Antimicrobial Use and Methicillin-Resistant Staphylococcus aureus in a Large Nursing Home

Drinka, Paul J.; Gauerke, Cathy; Le, D

doi:10.1097/01.jam.0000129820.98979.45

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…Historically, overuse of fluoroquinolones has been associated with MRSA selection. 84,85 Moreover, use of fluoroquinolones for treating MRSA infections is correlated with rapid acquisition of fluoroquinolone-resistant MRSA. The newer fluoroquinolones may have a role in the treatment of complicated skin and soft tissue infections, especially in patients who are allergic to penicillin.…”

Section: Treatment Optionsmentioning

confidence: 99%

Community-Associated Methicillin-ResistantStaphylococcus aureus: A Review

2005

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Methicillin-resistant Staphylococcus aureus (MRSA) is a common bacterial pathogen responsible for a variety of infections in both children and adults. Treatment of infections caused by this organism is problematic due to its resistance to many drugs. Recent reports of community-associated MRSA (CA-MRSA) infections in patients with no known risk factors have serious public health implications. Therapeutic options for these infections are untested; therefore, the potential exists for high morbidity and mortality. Recently, clinical definitions have been established, and new molecular approaches have allowed investigators to distinguish CA-MRSA more easily from traditional nosocomial-derived MRSA strains. Identifying potential risk factors for CA-MRSA acquisition and fully characterizing the epidemiologic, clinical, and molecular properties of these strains are necessary to provide effective therapeutic guidelines.

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Section: Treatment Optionsmentioning

confidence: 99%

Community-Associated Methicillin-ResistantStaphylococcus aureus: A Review

2005

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“…Vancomycin has been widely used to treat MRSA infections, and unsurprisingly, this has led to the identification of vancomycin-intermediate S. aureus in 1997 (4,21) and fully vancomycin-resistant S. aureus in 2002 (7)(8)(9). S. aureus continues to be a significant health problem in the hospital and other settings, such as nursing homes (15). Nasal carriage of S. aureus is an important risk factor in the hospital setting, particularly in patients requiring surgery, implanted devices, or hemodialysis (30,40,43).…”

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confidence: 99%

Antibacterial Activity of REP8839, a New Antibiotic for Topical Use

Critchley

Young

Stone

et al. 2005

Antimicrob Agents Chemother

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REP8839 is a novel methionyl-tRNA synthetase (MetS) inhibitor with potent antibacterial activity against clinical isolates of Staphylococcus aureus, Streptococcus pyogenes, and other clinically important gram-positive bacteria but little activity against gram-negative bacteria. All isolates of S. aureus, including strains resistant to methicillin, mupirocin, vancomycin, and linezolid were susceptible to REP8839 at concentrations of <0.5 g/ml. REP8839 was also active against Staphylococcus epidermidis, including multiply resistant strains (MIC, <0.25 g/ml). All S. pyogenes isolates were susceptible to REP8839 at concentrations of <0.25 g/ml, suggesting that MetS2, a second enzyme previously identified in Streptococcus pneumoniae, was not present in this organism. REP8839 was highly bound to the protein of human serum, and activity was not greatly influenced by inoculum size but was affected by pH, exhibiting optimal antibacterial activity in a neutral medium rather than a weak acidic medium. Like mupirocin, REP8839 exhibited bacteriostatic activity against key pathogens. The emergence of mupirocin resistance in S. aureus highlights the need for a new topical antibiotic with the ability to inhibit high-level mupirocin-resistant strains and other emerging phenotypes, such as vancomycinresistant and community-acquired methicillin-resistant isolates.

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“…Quinolones with the least activity against S pneumonia and S aureus are associated with the selection of resistant strains, including ciprofloxacin, ofloxacin, and low-dose levofloxacin. 49,50 Monotherapy with azithromycin may facilitate emergence of resistance because of its long half-life (68 hours) with prolonged exposure to sub-MIC levels when discontinued. 17,49 The most potent agents are less likely to promote resistance.…”

Section: Empiric Therapy and Antibiotic Resistancementioning

confidence: 99%