Treatment of severe MRSA infections: current practice and further development

Paiva, José Artur; Eggimann, Philippe

doi:10.1007/s00134-016-4572-4

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Generally, vancomycin is recommended for the treatment of MRSA implant-associated infections (Paiva and Eggimann, 2017), yet a high rate of vancomycin treatment failure in vancomycin-susceptible MRSA infections has been reported (Dombrowski and Winston, 2008;Abdelhady et al, 2013). This observation correlates with our findings showing the inefficiency of treating biofilms of clinical strains with vancomycin alone or combined with Sb-1.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of Staphylococcal Bacteriophage Sb-1 as an Adjunctive Agent to Antibiotics Against Rifampin-Resistant Staphylococcus aureus Biofilms

et al. 2020

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Rifampin plays a crucial role in the treatment of staphylococcal implant-associated infection, as it is the only antibiotic capable of eradicating Staphylococcus aureus biofilms. However, the emergence of rifampin resistance strongly limits its use. Combinatorial therapy of antibiotics and bacteriophages may represent a strategy to overcome the resistance. Here, we evaluated the activity of staphylococcal bacteriophage Sb-1 in combination with different antibiotics against the biofilms of 10 rifampin-resistant S. aureus clinical strains, including MRSA and MSSA. S. aureus biofilms formed on porous glass beads were exposed to antibiotics alone or combined with Sb-1 simultaneously or staggered (first Sb-1 for 24 h followed by antibiotic). Recovered bacteria were detected by measuring growth-related heat production at 37°C (isothermal microcalorimetry) and the biofilm eradication was assessed by sonication of beads and plating of the resulting sonication fluid. Minimum biofilm eradication concentration (MBEC) was defined as the lowest concentration of antibiotic required to kill all adherent bacteria, resulting in absence of growth after plating the sonication fluid. Tested antibiotics presented high MBEC values when administered alone (64 to > 1,024 μg/ml). The simultaneous or staggered combination of Sb-1 with daptomycin showed the highest activity against all MRSA biofilms, whereas the exposure to Sb-1 with vancomycin showed no improved anti-biofilm activity. Staggered administration of Sb-1 and flucloxacillin, cefazolin, or fosfomycin improved the antibiofilm activity in four out of six MSSA, whereas simultaneous exposure exhibited similar or lesser synergy. In conclusion, the combinatorial effect of Sb-1 and antibiotics enabled to eradicate rifampin-resistant S. aureus biofilms in vitro .

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Section: Discussionsupporting

confidence: 87%

Evaluation of Staphylococcal Bacteriophage Sb-1 as an Adjunctive Agent to Antibiotics Against Rifampin-Resistant Staphylococcus aureus Biofilms

et al. 2020

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“…We investigated whether systemic treatment with vancomycin, an antibiotic commonly used in the treatment of septic arthritis ( 21 , 22 ), effectively attenuates both infection and inflammation ( Fig. 2A ).…”

Section: Resultsmentioning

confidence: 99%

Dual therapeutic targeting of intra-articular inflammation and intracellular bacteria enhances chondroprotection in septic arthritis

Kwon

Lee

et al. 2021

Sci. Adv.

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Bacterial infections involving joints and vital organs represent a challenging clinical problem because of the two concurrent therapeutic goals of bacterial eradication and tissue preservation. In the case of septic arthritis, permanent destruction of articular cartilage by intense host inflammation is commonly seen even after successful treatment of bacterial infection. Here, we provide scientific evidence of a novel treatment modality that can protect articular cartilage and enhanced eradication of causative bacteria in septic arthritis. Locally delivered cell-penetrating antibiotics such as rifampicin effectively eradicate intracellular reservoirs of methicillin-resistant Staphylococcus aureus within joint cells. Furthermore, mitigation of intra-articular inflammation by targeting the NLRP3 (nucleotide-binding oligomerization domain-, leucine-rich repeat- and pyrin domain-containing 3) inflammasome protects articular cartilage from damage in a murine model of knee septic arthritis. Together, concurrent mitigation of intra-articular inflammation and local adjuvant targeting of intracellular bacteria represents a promising new therapeutic strategy for septic arthritis.

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“…Vancomycin, a tricyclic glycopeptide antibiotic, is a bactericidal agent exhibiting activity against Grampositive microorganisms by inhibiting their cell wall synthesis (Eyler & Shvets, 2019).Since its discovery in the 1950s, it has been widely used to treat infections caused by organisms resistant to certain antibiotics such as methicillin-resistant Staphylococcus aureus (MRSA), and as an alternative option in patients with allergy to penicillin group or cephalosporin group antibiotics (Levine, 2006(Levine, , 2008.Vancomycin has unique pharmacokinetic/pharmacodynamic characteristics which can cause nephrotoxicity and ototoxicity; hence it requires frequent therapeutic drug monitoring to optimize its efficacy and minimize its toxicities (Levine, 2008). Newer antibiotics with better safety profiles and similar therapeutic effectiveness, such as linezolid, daptomycin, teicoplanin and ceftaroline might be preferred by the clinicians in certain cases (Paiva & Eggimann, 2017). However, these new alternative antibiotics might not be available in certain hospitals in low-to-middle-income countries like Malaysia due to budget constraints.…”

Section: Introductionmentioning

confidence: 99%

Vancomycin Hypersensitivity: Case Reports of Successful Vancomycin Desensitization

San¹,

Lee²,

Tan³

et al. 2023

IJALSR

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Background: Vancomycin infusion reaction (VIR, previously known as “red man syndrome”) and anaphylaxis are two vancomycin hypersensitivity reactions with identical and clinically indistinguishable clinical presentations. Method: This was a retrospective study where vancomycin hypersensitivity cases who underwent vancomycin desensitization in the past two years were recruited. Results: Two vancomycin hypersensitivity cases were labeled as allergic to vancomycin in their previous hospitalizations before being admitted to our hospitals. The first case developed facial and lips swelling, while the second case developed transient hypotension; both occurred after the first dose of intravenous vancomycin, and hence were labelled as allergies without continuation of vancomycin in the previous hospitalizations. During current hospital admissions, both patients required vancomycin to treat infections. After weighing the risks and benefits, rapid vancomycin desensitization was conducted in both patients because of budget constraints in the public hospitals for alternative antibiotics. The desensitization was successfully conducted with no recurrence of previous reactions, and both cases completed intravenous vancomycin treatment for their infections. Conclusion: Clinical presentations in VIR and anaphylaxis might be identical and indistinguishable, especially the reactions that have happened in the past and confirmatory allergy test is not available. Our study reported that vancomycin desensitization could be conducted in cases where VIR or anaphylaxis are uncertain, with the past reactions not life-threatening, and if no other alternative antibiotic can be used to treat infections.

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Treatment of severe MRSA infections: current practice and further development

Cited by 8 publications

References 17 publications

Evaluation of Staphylococcal Bacteriophage Sb-1 as an Adjunctive Agent to Antibiotics Against Rifampin-Resistant Staphylococcus aureus Biofilms

Evaluation of Staphylococcal Bacteriophage Sb-1 as an Adjunctive Agent to Antibiotics Against Rifampin-Resistant Staphylococcus aureus Biofilms

Dual therapeutic targeting of intra-articular inflammation and intracellular bacteria enhances chondroprotection in septic arthritis

Vancomycin Hypersensitivity: Case Reports of Successful Vancomycin Desensitization

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