Serious Infections Caused by Methicillin‐ResistantStaphylococcus aureus

Abstract

Although first identified just >4 decades ago, methicillin-resistant Staphylococcus aureus (MRSA) has undergone rapid evolutionary changes and epidemiologic expansion to become a major cause of nosocomial and community-acquired infections worldwide. Increasing resistance to vancomycin among MRSA strains in conjunction with availability of new antibiotics, including daptomycin and linezolid, have increased treatment choices but made clinical treatment decisions more challenging. This article describes the clinical features and management issues of 2 challenging-to-treat manifestations of MRSA infection, bacteremia and/or endocarditis and osteomyelitis. It also presents a brief review of community-associated MRSA infections and preventive strategies directed against MRSA.

Infectious Dose Dictates the Host Response during Staphylococcus aureus Orthopedic-Implant Biofilm Infection

“…taphylococcal species (Staphylococcus aureus and coagulasenegative staphylococcus) are a primary cause of prosthetic joint infections (PJIs) that are typified by biofilm formation (1)(2)(3). Many PJIs are thought to originate from bacterial colonization at the time of surgery, although clinical signs of infection may not appear until months to years following joint replacement (4,5).…”

“…Given its frequency in clinical infections (1)(2)(3), S. aureus is a logical choice of pathogen to demonstrate clinical relevance with regard to PJIs. However, it has been well documented that S. aureus strains can behave differently in terms of clinical presentation and pathogenicity (1,(14)(15)(16)(17)(18). The fact that ca.…”

Mechanisms of NDV-3 vaccine efficacy in MRSA skin versus invasive infection

“…As a result, resistance to even the most recently developed agents is emerging at an alarming pace (17,18). The impact of this trend is of special concern in light of high rates of mortality associated with invasive MRSA infection (e.g., 15-40% in bacteremia or endocarditis), even with the most recently developed antistaphylococcal therapeutics (19,20).…”

Identification of a distinctive phenotype for endocarditis-associated clonal complex 22 MRSA isolates with reduced vancomycin susceptibility

“…Staphylococcus aureus infection has a range of consequences from asymptomatic colonization to bloodstream infection (BSI) with haematogenous complications, of which endocarditis is probably the most devastating [1]. There has been interest in understanding whether strains causing severe infections such as endocarditis have distinct genotypic or phenotypic characteristics [2][3][4][5][6].…”

“…Vancomycin-intermediate S. aureus (VISA) (4-8 mg l À1 ) and heteroresistant [(h)VISA] isolates have also been associated with endocarditis [1][2][3]7]. VISA and hVISA isolates have multiple phenotypic and metabolic differences compared with susceptible isolates, such as reduced autolysis and gradual thickening of the cell wall, changes in global gene regulators including down-regulation of agr, increased expression of surface adhesins that bind fibrinogen and fibronectin, and attenuated virulence [3,[8][9][10][11][12][13].…”