ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Leukocytoclastic Vasculitis ◽  
Food And Drug Administration ◽  
Lower Extremities ◽  
Methicillin Resistant ◽  
Palpable Purpura ◽  
Serious Infections

Vancomycin is U.S. Food and Drug Administration (FDA) approved for treatment of serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or in individuals who have failed, cannot tolerate, or are allergic to other antibiotics. Very few cases of vancomycin-associated leukocytoclastic vasculitis have been published. We report on a patient who developed pruritus and palpable purpura in both lower extremities after receiving six days of intravenous vancomycin. Skin biopsy revealed leukocytoclastic vasculitis.

scholarly journals Multi-drug resistance traits of methicillin-resistant Staphylococcus aureus and other Staphylococcal species from clinical and environmental sources

2019 ◽  
Vol 17 (6) ◽  
pp. 930-943 ◽  
Author(s):  
Adegboyega O. Oladipo ◽  
Oluwatosin G. Oladipo ◽  
Cornelius C. Bezuidenhout
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Animal Health ◽  
Antibiotic Resistance Genes ◽  
Multi Drug Resistance ◽  
Methicillin Resistant ◽  
Hospital Effluent ◽  
Resistance Traits

Abstract Multi-drug resistance traits of Staphylococcus species especially methicillin-resistant Staphylococcus aureus (MRSA) in the clinical settings are well established. Of environmental concern is hospital effluents discharging into wastewaters. This article investigated the prevalence and detection of antibiotic resistance genes in Staphylococcus species from clinical and environmental sources in Ile-Ife, Nigeria. Standard culture-based and molecular protocols were used. Seventy-six (27 clinical, 14 hospital effluent and 35 environmental) Staphylococcus isolates were recovered: 56.58% were coagulase-negative and 43.42% coagulase-positive (S. aureus). For the clinical isolates, 10, 6, 4, 4 and 1 were isolated from urine, skin, wounds, blood and pus, respectively. Isolates were resistant to methicillin and amoxycillin (91.7%), cloxacillin (88.0%), ciprofloxacin (84.0%), ofloxacin (83.3%), azithromycin (78.0%), ceftazidime (76.0%), gentamycin (75.0%), cefuroxime (75.0%) and erythromycin (72.0%). Nearly, all isolates (90.8%) had multiple antibiotic resistance (MAR) index >0.2. Overall MAR indices for Staphylococcus species isolated from the clinical, hospital effluent and environmental wastewaters were relatively similar (0.482; 0.500; 0.435). mecA, nuc and luk-pvl genes were detected in S. aureus, while mecA was detected in S. arlettae, S. sciuri, S. cohnii, S. epidermidis and S. saprophyticus. This study informs on the potential contamination of environmental waters downstream from hospitals and possible impacts that this could have on human and animal health.

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