scholarly journals TREATMENT OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) SEPSIS WITH COMBINATION OF FOSFOMYCIN AND AMIKACIN IN A PATIENT WITH SCALD-BURN INJURY

2018 ◽  
Vol 11 (15) ◽  
pp. 17 ◽  
Author(s):  
Oki Nugraha Putra ◽  
Iswinarno Doso Saputro ◽  
Ana Khusnul F
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Burn Injury ◽  
Definitive Treatment ◽  
Once Daily ◽  
Burn Center ◽  
Alternative Treatment Option ◽  
Empiric Antibiotic ◽  
Mrsa Infection ◽  
Burn Patient

Objective: Thus, this case report assesses the efficacy combination of fosfomycin and amikacin in the management of MRSA infection in a burn patient.Case Report: A 31-year-old male was transferred to the burn center for definitive treatment. Initially, the patient was treated with ceftazidime injection as empiric antibiotic one gram three times daily, but the patient became sepsis during the treatment. Blood specimen was taken and Methicilin Resistant Staphylococcus aureus (MRSA) was isolated from this culture. The patient was isolated and based on antibiotic susceptibility, the patient was started on fosfomycin 2 gram IV twice daily for first seven days, and after that fosfomycin was combined with amikacin IV 500 mg once daily. After administration of these antibiotics, a rapid clinical improvement was observed with the patient, leucocytosis did not occur and blood culture was negative. The patient completed a total of 14 days of fosfomycin and 8 days of amikacin therapy.Conclusion: The synergistic combination of fosfomycin with amikacin, may be useful alternative treatment option for sepsis related Methicilin- Resistant Staphylococcus aureus (MRSA) in burn injury. Further research is also needed to clarify effectiveness of fosfomycin and amikacin to treat MRSA infection in burn patient.

Rate of positive cultures necessitating definitive treatment in patients receiving empiric vancomycin therapy

2018 ◽  
Vol 39 (8) ◽  
pp. 989-990 ◽  
Author(s):  
C. Dustin Waters ◽  
Joshua Caraccio
Keyword(s):  
Staphylococcus Aureus ◽  
Definitive Treatment ◽  
Vancomycin Therapy ◽  
Methicillin Resistant ◽  
Empiric Antibiotic ◽  
Mrsa Infection ◽  
Culture Positive

AbstractVancomycin 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.

scholarly journals Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening in Hospitalized Children with Acute Infectious Disease Syndromes

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1434
Author(s):  
Ashley Sands ◽  
Nicole Mulvey ◽  
Denise Iacono ◽  
Jane Cerise ◽  
Stefan H. F. Hagmann
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospitalized Children ◽  
Methicillin Resistant ◽  
Osteoarticular Infections ◽  
Clinical Culture ◽  
Acute Infectious Disease ◽  
Mrsa Infection ◽  
Age Range ◽  
Mrsa Colonization

Studies in adults support the use of a negative methicillin-resistant Staphylococcus aureus (MRSA) nares screening (MNS) to help limit empiric anti-MRSA antibiotic therapy. We aimed to evaluate the use of MNS for anti-MRSA antibiotic de-escalation in hospitalized children (<18 years). Records of patients admitted between 1 January 2015 and 31 December 2020 with a presumed infectious diagnosis who were started on anti-MRSA antibiotics, had a PCR-based MNS, and a clinical culture performed were retrospectively reviewed. A total of 95 children were included with a median age (range) of 2 (0–17) years. The top three diagnosis groups were skin and soft tissue infections (n = 38, 40%), toxin-mediated syndromes (n = 17, 17.9%), and osteoarticular infections (n = 14, 14.7%). Nasal MRSA colonization and growth of MRSA in clinical cultures was found in seven patients (7.4%) each. The specificity and the negative predictive value (NPV) of the MNS to predict a clinical MRSA infection were both 95.5%. About half (n = 55, 57.9%) had anti-MRSA antibiotics discontinued in-house. A quarter (n = 14, 25.5%) were de-escalated based on the negative MNS test alone, and another third (n = 21, 38.2%) after negative MNS test and negative culture results became available. A high NPV suggests that MNS may be useful for limiting unnecessary anti-MRSA therapy and thereby a useful antimicrobial stewardship tool for hospitalized children. Prospective studies are needed to further characterize the utility of MNS for specific infectious diagnoses.

scholarly journals Association Between Serum Albumin And The Success Of Fluid Resuscitation In Children Hospitalizen In Cipto Mangunkusumo Hospital Burn Center

2019 ◽  
Vol 5 (2) ◽  
pp. 226-233
Author(s):  
Rismala Dewi ◽  
Karina Kaltha ◽  
Aditya Wardhana ◽  
Piprim B. Yanuarso
Keyword(s):  
Serum Albumin ◽  
Fluid Resuscitation ◽  
Sampling Method ◽  
Burn Injury ◽  
Significant Loss ◽  
Mortality And Morbidity ◽  
Burn Center ◽  
Pediatric Resuscitation ◽  
Almost All ◽  
Burn Patient

Background : Burn injury has a great impact on mortality and morbidity in children. Significant loss of albumin (hypoalbuminemia) in burn patient often leads to serious complications. However, it is still unclear whether serum albumin has a role in the success of fluid resuscitation in children with burn injury. Method : This is a retrospective cohort study based on medical record of children hospitalized with burn injury at Cipto Mangunkusumo Hospital Burn Centre from January 2012-March 2018. The subjects collected with the total sampling method. Result : Most burn injury happen because of scalds, and have grade 2 burn injury with PELOD score<10. Almost all subjects was succesfully resuscitated in the first 24 hour (95,1%). No association was found between the success of fluid resuscitation with either serum albumin [RR 1,175(95%CI 0,3-4,4) p=0,812], or with ureum, creatinin, lactate level, weight and the degree/extent of the burn injury. Conclusion: The success rate of fluid resuscitation in pediatric burn injury was quite high in Cipto Mangunkusumo Hospital Burn Centre. No association was found between serum albumin and the success of fluid resuscitation during the first 24 hour period. Keywords: albumin, burn, pediatric, resuscitation  

scholarly journals Daptomycin plus Fosfomycin, a Synergistic Combination in Experimental Implant-Associated Osteomyelitis Due to Methicillin-Resistant Staphylococcus aureus in Rats

2014 ◽  
Vol 59 (2) ◽  
pp. 859-863 ◽  
Author(s):  
Tilman Lingscheid ◽  
Wolfgang Poeppl ◽  
Dominik Bernitzky ◽  
Luzia Veletzky ◽  
Manuel Kussmann ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Once Daily ◽  
Methicillin Resistant ◽  
Bacterial Counts ◽  
Content Type ◽  
Bacterial Cultures ◽  
Development Of Resistance ◽  
Bacterial Inoculum ◽  
Titanium Wire ◽  
Mrsa Infection

ABSTRACTThe aim of this study was to evaluate the combination of daptomycin and fosfomycin in experimental chronic implant-associated osteomyelitis due to methicillin-resistantStaphylococcus aureus(MRSA). Infection was induced in the tibiae of rats by the insertion of a bacterial inoculum (1 to 5 × 108CFU/ml) of a clinical MRSA isolate and a titanium wire. Four weeks after infection, each animal was assigned to a treatment group: daptomycin monotherapy at 60 mg/kg of body weight once daily (n= 10), fosfomycin monotherapy at 40 mg/kg once daily (n= 10), or daptomycin and fosfomycin combined at 60 mg/kg and 40 mg/kg, respectively, once daily (n= 9). Ten animals were left untreated. After a 3-week treatment period, the animals were euthanized, and the infected tibiae and implants were processed for quantitative bacterial cultures. The bacterial cultures from bones were positive for MRSA in all animals in the untreated group, the daptomycin group, and the fosfomycin group, with median bacterial counts of 2.34 × 106CFU/g bone, 1.57 × 106CFU/g bone, and 3.48 × 102CFU/g bone, respectively. In the daptomycin-fosfomycin group, 6 out of 9 animals were positive for MRSA, with a median count of 7.92 CFU/g bone. Bacterial cultures derived from the titanium wires were negative in the fosfomycin- and daptomycin-fosfomycin-treated groups. Based on bacterial counts in bones, treatment with daptomycin-fosfomycin was statistically significantly superior to all that of the other groups (P≤ 0.003). Fosfomycin was superior to daptomycin and no treatment (P< 0.0001). No development of resistance was observed in any treatment arm. The combination of daptomycin and fosfomycin demonstrated synergism against MRSA in experimental implant-associated osteomyelitis.

scholarly journals 1230. Epidemiology and Risk Factors for Recurrent Invasive Methicillin-Resistant Staphylococcus aureus Infection: nine US States, 2006–2013

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S374
Author(s):  
Ian Kracalik ◽  
Kelly Jackson ◽  
Joelle Nadle ◽  
Wendy Bamberg ◽  
Susan Petit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Infection Type ◽  
The United States ◽  
Emerging Infections ◽  
Methicillin Resistant ◽  
Initial Infection ◽  
Joint Infections ◽  
Mrsa Infection

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) causes &gt;70,000 invasive infections annually in the United States, and recurrent infections pose a major clinical challenge. We examined risk factors for recurrent MRSA infections. Methods We identified patients with an initial invasive MRSA infection (isolation from a normally sterile body site) from 2006 to 2013, through active, population-based surveillance in selected counties in nine states through the Emerging Infections Program. Recurrence was defined as invasive MRSA isolation &gt;30 days after initial isolation. We used logistic regression with backwards selection to evaluate adjusted odds ratios (aOR) associated with recurrence within 180 days, prior healthcare exposures, and initial infection type, controlling for patient demographics and comorbidities. Results Among 24,478 patients with invasive MRSA, 3,976 (16%) experienced a recurrence, including 61% (2,438) within 180 days. Risk factors for recurrence were: injection drug use (IDU) (aOR; 1.38, 95% confidence interval [CI]: 1.15–1.65), central venous catheters (aOR; 1.35, 95% CI: 1.22–1.51), dialysis (aOR; 2.00, 95% CI: 1.74–2.31), and history of MRSA colonization (aOR; 1.35, 95% CI: 1.22–1.51) (figure). Recurrence was more likely for bloodstream infections (BSI) without another infection (aOR; 2.08, 95% CI: 1.74–2.48), endocarditis (aOR; 1.46, 95% CI: 1.16–1.55), and bone/joint infections (aOR; 1.38, 95% CI: 1.20–1.59), and less likely for pneumonia (aOR: 0.75, 95% CI: 0.64–0.89), compared with other initial infection types. When assessed separately, the presence of a secondary BSI with another infection increased the odds of recurrence over that infection without a BSI (aOR: 1.96, 95% CI: 1.68–2.30). Conclusion Approximately one in six persons with invasive MRSA infection had recurrence. We identified potential opportunities to prevent recurrence through infection control (e.g., management and early removal of central catheters). Other possible areas for preventing recurrence include improving the management of patients with BSI and bone/joint infections (including both during and after antibiotic treatment) and mitigating risk of infection from IDU. Disclosures All authors: No reported disclosures.

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