A Comparison of Pneumonia Caused by Gentamicin, Methicillin-Resistant and Gentamicin, Methicillin-SensitiveStaphylococcus aureus: Epidemiologic and Clinical Studies

Abstract

We investigated an outbreak of nosocomial pneumonia due to gentamicin, methicillin-resistant Staphylococcus aureus (GMRSA). We compared the predisposing factors for pneunomia due to GMRSA to those for pneumonia due to gentamicin, methicillin-sensitive Staphylococcus aureus (GMSSA). Seventeen of 29 patients with staphylococcal pneumonia were infected with GMRSA. Risk factors and associated diseases which selected for infection with GMRSA as opposed to GMSSA included prior antibiotic therapy for a prolonged period of time (p = 0.0001), number of risk factors per patient (p = 0.0001), days hospitalized prior to diagnosis of pneumonia (p = 0.002) and number of associated diseases per patient (p = 0.002).Despite the epidemiologic differences between GMSSA and GMRSA pneumonia, there were no differences in the clinical presentation, course of illness, complications, response to appropriate therapy or outcome between the two groups. Survival was adversely affected by age only among the GMSSA patients (p = 0.02) and by the number of associated diseases (p = 0.005).

Impact of methicillin resistance on mortality inStaphylococcus aureusVAP: a systematic review

“…However, the results of the current contribution contradict those of two clinical studies on the same issue that did not fulfil the present inclusion criteria [25,26]. The fact that these two studies did not establish any association between methicillin resistance and excess mortality may not be surprising.…”

“…It is noteworthy that several investigators have reported that patients with MSSA infections experience worse clinical outcomes when treated with vancomycin rather than a b-lactam [27][28][29]. In the other study [26], several methodological issues (such as the enrolment of patients not receiving mechanical ventilation, as well as the absence of an accurate microbiological confirmation of the pneumonia diagnosis based on quantitative cultures) might have substantially influenced its findings. Likewise, three [18,20,24] of the eight articles included in the present review also demonstrate no relationship between methicillin resistance and mortality in patients with S. aureus VAP.…”

Comparison of in vitro activity of quinolone antibiotics and vancomycin against gentamicin- and methicillin-resistant Staphylococcus aureus by time-kill kinetic studies

“…The quinolone antibiotics have been proposed as a possible alternative to parenteral vancomycin therapy on the basis of in vitro (1,3,21) and in vivo animal model (6) data. The present study was undertaken to compare the activities of several of the fluoroquinolone antibiotics and vancomycin against strains of gentamicin-and methicillin-resistant S. aureus, which has become a major pathogen at our institution (13).…”

The importance of timely introduction of vancomycin therapy against methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and severity of MRSA bacteremia at Teaching Hospital, Anuradhapura, Sri Lanka

“…Meantime, some of the European countries have shown a wide range of MRSA bacteremia proportions (0% in Iceland to 52.4% in Malta) and a few countries such as France, the UK, and Slovenia have demonstrated a decline in MRSA bacteremia rates over recent years due to the implementation of multifaceted prevention programs [16]. Therefore, compared to other countries, THA, Sri Lanka shows a comparatively low prevalence of MRSA bacteremia.…”