Bacteremia due to Methicillin-Resistant Staphylococcus aureus

Holubar, Marisa; Meng, Long; Deresinski, Stan

doi:10.1016/j.idc.2016.02.009

Cited by 36 publications

(22 citation statements)

References 56 publications

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“…For example, ceftaroline is a cephalosporin antibiotic active against MRSA and has been used as salvage therapy for IE alone or in combination with other anti-staphylococcal antibiotics 158,159 . Other combinations have displayed in vitro synergy and have limited human data in MRSA bacteraemia, such as vancomycin or daptomycin paired with other β-lactams or with trimethoprim-sulfamethoxazole, daptomycin plus fosfomycin, or fosfomycin combined with β-lactams 160,161 .…”

Section: Managementmentioning

confidence: 99%

Infective endocarditis

Holland

Baddour

Bayer³

et al. 2016

Nat Rev Dis Primers

342

278

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Infective endocarditis (IE) is a rare, life-threatening disease that has long-lasting effects even among patients who survive and are cured. IE disproportionately affects those with underlying structural heart disease and is increasingly associated with healthcare contact, particularly in patients who have intravascular prosthetic material. In the setting of bacteraemia with a pathogenic organism, an infected vegetation may form as the end result of complex interactions between invading microorganisms and the host immune system. Once established, IE can involve almost any organ system in the body. The diagnosis of IE may be difficult to establish and a strategy that combines clinical, microbiological and echocardiography results has been codified in the modified Duke criteria. In cases of blood culture-negative IE, the diagnosis may be especially challenging and novel microbiological and imaging techniques have been developed to establish its presence. Once diagnosed, IE is best managed by a multidisciplinary team with expertise in infectious diseases, cardiology and cardiac surgery. Antibiotic prophylaxis for the prevention of IE remains controversial. Efforts to develop a vaccine targeting common bacterial causes of IE are ongoing, but have not yet yielded a commercially available product.

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Section: Managementmentioning

confidence: 99%

Infective endocarditis

Holland

Baddour

Bayer³

et al. 2016

Nat Rev Dis Primers

342

278

View full text Add to dashboard Cite

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“…While the average daily cost of vancomycin is relatively low (approximately $US15–55) [9], a comprehensive account of the cost of vancomycin use would include the direct costs associated with measuring serum concentrations and those associated with the treatment of adverse reactions, namely nephrotoxicity. Monitoring serum concentrations involves the time of several health professionals to write orders, collect and process blood samples, report and interpret results, and document recommendations.…”

Section: Introductionmentioning

confidence: 99%

The Whole Price of Vancomycin: Toxicities, Troughs, and Time

Jeffres

2017

Drugs

144

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Vancomycin is a glycopeptide antibiotic that is active against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Nephrotoxicity, which is usually reversible, is the most serious common adverse effect of vancomycin. Vancomycin-associated nephrotoxicity prolongs hospital stays, imposes a need for additional antibiotics and, in rare circumstances, dialysis treatment, and increases medical costs and mortality. Risk factors for nephrotoxicity include the dose and duration of vancomycin treatment, serum trough concentration, patient characteristics, and concomitant receipt of nephrotoxins. Contemporary guidelines recommend targeting vancomycin trough concentrations of ≥10 mg/L to prevent resistance and trough concentrations of 15–20 mg/L to optimize outcomes. There is significant correlation between vancomycin trough serum concentrations and the incidence of vancomycin-associated nephrotoxicity; however, evidence of an association between trough concentrations and efficacy is less convincing. Routine monitoring of serum vancomycin concentrations consumes time and limited healthcare resources and may not be cost effective. The use of alternative antibacterial agents that do not require monitoring would free up pharmacy resources. This time could then be devoted to initiatives such as pharmacist-led antibiotic stewardship programs that are known to reduce antibiotic use and promote improved patient outcomes.

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“…Treatment options for persistent MRSA bacteremia or bacteremia due to VISA or vancomycin-resistant S.aureus (VRSA), include vancomycin-based therapy with semisynthetic penicillins, cephalosporins, 5 β-lactam/β-lactamase inhibitor combinations, or carbapenems. 18 It has been suggested that synergy results from a reduction in cell wall thickness caused by β-lactam exposure with a reduction in sequestration of the glycopeptides. Similarly, daptomycin-based therapy was evaluated using combination with β-lactams, ceftaroline, and TMP/SMX.…”

Section: Discussionmentioning

confidence: 99%

Septic Thrombophlebitis with Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia and de novo Resistance to Vancomycin and Daptomycin

Koton

Bisharat

2017

Infectious Disease Reports

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Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is associated with significant risk of mortality, especially when it occurs while on appropriate antimicrobial therapy. We herein describe an unusual case of a patient with prosthetic aortic tissue valve, who suffered from central venous catheter related MRSA bacteremia with septic thrombus formation in the superior vena cava. MRSA bacteremia persisted despite removal of the catheter and appropriate antimicrobial therapy including vancomycin, rifampin, and daptomycin. Subsequently, the MRSA strain exhibited de novo resistance to vancomycin, rifampin and daptomycin. Eventually, salvage combination therapy with high dose daptomycin and trimethoprim-sulfamethoxazole was successful and achieved clearance of MRSA bacteremia. The case illustrates the growing complexity of treating MRSA infections.

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Bacteremia due to Methicillin-Resistant Staphylococcus aureus

Cited by 36 publications

References 56 publications

Infective endocarditis

Infective endocarditis

The Whole Price of Vancomycin: Toxicities, Troughs, and Time

Septic Thrombophlebitis with Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia and de novo Resistance to Vancomycin and Daptomycin

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