Methicillin-resistant Staphylococcus aureus as a cause of community-acquired pneumonia

Abstract

New pathogens have emerged that now complicate the management of community-acquired pneumonia (CAP). Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as a potential cause of CAP, particularly complicated CAP. In this literature review, the incidence, invasiveness, and antimicrobial management of CA-MRSA is discussed. Based on existing data and the rising incidence of CA-MRSA, we recommend a change in antibiotic selection for complicated CAP.

Incidence, characteristics and outcomes of patients with severe community acquired-MRSA pneumonia

“…Two reviews reported that the evidence on epidemiology and characteristics of MRSA CAP is unknown and is extrapolated from studies on patients hospitalised with MSSA (methicillin-sensitive S. aureus) CAP (which is also scarce) [112,113]. One of them also commented that ''this should be attributed to the lack of routine culture in patients with uncomplicated pneumonia'' [113].…”

“…Two reviews reported that the evidence on epidemiology and characteristics of MRSA CAP is unknown and is extrapolated from studies on patients hospitalised with MSSA (methicillin-sensitive S. aureus) CAP (which is also scarce) [112,113]. One of them also commented that ''this should be attributed to the lack of routine culture in patients with uncomplicated pneumonia'' [113]. Several studies reported that after the implementation of the antipneumococcal vaccine the incidence of Streptococcus pneumoniae CAP decreased with a simultaneous increase in MRSA CAP, especially in cases complicated with pleural effusions [114][115][116].…”

Incidence and characterization of Staphylococcus aureus in fishery products marketed in Galicia (Northwest Spain)

“…Multi-resistant S. aureus is rather common in hospital settings and farms (Livermore, 2000;Sakoulas and Moellering, 2008). Community-associated multi-resistant S. aureus is becoming an emerging problem too (Popovich et al, 2007;Ribeiro et al, 2007;Stankovic et al, 2007). Antibiotic-resistant strains of S. aureus have been detected in food animals (Lee, 2003) and food like meat (Normanno et al, 2007;Pesavento et al, 2007), milk and dairy products (Gündogân et al, 2006;Peles et al, 2007;Pereira et al, 2009) and also fishery products (Beleneva, 2011), and it may be very hazardous for human health.…”

Activity of the new cephalosporin ceftaroline against bacteraemia isolates from patients with community-acquired pneumonia

“…Clinicians continue to use ␤-lactams because of their potent bactericidal activity and adequate coverage of most community-based infections and because of their excellent safety and tolerability profiles. However, many community-based infections, such as community-acquired pneumonia (CAP), are becoming more difficult to treat owing to the emergence of resistant organisms such as multidrug-resistant Streptococcus pneumoniae (MDRSP) and methicillin-resistant Staphylococcus aureus (MRSA) [1,2]. Streptococcus pneumoniae, one of the most common causes of CAP, is developing resistance to many of the currently available antibiotics, including macrolides, quinolones, penicillins and cephalosporins [3,4].…”