Combination Therapy for MRSA Bacteremia —Not Ready for Prime Time

Enhanced infection control efforts have helped reduce the rate of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia over the past decade, but the decline has stalled in recent years, and associated mortality remains steady at 20% to 25%. In terms of both clinical burden and absolute number of patients, MRSA bacteremia remains a common and highly morbid infection. While clinical practice guidelines, evidence-based management algorithms, and infectious diseases consultation can contribute to improved patient outcomes, a substantial proportion of patients still experience treatment failures. Vancomycin or daptomycin remain the preferred treatment for MRSA bacteremia, but the search for safer and more effective options continues.
Source: JAMA - Category: General Medicine Source Type: research

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This study examined the presence of MRSA in 400 samples comprising 200 raw milks (145 from goat and 55 from sheep) and 200 nasal swabs (145 from goats and 55 from sheep) collected from ten different locations in Abeokuta, Nigeria. Samples were examined using standard bacteriological methods for the isolation and identification ofStaphylococcus aureus and culture on oxacillin (6  μg/ml) and cefoxitin (2 μg/ml) selective media for the detection of MRSA. Suspected MRSA isolates were confirmed by latex agglutination test for the detection of penicillin-binding protein 2a (PBP2a). Antibiotic susceptibility testi...
Source: Tropical Animal Health and Production - Category: Veterinary Research Source Type: research
Nasal colonization with S. aureus is a well referenced risk factor for post-operative surgical site infections (SSIs). Our healthcare system that performs>40,000 surgeries per year assessed both the diagnostic accuracy of the BD MAX StaphSR (MAX StaphSR) assay, a PCR-based test that detects and differentiates Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA), compared to our standard of care culture and the subsequent clinical impact on SSIs one year after implementation.
Source: Journal of Molecular Diagnostics - Category: Pathology Authors: Tags: Regular Article Source Type: research
Authors: Hriouech S, Akhmouch AA, Mzabi A, Chefchaou H, Tanghort M, Oumokhtar B, Chami N, Remmal A Abstract The aim of this research paper is to test the antistaphylococcal effect of 1,8-cineole, amoxicillin/clavulanic acid (AMC), and gentamicin, either separately or in combination against three Staphylococcus aureus strains isolated from patients suffering from osteomyelitis. This activity was tested in vitro by using the microdilution method and the checkerboard assay. The efficacy of these three antibacterial agents was then tested in vivo by using an experimental model of methicillin-resistant S. aureus osteomy...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
This study aimed to detect S. aureus from nares of AD patients and their family contacts, as well as to evaluate the antimicrobial resistance, virulence and clonality of these isolates. Among the 48 family groups investigated, 30 groups were selected, as both the child and his/her respective contact had methicillin-sensitive S. aureus (MSSA) (24 cases; 54 MSSA isolates) or methicillin-resistant S. aureus (MRSA) isolates (6 cases; 13 MRSA isolates). All MRSA isolates carried SCCmec IV. S. aureus carrying PVL genes were detected in 60 % of patients. Pulsed-field gel electrophoresis (PFGE) analysis was performed for 31 isol...
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research
Infections caused by multidrug resistant organisms (MDROs) are on the rise and often attributed to prior asymptomatic carriage [1-3]. The epidemiology of MDROs has been extensively studied in healthcare settings [4-6]. However, recent isolation of MDROs in the community [6, 7] highlights the need for community-based studies to update their epidemiology. Among the MDROs, extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E), carbapenem-resistant Enterobacteriaceae (CRE) and methicillin-resistant Staphylococcus aureus (MRSA) are among the top threats identified by the United States Centers for Disease Contro...
Source: Journal of Infection - Category: Infectious Diseases Authors: Source Type: research
CONCLUSION: In the case described here, linezolid at a dose of 600 mg every 8 hours did not achieve target plasma concentrations in a patient receiving concomitant venovenous ECMO support. PMID: 32426841 [PubMed - in process]
Source: American Journal of Health-System Pharmacy : AJHP - Category: Drugs & Pharmacology Authors: Tags: Am J Health Syst Pharm Source Type: research
Yamuna Devi Bakthavatchalam, Shoma Vinay Rao, Barney Isaac, Abi Manesh, Senthur Nambi, Subramanian Swaminathan, Vasanth Nagvekar, Vivek Nangia, Peter Victor John, Balaji VeeraraghavanIndian Journal of Medical Microbiology 2019 37(4):478-487Staphylococcus aureus is of significant clinical concern in both community- and hospital-onset infections. The key to the success of S. aureus as a pathogen is its ability to swiftly develop antimicrobial resistance. Methicillin-resistant S. aureus (MRSA) is not only resistant to nearly all beta-lactams but also demonstrates resistance to several classes of antibiotics. A high prevalence...
Source: Indian Journal of Medical Microbiology - Category: Microbiology Authors: Source Type: research
Abstract The cylindrocyclophanes are a family of macrocyclic natural products reported to exhibit antibacterial activity. Little is known about the structural basis of this activity due to challenges associated with their synthesis or isolation. We hypothesised that structural modification of the cylindrocyclophane scaffold could streamline their synthesis without significant loss of activity. Herein we report a divergent synthesis of the cylindrocyclophane core enabling access to symmetrical macrocycles by means of a catalytic, domino cross-metathesis-ring-closing metathesis cascade, followed by late-stage divers...
Source: ChemMedChem - Category: Chemistry Authors: Tags: ChemMedChem Source Type: research
PBP2a confers resistance to β‐lactam antibiotics inStaphylococcus aureus. We expressed the gene encoding PBP2a in a β‐lactam sensitive strain ofS.  aureus. We found that the resistance level conferred by PBP2a varies considerably between β‐lactams and between single cells in a population. AbstractMethicillin ‐resistantStaphylococcus aureus (MRSA) is resistant to most β‐lactams due to the expression of an extra penicillin‐binding protein, PBP2a, with low β‐lactam affinity. It has long been known that heterologous expression of the PBP2a‐encodingmecA gene in methicillin ‐sensit...
Source: MicrobiologyOpen - Category: Microbiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
We present evidence for the existence of several, hitherto unreported, nonsynonymous SNPs in genes encoding the RNAP and associated factors of MRSA ST22 clinical isolates and propose that the acquisition of amino acid substitutions in the RNAP could represent an adaptive strategy that contributes to the pathogenic success of MRSA.
Source: MicrobiologyOpen - Category: Microbiology Authors: Tags: COMMENTARIES Source Type: research
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