Hamrsa

Epidemiology

Casette chromosome type Toxins

Susceptibility testing Antibiotic susceptibility pattern

Clinical features

Empiric antibiotic therapy

Young adults Community origin

In vitro Susceptibility = In vivo Effectiveness Pauci-resistant (susceptible to many antibiotics)

Severe necrotizing CAP Postviral influenza with PVL+ strains Nonsevere CAP with PVL— strains Severe pyomyositis/fasciitis with PVL+ strains Nonsevere cSSSI with PVL strains

Clindamycin Doxycycline TMP-SMX

Older adults/elderly Hospital origin SCCmec I, II, III PVL-

In vitro Susceptibility s In vivo Effectiveness Multidrug resistant (not susceptible to most antibiotics) Bacteremias Nosocomial ABE Skin/soft tissue infections Respiratory secretions colonization common in ventilator patients MRSA VAP uncommon Daptomycina Linezolida Tigecyclinea Minocyclinea Quinupristin/dalfopristina Vancomycina

Abbreviations: cSSSI, complicated skin/soft tissue infection; SCC, staphylococcal casette chromosome; VAP, ventilator-associated pneumonia. a Also effective against CA-MRSA.

Adapted from Cunha BA. Clinical manifestations and antimicrobial therapy of methicillin-resistant Staphylococcus aureus (MRSA). Clin Microbiol Infect 2005;11:33-42; Arshad S, Brown RB. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Infectious Disease Practice 2006;30:479-83; Cunha BA. Antibiotic essentials. 5th edition. Royal Oak (MI): Physicians' Press; 2006.

References

[1] Bassetti M, Melica G, Cenderello G, et al. Gram-positive bacterial resistance. A challenge for the next millennium. Panminerva Med 2002;44:179-84.

[2] Pallares R, Fenoll A, Linares J, et al. The epidemiology of antibiotic resistance in Streptococcus pneumoniae and the clinical relevance of resistance to cephalosporins, macrolides and quinolones. Int J Antimicrob Agents 2003;22(Suppl 1):S15-24.

[3] Cunha BA. Antibiotic resistance. Drugs for Today 1998;31:691-8.

[4] Boneca IG, Chiosis G. Vancomycin resistance: occurrence, mechanisms and strategies to combat it. Expert Opin Ther Targets 2003;7:311-28.

[5] Bonten MJ, Willems R, Weinstein RA. Vancomycin-resistant enterococci. Clin Infect Dis 2000;31:1058-65.

[6] Cetinkaya Y, Falk P, Mayhall CG. Vancomycin-resistant enterococci. Clin Microbiol Rev 2000;13:686-707.

[7] Cunha BA. Penicillin-resistant pneumococci. Postgrad Med 2003;113:42-54.

[8] Feldman C. Clinical relevance of antimicrobial resistance in the management of pneumococcal community-acquired pneumonia. J Lab Clin Med 2004;143:269-83.

[9] Lynch JP 3rd, Zhanel GG. Escalation of antimicrobial resistance among Streptococcus pneumoniae: implications for therapy. Semin Respir Crit Care Med 2005;26:575-16.

[10] Cunha BA. Penicillin resistant Streptococcus pneumoniae. Drugs Today 1998;31:31-5.

[11] Cunha BA. Antibiotic resistance: control strategies. Crit Care Clin 1998;8:309-28.

[12] CunhaBA. Strategies to control antibiotic resistance. Semin Respir Crit Care Med 2000;21: 3-8.

[13] CunhaBA. Effective antibiotic resistance and control strategies. Lancet 2001;3570:1307-8.

[14] Shea KW, Ueno Y, Abumustafa F, et al. Doxycycline activity against Streptococcus pneumoniae. Chest 1995;107:1775-6.

[15] Lederman ER, Gleeson TD, Driscoll T, et al. Doxycycline sensitivity of S. pneumoniae isolates. Clin Infect Dis 2003;36:1091.

[16] Jones RN, Sader HS, Fritsche TR. Doxycycline use for community-acquired pneumonia: contemporary in vitro spectrum of activity against Streptococcus pneumoniae (19992002). Diagn Microbiol Infect Dis 2004;(49):147-9.

[17] Johnson JR. Doxycycline for treatment of community-acquired pneumonia. Clin Infect Dis 2002;35:632-3.

[18] Klugman KP, Lonks JR. Hidden epidemic of macrolide-resistant pneumococci. Emerg Infect Dis 2005;11:802-7.

[19] Pihlajamaki M, Kotilainen P, Kaurila T, et al. Macrolide-resistant Streptococcus pneumoniae and use of antimicrobial agents. Clin Infect Dis 2001;33:483-8.

[20] Cunha BA, editor. Antibiotic essentials. 5th edition. Royal Oak (MI): Physicians' Press; 2006.

[21] Lonks JR, Garau J, Medeiros AA. Implications of antimicrobial resistance in the empirical treatment of community-acquired respiratory tract infections: the case of macrolides. J Antimicrob Chemother 2002;50(Suppl S2):87-92.

[22] Rzeszutek M, Wierzbowski A, Hoban DJ, et al. A review of clinical failures associated with macrolide-resistant Streptococcus pneumoniae. Int J Antimicrob Agents 2004;24:95-104.

[23] Cunha BA. The significance of antibiotic false sensitivity testing with in vitro testing. J Chemother 1997;9:25-35.

[24] Cunha BA. MRSA & VRE: in vitro susceptibility versus in vivo efficacy. A cause of skin and soft tissue infections. Ann Intern Med 2006;144:309-17.

[25] Schito GC. The importance of the development of antibiotic resistance in Staphylococcus aureus. Clin Microbiol Infect 2006;12(Suppl 1):3-8.

[26] Hayden MK. Insights into the epidemiology and control of infection with vancomycin-resistant enterococci: why are they here, and where do they come from? Lancet Infect Dis 2000;31:1058-65.

[27] Chavers LS, Moser SA, Benjamin WH, et al. Vancomycin-resistant enterococci: 15 years and counting. J Hosp Infect 2003;53:159-71.

[28] Patel R. Clinical impact of vancomycin-sresistant enterococci. J Antimicrob Chemother 2003;51(Suppl 3):iii3-21.

[29] Donskey CJ, Hoyen CK, Das SM, et al. Recurrence of vancomycin-resistant Enterococcus stool colonization during antibiotic therapy. Infect Control Hosp Epidemiol 2002;23: 436-40.

[30] Lautenbach E, LaRosa LA, Marr AM, et al. Changes in the prevalence of vancomycin-resistant enterococci in response to antimicrobial formulary interventions: impact of progressive restrictions on use of vancomycin and third-generation cephalosporins. Clin Infect Dis 2003;36:440-6.

[31] Cunha BA. Clinical relevance of penicillin resistant Streptococcus pneumoniae. Semin Respir Infect 2002;17:204-14.

[32] Fuller JD, McGeer A, Low DE. Drug-resistant pneumococcal pneumonia: clinical relevance and approach to management. Eur J Clin Microbiol Infect Dis 2005;24:780-8.

[33] Zhanel GG, Hisanaga T, Nichol K, et al. Ketolides: an emerging treatment for macrolide-resistant respiratory infections, focusing on S. pneumoniae. Expert Opin Emerg Drugs 2003; 8:297-321.

[34] Craig WA. Overview of newer antimicrobial formulations for overcoming pneumococcal resistance. Am J Med 2004;117(Suppl 3A):16S-22S.

[35] Ortega M, Marco F, Almela M, et al. Activity of telithromycin against erythromycin-susceptible and resistant Streptococcus pneumoniae is from adults with invasive infections. Int J Antimicrob Agents 2004;24:616-8.

[36] Quintiliani R. Clinical management of respiratory tract infections in the community: experience with telithromycin. Infection 2001;(Suppl 2):16-22.

[37] Low DE, Felmingham D, Brown SD, et al. Activity of telithromycin against key pathogens associated with community-acquired respiratory tract infections. J Infect 2004;49: 115-25.

[38] Reinert RR. Clinical efficacy of ketolides in the treatment of respiratory tract infections. J Antimicrob Chemother 2004;53:918-27.

[39] van Rensburg DJ, Fogarty C, Kohno S, et al. Efficacy of telithromycin in community-acquired pneumonia caused by pneumococci with reduced susceptibility to penicillin and/or erythromycin. Chemotherapy 2005;51:186-92.

[40] Mascini EM, Bonten MJ. Vancomycin-resistant enterococci: consequences for therapy and infection control. Clin Microbiol Infect 2005;11(Suppl 4):43-56.

[41] Linden PK. Treatment options for vancomycin-resistant enterococcal infections. Drugs 2002;62:425-41.

[42] Chant C, Ryback MH. Quinupristin/dalfopristin (RP 59500): a new streptogramin antibiotic. Ann Pharmacother 1995;29:1022-7.

[43] BrysonHM, Spencer CM. Quinupristin/dalfopristin. Drugs 1996;52:406-15.

[44] Griswold MW, Lomaestro BM, Briceland LL. Quinupristin-dalfopristin (RP 59500): an injectable streptogramin combination. Am J Health Syst Pharm 1996;53:2045-53.

[45] Kim MK, Nicolau DP, Nightingale CH, et al. Quinupristin/dalfopristin: a treatment option for vancomycin-resistant enterococci. Conn Med 2000;64:209-12.

[46] Goff DA, Sierawski SJ. Clinical experience of quinupristin-dalfopristin for the treatment of antimicrobial-resistant gram-positive infections. Pharmacotherapy 2002;22:748-58.

[47] Blondeau JM, Sanche SE. Quinupristin/dalfopristin. Expert Opin Pharmacother 2002;3: 1341-64.

[48] Gould CV, Fishman NO, Nachamkin I, et al. Chloramphenicol resistance in vancomycin-resistant enterococcal bacteremia: impact of prior fluoroquinolone use? Infect Control Hosp Epidemiol 2004;25:138-45.

[49] Kauffman CA. Therapeutic and preventative options for the management of vancomycin-resistant enterococcal infections. J Antimicrob Chemother 2003;51(Suppl 3):iii23-30.

[50] Zirakzadeh A, Patel R. Vancomycin-resistant enterococci: colonization, infection, detection, and treatment. Mayo Clin Proc 2006;81:529-36.

[51] Tigecycline. Med Lett Drugs Ther 2005;47:73-4.

[52] Sader HS, Jones RN, Dowzicky MJ, et al. Antimicrobial activity of tigecycline tested against nosocomial bacterial pathogens from patients hospitalized in the intensive care unit. Diagn Microbiol Infect Dis 2005;52:203-8.

[53] Frampton JE, Curran MP. Tigecycline. Drugs 2005;65:2623-35.

[54] Felmingham D. Tigecycline: an expanded broad-spectrum intravenous antibiotic. Preface and summary. J Chemother 2005;17(Suppl 1):3-4.

[55] Livermore DM. Tigecycline: what is it, and where should it be used? J Antimicrob Chemother 2005;56:611-4.

[56] Zhanel GG, Karlowsky JA, Rubinstein E, et al. Tigecycline: a novel glycylcycline antibiotic. Expert Rev Anti Infect Ther 2006;4:9-25.

[57] Jones CH, Petersen PJ. Tigecycline: a review of preclinical and clinical studies of the first-in-class glycylcycline antibiotic. Drugs Today (Barc) 2005;41:637-69.

[58] Clemett D, Markham A. Linezolid. Drugs 2000;59:815-27.

[59] Wilcox MH. Efficacy of linezolid versus comparator therapies in gram-positive infections. J Antimicrob Chemother 2003;51(Suppl 2):ii27-35.

[60] Carpenter CF, Chambers HF. Daptomycin: another novel agent for treating infections due to drug-resistant gram-positive pathogens. Clin Infect Dis 2004;38:994-1000.

[61] Fenton C, Keating GM, Curran MP. Daptomycin. Drugs 2004;64:445-55.

[62] Cha R, Grucz RG Jr, Rybak MJ. Daptomycin dose-effect relationship against resistant gram-positive organisms. Antimicrob Agents Chemother 2003;47:1598-603.

[63] Dvorchik BH, Brazier D, DeBruin MF, et al. Daptomycin pharmacokinetics and safety following administration of escalating doses once daily to healthy subjects. Antimicrob Agents Chemother 2003;47:1318-23.

[64] Cunha BA. Methicillin-resistant Staphylococcus aureus: clinical manifestations and antimicrobial therapy. Clin Microbiol Infect 2005;11(Suppl 4):33-42.

[65] Anstead GM, Owens AD. Recent advances in the treatment of infections due to resistant Staphylococcus aureus. Curr Opin Infect Dis 2004;17:549-55.

[66] Mounzer KC, DiNubile MJ. Clinical presentation and management of methicillin-resistant Staphylococcus aureus (MRSA) infections. Antibiotics Clinicians 1998;2:15-20.

[67] Paradisi F, Corti G, Messeri D. Antistaphylococcal (MSSA, MRSA, MSSE, MRSE) antibiotics. Med Clin North Am 2001;85:1-17.

[68] Turnidge J, Grayson ML. Optimum treatment of staphylococcal infections. Drugs 1993;45: 353-66.

[69] Segreti J. Efficacy of current agents used in the treatment of gram-positive infections and the consequences of resistance. Clin Microbiol Infect 2005;11(Suppl 3):29-35.

[70] Eliopoulos GM. Antimicrobial agents for treatment of serious infections caused by resistant Staphylococcus aureus and enterococci. Eur J Clin Microbiol Infect Dis 2005;24:826-31.

[71] Alder JD. Daptomycin: a new drug class for the treatment of gram-positive infections. Drugs Today (Barc) 2005;41:81-90.

[72] Rybak MJ. The efficacy and safety of daptomycin: first in a new class of antibiotics for gram-positive bacteria. Clin Microbiol Infect 2006;12(Suppl 1):24-32.

[73] Tally FP, Zeckel M, Wasilewski MM, et al. Daptomycin: a novel agent for gram-positive infections. Expert Opin Investig Drugs 1999;8:1223-38.

[74] Eisenstein BI. Lipopeptides, focusing on daptomycin, for the treatment of gram-positive infections. Expert Opin Investig Drugs 2004;13:1159-69.

[75] Sader HS, Streit JM, Fritsche TR, et al. Antimicrobial activity of daptomycin against multidrug-resistant gram-positive strains collected worldwide. Diagn Microbiol Infect Dis 2004;50:201-4.

[76] Tedesco KL, Rybak MJ. Daptomycin. Pharmacotherapy 2004;24:41-57.

[77] Wilcox MH. Tigecycline and the need for a new broad-spectrum antibiotic class. Surg Infect (Larchmt) 2006;7:69-80.

[78] Menichetti F. Current and emerging serious gram-positive infections. Clin Microbiol Infect 2005;11(Suppl 3):22-8.

[79] LaPlante KL, Rybak MJ. Clinical glycopeptide-intermediate staphylococcal tested against arbekacin, daptomycin, and tigecycline. Diagn Microbiol Infect Dis 2004;50:125-30.

[80] Stevens DL, Herr D, Lampiris H, et al. Linezolid versus vancomycin for the treatment of methicillin-resistant Staphylococcal aureus infections. Clin Infect Dis 2002;34:1481-90.

[81] Hill EE, Herijgers P, Herregods M-C, et al. Infective endocarditis treated with linezolid: case report and literature review. Eur J Clin Microbiol Infect Dis 2006;25:202-4.

[82] Itani KM, Weigelt J, Li JZ, et al. Linezolid reduces length of stay and duration of intravenous treatment compared with vancomycin for complicated skin and soft tissue infections due to suspected or proven methicillin-resistant Staphylococcus aureus (MRSA). Int J Anti-microb Agents 2005;26:442-8.

[83] Souli M, Pontikis K, Chryssouli Z, et al. Successful treatment of right-sided prosthetic valve endocarditis due to methicillin-resistant teicoplanin-heteroresistant Staphylococcus aureus with linezolid. Eur J Clin Microbiol Infect Dis 2005;24:760-2.

[84] Pankey GA, Sabath LD. Clinical relevance of bacteriostatic versus bactericidal mechanisms of action in the treatment of gram-positive bacterial infections. Clin Infect Dis 2004;38:864-70.

[85] Jonas M, Cunha BA. Minocycline. Ther Drug Monit 1982;4:137-45.

[86] Clumeck N, Marcelis L, Amiri-Lamraski MH, et al. Treatment of severe staphylococcal infections with rifampin-minocycline association. J Antimicrob Chemother 1984;13:71-2.

[87] Lawler MT, Sullivan MC, Levitz RE, et al. Treatment of prosthetic valve endocarditis due to methicillin-resistant Staphylococcus aureus with minocycline. J Infect Dis 1990;161: 812-4.

[88] Lewis S, Lewis B. Minocycline therapy of resistant Staphylococcus aureus infections. Infect Control Hosp Epidemiol 1993;14:423.

[89] Yuk JH, Dignani MC, Harris RL, et al. Minocycline as an alternative antistaphylococcal agent. Rev Infect Dis 1991;13:1023.

[90] Cunha BA. Oral antibiotics to treat MRSA infections. J Hosp Infect 2005;60:88-90.

[91] Padmanabhan RA, Fraser TC. The emergence of methicillin-resistant Staphylococcus aureus in the community. Cleve Clin J Med 2005;72:235-41.

[92] Chini V, Petinaki E, Foka A, et al. Spread of Staphylococcus aureus clinical isolates carrying Panton-Valentine leukocidin genes during a 3-year period in Greece. Clin Microbiol Infect 2006;12:29-34.

[93] Kluytmans-Vandenbergh MF, Kluytmans JA. Community-acquired, methicillin-resistant Staphylococcus aureus: current perspectives. Clin Microbiol Infect 2006;12(Suppl 1):9-15.

[94] Diederen BMW, Kluytmans JAJW. The emergence of infections with community-associated methicillin-resistant Staphylococcus aureus. J Infect 2006;52:157-68.

[95] Tenover FC. Community-associated methicillin-resistant Staphylococcus aureus: it's not just in communities anymore. Clin Microbiol Newsl 2005;28:33-5.

[96] Rybak MJ, LaPlante KL. Community-associated methicillin-resistant Staphylococcus aureus: a review. Pharmacotherapy 2005;25:74-85.

[97] Maltezou HC, Giamarellou H. Community-acquired methicillin-resistant Staphylococcus aureus infections. Int J Antimicrob Agents 2006;27:87-96.

[98] King MD, Humphrey BJ, Wang YF, et al. Emergence of community-acquired methicillin-resistant Staphylococcus aureus WSA 300 clone as the predominant cause of skin and soft-tissue infections. Ann Intern Med 2006;144(5):309-17.

[99] Miller LG, Perdreau-Remington F, Rieg G, et al. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. N Engl J Med 2005;352:1445-53.

[100] Francis JS, Doherty MC, Lopatin U, et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis 2005;40:100-7.

[101] Gillet Y, Issartel B, Vanhems P, et al. Association between Staphylococcus aureus strains carrying genes for Panton-Valentine leukocidin and highly lethal necrotizing pneumonia in young immunocompetent patients. Lancet 2002;359:753-9.

[102] Alonso-Tarros C, Villegas ML, de Gispert FJ, et al. Favorable outcome of pneumonia due to Panton-Valentine leukocidin-producing Staphylococcus aureus associated with hema-togenous origin and absence of flu-like illness. Eur J Clin Microbiol Infect Dis 2005;24: 756-9.

[103] Shopsin B, Zhao X, Kreiswirth BN, et al. Are the new quinolones appropriate treatment for community-acquired methicillin-resistant Staphylococcus aureus? Int J Antimicrob Agents 2004;24:32-4.

[104] Moellering RC Jr. The growing menace of community-acquired methicillin-resistant Staphylococcus aureus. Ann Intern Med 2006;144:368-70.

[105] Arshad S, Brown RB. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Infectious Disease Practice 2006;30:479-83.

Was this article helpful?

0 0

Post a comment