scholarly journals Multimicrobial Pneumonia during the Early Stages of a Global Pandemic

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Jalal H ◽  
◽  
Henriksen G ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Acute Infection ◽  
Standard Of Care ◽  
Antibiotic Use ◽  
Lung Parenchyma ◽  
Community Acquired Pneumonia ◽  
Methicillin Resistant ◽  
Global Pandemic

Community-acquired pneumonia is an acute infection of lung parenchyma which causes local and systemic inflammatory changes via cytokines. Several bacteria and viruses are responsible for this type of pneumonia, and the most common bacterial cause is Streptococcus pneumoniae. The classic symptoms are cough, fever, and pleuritic chest pain. In the Winter of 2020, a new strain of coronavirus known as SARS-CoV-2 spread throughout the world and was responsible for a global pandemic that transformed the way we live our lives. A 93-year old female presented to the hospital with respiratory distress and was found to have not only COVID-19 pneumonia but also superimposed Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa pneumonia. Following the most up-to-date guidelines, she was determined to have community-acquired pneumonia. Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa are uncommon causes of communityacquired pneumonia. She was treated with the standard of care at the time, which included vancomycin, piperacillin-tazobactam, and hydroxychloroquine. This case highlights the rarity of this specific presentation of community acquired pneumonia in regards to microbial etiology. It showcases that patients may develop certain diseases despite not having any risk factors. A major takeaway point is that apt decision making is a critical and time sensitive matter when determining whether a bacterial co-infection is present since it can affect patient outcomes. Since co-infections are relatively infrequent, antibiotic use in COVID-19 positive patients needs to be tailored accordingly. At the same time, it is crucial to keep in mind that co-infections are associated with increased severity of COVID-19 as well as poorer outcomes.

scholarly journals 1301. Risk Factors for Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa in Community Acquired Pneumonia

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S738-S739
Author(s):  
Maya Bell ◽  
Courtney Veltri ◽  
Evelina Kolychev ◽  
Leila S Hojat
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Academic Medical Center ◽  
Community Acquired Pneumonia ◽  
Methicillin Resistant ◽  
Independent Risk Factors ◽  
The Impact

Abstract Background The 2019 American Thoracic Society and Infectious Diseases Society of America Community-Acquired Pneumonia (CAP) guidelines concluded that the major risk factors for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) include prior isolation of these organisms and previous hospitalization with IV antibiotic use within 90 days. However, the guidelines recognized that results may vary by region and recommended local validation of risk factors. The primary objective of this study was to determine which potential risk factors are associated with MRSA and Pseudomonas aeruginosa in CAP in our institution. This study also evaluated appropriateness of antibiotics used for empiric CAP therapy. Methods This was a single-center, retrospective cohort study performed in an urban academic medical center in Cleveland, OH. Adults hospitalized for CAP who had a respiratory culture performed between January 2016 and September 2020 were included. Patients were randomized in a 1:1:1 ratio into MRSA, PsA, and non-resistant CAP (NR-CAP) groups. Patients with bacterial co-infections or resistant pathogens other than MRSA or PsA were excluded. Results The study included 111 patients with 37 patients in each group. The median age was 61 years (IQR 52-70), and 58.6% of patients were male. There were no independent risk factors for MRSA (Table 1). Independent risk factors for PsA included prior isolation and enteral feeding (Table 2). MRSA risk factors as defined by the 2019 CAP guidelines were found in 48.6% of patients with MRSA CAP (Figure 1). Guideline-defined PsA risk factors were found in 56.8% of patients with PsA CAP (Figure 2). In NR-CAP, 62.2% received empiric MRSA coverage while only 27% had a guideline-defined risk factor; PsA coverage was administered in 78.4% of NR-CAP patients, but risk factors were found in only 24.3% of this cohort. MRSA and P. aeruginosa Risk Factor Analyses Empiric MRSA and P. aeruginosa Coverage and Guideline-Defined Risk Factors Conclusion Our findings were consistent with the risk factors identified in the 2019 CAP guidelines, but additional risk factors may be present in our patient population. Empiric coverage for MRSA and PsA was disproportionately high relative to the rate of recovery. This study encourages local validation of risk factors; however, further analyses are needed to determine the impact on empiric therapy. Disclosures All Authors: No reported disclosures

scholarly journals Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Justin J Kim ◽  
Alison Lydecker ◽  
Rohini Davé ◽  
Jacqueline T Bork ◽  
Mary-Claire Roghmann
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections ◽  
Control Study

Abstract We identified deep diabetic foot infections by culture and conducted a case–control study examining the risk factors for moderate to severe methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) diabetic foot infections. Our MRSA prevalence was lower than literature values; PsA was higher. Gangrene may be predictive of Pseudomonas infection.

scholarly journals PES Pathogens in Severe Community-Acquired Pneumonia

2019 ◽  
Vol 7 (2) ◽  
pp. 49 ◽  
Author(s):  
Catia Cillóniz ◽  
Cristina Dominedò ◽  
Antonello Nicolini ◽  
Antoni Torres
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Distress Syndrome ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
Cardiac Events ◽  
Intensive Care Admission ◽  
Methicillin Resistant ◽  
Admission Rates ◽  
Severe Community Acquired Pneumonia

Worldwide, there is growing concern about the burden of pneumonia. Severe community-acquired pneumonia (CAP) is frequently complicated by pulmonary and extra-pulmonary complications, including sepsis, septic shock, acute respiratory distress syndrome, and acute cardiac events, resulting in significantly increased intensive care admission rates and mortality rates. Streptococcus pneumoniae (Pneumococcus) remains the most common causative pathogen in CAP. However, several bacteria and respiratory viruses are responsible, and approximately 6% of cases are due to the so-called PES (Pseudomonas aeruginosa, extended-spectrum β-lactamase Enterobacteriaceae, and methicillin-resistant Staphylococcus aureus) pathogens. Of these, P. aeruginosa and methicillin-resistant Staphylococcus aureus are the most frequently reported and require different antibiotic therapy to that for typical CAP. It is therefore important to recognize the risk factors for these pathogens to improve the outcomes in patients with CAP.

scholarly journals In Vitro Comparison of Antibacterial and Antibiofilm Activities of Selected Fluoroquinolones against Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus

Pathogens ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 12 ◽  
Author(s):  
Majed Masadeh ◽  
Karem Alzoubi ◽  
Wesam Ahmed ◽  
Aisha Magaji
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Culture Collection ◽  
Strain Atcc ◽  
Inhibitory Effects ◽  
Planktonic Cells ◽  
Methicillin Resistant ◽  
Insight Into

An in vitro overview of the inhibitory effects of selected fluoroquinolones against planktonic and biofilm cells of the methicillin-resistant Staphylococcus aureus (MRSA) strain American type culture collection (ATCC) 43300 and the Pseudomonas aeruginosa strain ATCC 27853 was carried out. Biofilm cells of both strains were less susceptible to the selected antibiotics than their planktonic counterparts. In addition, certain antibiotics were more effective against biofilm cells, while others performed better on the planktonic cells. Against P. aeruginosa, ciprofloxacin was the most potent on both planktonic and biofilm cells, whereas ofloxacin was the least potent on both biofilm and planktonic cells. Moxifloxacin and gatifloxacin were the most potent against both planktonic and biofilm MRSA bacteria, however, not in the same order of activity. Norfloxacin was the least active when tested against both planktonic and biofilm cells. The results of this work are expected to provide insight into the efficacy of various fluoroquinolones against MRSA and Pseudomonas aeruginosa biofilms. This study could form the basis for future clinical studies that could recommend special guidelines for the management of infections that are likely to involve bacteria in their biofilm state.

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