MRSA Infection

Epidemic impetigo and MRSA

Spread of the epidemic European fusidic acid-resistant impetigo clone (EEFIC) in general practice patients in the south of The Netherlands.

Objectives We evaluated the susceptibility to fusidic acid, mupirocin and retapamulin of Staphylococcus aureus isolated from nasal and wound swabs. Methods The susceptibility to the three agents of S. aureus isolated from general patients in the south of The Netherlands with a skin or soft tissue infection was determined between January 2007 and December 2008. Fusidic acid-resistant isolates were tested for the presence of fusidic acid-resistant genes and compared with the epidemic European fusidic acid-resistant impetigo clone (EEFIC). Results Fusidic acid resistance was found in 23% of the nasal and 35% of the wound isolates, the majority (∼90%) being fusB positive. Most of the isolates belonged to spa type t171 and were isolated from younger patients. One isolate was retapamulin resistant (MIC 8 mg/L) and two were mupirocin resistant. Conclusions The EEFIC clone was relatively highly prevalent among the isolated S. aureus. The usefulness of fusidic acid as first-line agent for the treatment of impetigo is questionable. As mupirocin is used in The Netherlands for eradication of methicillin-resistant S. aureus, it is not an alternative; retapamulin might be useful, but further in vivo studies are warranted.

Linezolid better than vancomycin for MRSA?

Linezolid in Methicillin-Resistant Staphylococcus aureus Nosocomial Pneumonia: A Randomized, Controlled Study.

Background. Post hoc analyses of clinical trial data suggested that linezolid may be more effective than vancomycin for treatment of methicillin-resistant Staphylococcus aureus (MRSA) nosocomial pneumonia. This study prospectively assessed efficacy and safety of linezolid, compared with a dose-optimized vancomycin regimen, for treatment of MRSA nosocomial pneumonia.  Results.  In the PP population, 95 (57.6%) of 165 linezolid-treated patients and 81 (46.6%) of 174 vancomycin-treated patients achieved clinical success at EOS (95% confidence interval for difference, 0.5%–21.6%; P = .042). All-cause 60-day mortality was similar (linezolid, 15.7%; vancomycin, 17.0%), as was incidence of adverse events. Nephrotoxicity occurred more frequently with vancomycin (18.2%; linezolid, 8.4%). Conclusions. For the treatment of MRSA nosocomial pneumonia, clinical response at EOS in the PP population was significantly higher with linezolid than with vancomycin, although 60-day mortality was similar.

Genetic change: a Case Study of Staphylococcus aureus

Population Genomics in Bacteria: A Case Study of Staphylococcus aureus.

We analyzed the genome-wide pattern of single nucleotide polymorphisms (SNPs) in a sample with 12 strains of Staphylococcus aureus. Population structure of S. aureus seems to be complex, and the 12 strains were divided into five groups, named A, B, C, D, and E. We conducted a detailed analysis of the topologies of gene genealogies across the genomes and observed a high rate and frequency of tree-shape switching, indicating extensive homologous recombination. Our results call for more research into the evolutionary role of homologous recombination in bacterial populations.

Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated From Pets Living in Households With MRSA-Infected Children

Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated From Pets Living in Households With MRSA-Infected Children.

Methicillin-resistant Staphylococcus aureus (MRSA) is among the most important causes of human healthcare-associated infections. Various studies have described suspected interspecies transmission of MRSA between human patients, their family members, and pets living in the same household [1–5]. Similarly, we described MRSA isolation from pets residing in a long-term care facility [6]. The recent emergence of community-associated MRSA (CA-MRSA) among adults and children who lack traditional health-care associated risk factors has raised concern in both the veterinary and medical communities about the role of companion animals in CA-MRSA transmission.

Severe Neutropenia and Long Term Vancomycin Treatment

Severe Neutropenia Following a Prolonged Course of Vancomycin That Progressed to Agranulocytosis with Drug Reexposure.

OBJECTIVE: To report a case of severe neutropenia after discontinuing prolonged treatment with vancomycin that progressed to agranulocytosis with vancomycin reexposure.

 CONCLUSIONS: This case demonstrates a serious adverse event potentially associated with vancomycin use, and calls attention to the safety of rechallenging with vancomycin during a possible drug-induced neutropenia.

How Staphylococcus aureus biofilms develop their characteristic structure

How Staphylococcus aureus biofilms develop their characteristic structure.

Our study describes a mechanism of biofilm structuring in molecular detail, and the general principle (i.e., quorum-sensing controlled expression of surfactants) seems to be conserved in several bacteria, despite the divergence of the respective biofilm-structuring surfactants. These findings provide a deeper understanding of biofilm development processes, which represents an important basis for strategies to interfere with biofilm formation in the environment and human disease.

Scottish MRSA rate at 'lowest levels since records began'

Scottish MRSA rate at 'lowest levels since records began' | Nursing in Practice.

MRSA and MSSA infections are at their lowest levels in Scotland since records began in 2005, official figures suggest. Statistics from Health Protection Scotland shows MRSA (meticillin-resistant Staphylococcus aureus) cases decreased from 73 to 48 (34.3%) during the past year, with a 7.7% reduction during April and June alone.

Four Key Risk Factors for HA-MRSA Infection in ICU

Researchers Find Four Prognostic Variables as Risk Factors for HA-MRSA Infection in ICU.

The researchers concluded that four prognostic variables were found to be risk factors for HA-MRSA infection in ICU: intubation, open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission. Preemptive infection control in patients with these risk factors might effectively decrease HA-MRSA infection. Their research was published in BMC Infectious Diseases.

Resistant Bacteria Found in Poultry Meat

Resistant Bacteria Found in Poultry Meat.

Of 20 chicken tests done at random in supermarkets and discount stores in Berlin, Hamberg, Cologne, Nuremberg and Stuttgart, 10 were positive with ESBL (Extended Spectrum Beta-lactamase) and methicillin-resistant bacteria MRSA (Methicillin resistant Staphylococcus aureus). "This is the result of persistent disturbing abuse of antibiotics," said the president of the environmental organisation, BUND, Hubert Weiger, who criticised the use of antibiotics in animal production.

Reducing the development of antibiotic resistance

Reducing the development of antibiotic... [Curr Pharm Biotechnol. 2011] - PubMed - NCBI.

This article gives an overview of the mechanisms of antibacterial resistance and actual resistance data worldwide of the most prevalent Gram positive (MRSA, VISA/VRSE and VRE) and Gram negative bacteria (Pseudomonas aeruginosa, Acinetobacter spp., ESBL producing Enterobacteriaceae and Stenotrophomonas maltophilia). Furthermore, strategies to reduce antibiotic resistance are reviewed. Most important is institution of infection control policies including guidelines on surveillance, isolation of colonized patients and contact precautions, hand hygiene, decolonization measures and environmental decontamination.

FDA OKs Vioguard's germ-killing keyboard

Brier Dudley's Blog | FDA OKs Vioguard's germ-killing keyboard | Seattle Times Newspaper.

Vioguard's keyboard retracts, when not in use, into a case where germicidal ultraviolet lights kill microorganisms including influenza and MRSA. In June, the American Journal of Infection Control published a study of the effectiveness of ultraviolet light-sanitized keyboards in a pediatric hospital. It found the approach to disinfection was 67 percent effective in eliminating bacterial infection. A patent and the FDA approval were both issued last month, and Vioguard is now looking for investors to help launch the product. It employs about 5 people plus contractors.

Record number of patients catch infections in UK hospitals

Record number of patients catch infections in hospitals - Telegraph.

Recorded cases of patients with a “nosocomial condition” – any infection acquired in hospital or a medical environment – also rose by more than a third last year compared with the year before. A large proportion of the patients involved were aged over 75, the figures from the NHS Information Centre show. Illnesses related to such infections led to average stays in hospital last year of 31.1 days. Experts blamed poor hygiene for the dramatic rise in infections, including superbugs MRSA and Clostridium difficile (C. diff) as well as norovirus and E.coli. But the Department of Health dismissed the “misleading” figures, published online, saying that officials have “got better and better at tackling hospital infections”. According to the new figures, supplied by NHS hospitals, the number of patients found by consultants to have hospital-acquired infections rose last year reached a record 42,712.

Copper Door Handles Reduce MRSA Spread

Copper Door Handles Reduce Spread of Infection.

Health Trusts across the UK are facing a difficult decision. Door Handles LTD has learnt that evidence from the Infectious Diseases Society of America shows that copper door handles and work surfaces could dramatically reduce the spread of deadly infections. However, at a time when budgets are being cut and money is in short supply, choosing copper over the less expensive alternative of stainless steel is not as straight forward as it may appear. Owing to the anti-bacterial, anti-viral and anti-fungal properties of copper, door handles and work surfaces that are at least 60 per cent copper can prevent the spread of infections such as MRSA, influenza, E. coli and salmonella. According to research conducted in the US, as reported by the BBC, changing from stainless steel to copper fittings could reduce the spread of infections by 40 per cent.

MRSA Transmission in Piglets

Colonization and transmission of meth... [Appl Environ Microbiol. 2011] - PubMed - NCBI.

A transmission experiment was performed to evaluate the spread of methicillin-resistant Staphylococcus aureus (MRSA) ST398 in nursery piglets. Reproduction ratios (R(0)) in three experimental groups were found to vary between 3.92 and 52.54, indicating that after introduction, MRSA ST398 will spread easily among weaned piglets, with a tendency to become endemic.

A Modern Plague » One Family and MRSA

A Modern Plague » Scienceline.

MRSA, or Methicillin-resistant Staphylococcus aureus, is now a common topic of conversation in my family. But when my 82-year-old grandmother came down with it in September of 2010, I had no idea what it was. I half-remembered news reports of something bad, some new disease that lurked in hospitals and gyms, and I remembered that the R stood for “resistant,” but I knew nothing else.

Pharmacy Review Cuts Cost of MRSA Treatment

Medical News: ASHP: Pharmacy Review Cuts Cost of MRSA Treatment - in Meeting Coverage, ASHP from MedPage Today.

Pharmacist review of physician orders for antibiotics targeting methicillin-resistant Staphylococcus aureus (MRSA) improved adherence to antibiotic treatment guidelines and decreased spending on anti-infective drugs by 20%, a researcher reported here. The antimicrobial stewardship program, in which linezolid or daptomycin could only be given to patients meeting guidelines for their use, such as after failure on vancomycin, increased the percentage of patients meeting the guidelines for receiving linezolid from 26% to 71% (P=0.0006), according to Lori Eskridge, PharmD, of Cardinal Health Pharmacy Solutions and Town & Country Hospital in Tampa, Fla., and colleagues.

MRSA-busting sanitizers? Not so quick, FDA says - Health - BradentonHerald.com

MRSA-busting sanitizers? Not so quick, FDA says - Health - BradentonHerald.com.

The U.S. Food and Drug Administration is warning customers that several companies are making unproven claims that their products will prevent methicillin-resistant Staphylococcus aureus infections. MRSA does not respond to standard antibiotic treatment and can be deadly. Makers of some hand sanitizers and other products are boasting that the products kill MRSA bacteria.  “Don’t believe them,” says a warning recently released by the FDA.

Serotonin toxicity and Linezolid examined

Comparison of serotonin toxicity with concomitant use of either linezolid or comparators and serotonergic agents: an analysis of Phase III and IV randomized clinical trial data.

Conclusions While the potential exists for serotonin toxicity to occur with concomitant use of linezolid and serotonergic agents, the risk appears to be low. Based on the large database of Phase III and IV studies included in our analysis, we did not find enough evidence to conclude that linezolid-induced serotonin toxicity was different from that of comparators.

Novel vga(E) gene in MRSA CC398 isolates from cattle and poultry

Detection of the novel vga(E) gene in methicillin-resistant Staphylococcus aureus CC398 isolates from cattle and poultry.

The genes vga(A) and vga(C)1 and the most recently identified gene, vga(E),2 as well as the gene cfr, mediate transferable resistance to pleuromutilins in staphylococci.3 The vga genes encode ABC transporters, which also export streptogramin A antibiotics and lincosamides, and the cfr gene encodes a methyltransferase that confers additional resistance to phenicols, lincosamides, oxazolidinones and streptogramin A antibiotics. All these genes are located on either plasmids or transposons. Point mutations in the domain V of 23S rRNA or in the rplC gene, encoding the ribosomal protein L3, are also known to mediate pleuromutilin resistance in staphylococci.4 In two previous studies on methicillin-resistant Staphylococcus aureus (MRSA) in dairy cattle (n = 25)5 and in poultry meat and poultry meat products (n = 32)6 and one ongoing study on MRSA from cattle (n = 11) and poultry (n = 2) collected in the GERM-Vet programme 2008–09, we detected pleuromutilin resistance in a total of nine MRSA isolates, which were negative by PCR for the cfr gene and the staphylococcal genes vga(A), vga(B) and vga(C), but also for the enterococcal gene vga(D) and the streptococcal gene lsa(C).7,8

ST398 MRSA in Spanish Hospitals

High prevalence of spa types associated with the clonal lineage CC398 among tetracycline-resistant methicillin-resistant Staphylococcus aureus strains in a Spanish hospital.

Methods Fifty-two TetR MRSA strains from unrelated patients were included in this study. Susceptibility to 26 antimicrobial agents was determined and 24 resistance genes were tested for by PCR. The sequences of the genes grlA and gyrA were analysed in all ciprofloxacin-resistant MRSA isolates. For all strains, spa, SCCmec and agr typing was implemented. Multilocus sequence typing was performed for 16 representative strains of the different spa types. The presence of the genes tst, lukF/lukS-PV, eta, etb, etd and cna was investigated by PCR. Results Fifteen different spa types, four of them new ones, were detected among the 52 strains, being associated with the following clonal complexes (CCs): CC398 (67.3%), CC1 (11.5%), CC5 (11.5%) and CC8 (9.6%). A novel sequence type (ST), ST2077, belonging to CC398 was identified. Most MRSA CC398 strains were typed as SCCmecV-agrI. In addition to β-lactam resistance, isolates showed resistance to (gene/number of strains): tetracycline [tet(K)/36, tet(L)/8 and tet(M)/48], macrolides and lincosamides [erm(B)/6, erm(C)/25, erm(T)/2, msr(A)/msr(B)/4 and mph(C)/4], aminoglycosides [aac(6′)-Ie–aph(2′)-Ia/8, ant(4′)-Ia/13 and aph(3′)-IIIa/15], trimethoprim [dfrS1/2 and dfrK/3] and mupirocin (mupA/3). Strains investigated for mutations mediating quinolone resistance revealed an S80F exchange in GrlA and different changes in GyrA. Three strains were Panton–Valentine leucocidin-positive (ST8 and ST94) and 41 strains were cna-positive. All MRSA isolates were negative for the genes tst, eta, etb and etd. Conclusions Tetracycline resistance could be a good marker for MRSA CC398, although this resistance can also be found in other lineages.