-
Pharmacotherapy Jan 2023Neonatal sepsis remains a high cause of morbidity and mortality in preterm neonates. Methicillin-susceptible Staphylococcus aureus (MSSA) can cause persistent...
Neonatal sepsis remains a high cause of morbidity and mortality in preterm neonates. Methicillin-susceptible Staphylococcus aureus (MSSA) can cause persistent bloodstream infections and invasive disease in neonates. We report the first published case of persistent MSSA bacteremia in a preterm neonate successfully treated with oxacillin and ertapenem combination therapy.
Topics: Infant, Newborn; Humans; Oxacillin; Staphylococcus aureus; Ertapenem; Anti-Bacterial Agents; Methicillin; Staphylococcal Infections; Osteomyelitis; Bacteremia; Methicillin-Resistant Staphylococcus aureus
PubMed: 36401791
DOI: 10.1002/phar.2745 -
Antimicrobial Agents and Chemotherapy Mar 1972The incidence of isolation of Staphylococcus aureus strains resistant to methicillin is increasing in England and other European countries, whereas there have been only...
The incidence of isolation of Staphylococcus aureus strains resistant to methicillin is increasing in England and other European countries, whereas there have been only isolated reports of resistance in the United States. We thought this contrast might be related to the use of special sensitive screening techniques (i.e., incubation at 30 C, prolonged incubation, use of 5% sodium chloride-agar medium, and use of a large inoculum) in these other countries. A survey was undertaken in a hospital in Philadelphia to detect methicillin-resistant S. aureus. In spite of using large inocula, 5% sodium chloride-agar medium, and prolonged incubation at 30 C, no strains of S. aureus resistant to methicillin were found.
Topics: Culture Media; Methicillin; Microbial Sensitivity Tests; Penicillin Resistance; Staphylococcus
PubMed: 4483685
DOI: 10.1128/AAC.1.3.235 -
Annals of Internal Medicine Sep 1982Ten patients with bacteremia due to methicillin-resistant Staphylococcus aureus were treated with vancomycin. These patients were compared with matched controls, nine...
Ten patients with bacteremia due to methicillin-resistant Staphylococcus aureus were treated with vancomycin. These patients were compared with matched controls, nine bacteremic patients with methicillin-sensitive S. aureus, and one patient with penicillin-sensitive S. aureus. Controls were treated with a penicillin. There were no significant differences in time to defervescence, metastatic infections, relapse, mortality, need for surgical drainage, or duration of therapy. Fifteen of 19 episodes of serious methicillin-resistant S. aureus infection responded to vancomycin. Severe toxic effects included tinnitus, neutropenia, rash, and possible nephrotoxicity. Tolerance (a minimal bactericidal concentration to minimal inhibitory concentration ratio of at least 32), but not a minimal bactericidal concentration of at least 32 mg/L, correlated with therapeutic failure (respectively, p = 0.04 and p = 0.11, Fisher's exact test). Bacteremic infections due to methicillin-resistant and methicillin-sensitive S. aureus cause similar morbidity and mortality. Vancomycin is effective but potentially toxic therapy for most serious infections due to methicillin-resistant S. aureus. In-vitro tests may not predict therapeutic efficacy.
Topics: Dose-Response Relationship, Drug; Humans; Methicillin; Microbial Sensitivity Tests; Penicillin Resistance; Sepsis; Staphylococcal Infections; Staphylococcus aureus; Vancomycin
PubMed: 7114631
DOI: 10.7326/0003-4819-97-3-344 -
Clinical Pediatrics Nov 1976
Topics: Antigen-Antibody Complex; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Hypersensitivity; Drug Therapy, Combination; Female; Glomerular Filtration Rate; Humans; Kidney Tubular Necrosis, Acute; Kidney Tubules; Male; Methicillin; Nephritis, Interstitial
PubMed: 975706
DOI: 10.1177/000992287601501107 -
Clinical Infectious Diseases : An... Nov 2019Information on outcomes of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA, respectively) bacteremia, particularly readmission, is scarce and...
Methicillin-susceptible and Methicillin-resistant Staphylococcus aureus Bacteremia: Nationwide Estimates of 30-Day Readmission, In-hospital Mortality, Length of Stay, and Cost in the United States.
BACKGROUND
Information on outcomes of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA, respectively) bacteremia, particularly readmission, is scarce and requires further research to inform optimal patient care.
METHODS
We performed a retrospective analysis using the 2014 Nationwide Readmissions Database, capturing 49.3% of US hospitalizations. We identified MSSA and MRSA bacteremia using International Classification of Diseases, Ninth Revision, Clinical Modification among patients aged ≥18 years. Thirty-day readmission, mortality, length of stay, and costs were assessed using Cox proportional hazards regression, logistic regression, Poisson regression, and generalized linear model with gamma distribution and log link, respectively.
RESULTS
Of 92 089 (standard error [SE], 1905) patients with S. aureus bacteremia, 48.5% (SE, 0.4%) had MRSA bacteremia. Thirty-day readmission rate was 22% (SE, 0.3) overall with no difference between MRSA and MSSA, but MRSA bacteremia had more readmission for bacteremia recurrence (hazard ratio, 1.17 [95% confidence interval {CI}, 1.02-1.34]), higher in-hospital mortality (odds ratio, 1.15 [95% CI, 1.07-1.23]), and longer hospitalization (incidence rate ratio, 1.09 [95% CI, 1.06-1.11]). Readmission with bacteremia recurrence was particularly more common among patients with endocarditis, immunocompromising comorbidities, and drug abuse. The cost of readmission was $12 425 (SE, $174) per case overall, and $19 186 (SE, $623) in those with bacteremia recurrence.
CONCLUSIONS
Thirty-day readmission after S. aureus bacteremia is common and costly. MRSA bacteremia is associated with readmission for bacteremia recurrence, increased mortality, and longer hospitalization. Efforts should continue to optimize patient care, particularly for those with risk factors, to decrease readmission and associated morbidity and mortality in patients with S. aureus bacteremia.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacteremia; Comorbidity; Female; Health Care Costs; Hospital Mortality; Humans; Length of Stay; Male; Methicillin; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Patient Readmission; Public Health Surveillance; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus; United States; Young Adult
PubMed: 30753447
DOI: 10.1093/cid/ciz123 -
Ugeskrift For Laeger Jul 1977
Topics: Humans; Immunity, Cellular; Kidney; Male; Methicillin; Middle Aged; Nephritis, Interstitial
PubMed: 898342
DOI: No ID Found -
Antimicrobial Agents and Chemotherapy May 1981We evaluated the distribution of methicillin into normal and damaged heart valves and the accuracy with which subcutaneous plastic chambers reflected tissue uptake of...
We evaluated the distribution of methicillin into normal and damaged heart valves and the accuracy with which subcutaneous plastic chambers reflected tissue uptake of this antibiotic. A total of 24 male New Zealand rabbits were given constant infusion doses of methicillin through central venous catheters. Five of these animals had their aortic and mitral valves damaged by catheterization of the left ventricle. A total of 19 rabbits had perforated plastic chambers inserted subcutaneously 7 to 10 days before methicillin infusion. In all animals more than 80% of the total infused dose of methicillin was accounted for in the serum, urine, and tissues. In the 12 animals infused to steady state (less than 7 h), the steady-state serum concentrations (11 to 120 micrograms/ml) were equal to the concentrations attained in either peritoneal or tissue chamber fluids. In the 12 animals sacrificed before 7 h, tissue chamber concentrations lagged behind serum and heart tissue concentrations in attaining steady state. Steady-state concentrations in normal heart valves and heart muscles failed to increase proportionally to increased constant infusion doses (8.7 to 87.2 mg/kg per h). The steady-state methicillin concentrations in fibrin-scarred heart valves were invariably higher than the steady-state concentrations in the normal right heart of the same animals (P less than 0.05). Tissue uptake of methicillin was altered in scarred heart valves as compared to normal heart valves, and large-volume subcutaneous tissue chambers misrepresented the uptake rate of methicillin into heart tissues and valves.
Topics: Animals; Aortic Valve; Body Fluids; Heart Valve Diseases; Heart Valves; Infusions, Parenteral; Male; Methicillin; Rabbits
PubMed: 7294768
DOI: 10.1128/AAC.19.5.836 -
The Medical Journal of Australia Feb 1979
Topics: Bedding and Linens; Cross Infection; Humans; Methicillin; Penicillin Resistance; Staphylococcal Infections; Staphylococcus aureus
PubMed: 254847
DOI: 10.5694/j.1326-5377.1979.tb112014.x -
Genome Biology Jul 2017The spread of drug-resistant bacterial pathogens poses a major threat to global health. It is widely recognised that the widespread use of antibiotics has generated...
BACKGROUND
The spread of drug-resistant bacterial pathogens poses a major threat to global health. It is widely recognised that the widespread use of antibiotics has generated selective pressures that have driven the emergence of resistant strains. Methicillin-resistant Staphylococcus aureus (MRSA) was first observed in 1960, less than one year after the introduction of this second generation beta-lactam antibiotic into clinical practice. Epidemiological evidence has always suggested that resistance arose around this period, when the mecA gene encoding methicillin resistance carried on an SCCmec element, was horizontally transferred to an intrinsically sensitive strain of S. aureus.
RESULTS
Whole genome sequencing a collection of the first MRSA isolates allows us to reconstruct the evolutionary history of the archetypal MRSA. We apply Bayesian phylogenetic reconstruction to infer the time point at which this early MRSA lineage arose and when SCCmec was acquired. MRSA emerged in the mid-1940s, following the acquisition of an ancestral type I SCCmec element, some 14 years before the first therapeutic use of methicillin.
CONCLUSIONS
Methicillin use was not the original driving factor in the evolution of MRSA as previously thought. Rather it was the widespread use of first generation beta-lactams such as penicillin in the years prior to the introduction of methicillin, which selected for S. aureus strains carrying the mecA determinant. Crucially this highlights how new drugs, introduced to circumvent known resistance mechanisms, can be rendered ineffective by unrecognised adaptations in the bacterial population due to the historic selective landscape created by the widespread use of other antibiotics.
Topics: Bacterial Proteins; Bayes Theorem; Drug Resistance, Bacterial; Evolution, Molecular; History, 20th Century; Humans; Methicillin; Methicillin-Resistant Staphylococcus aureus; Penicillin-Binding Proteins; Phylogeny; Whole Genome Sequencing
PubMed: 28724393
DOI: 10.1186/s13059-017-1252-9 -
Antimicrobial Agents and Chemotherapy Feb 2022Cefazolin and ertapenem have been shown to be an effective salvage regimen for refractory methicillin-susceptible Staphylococcus aureus bacteremia. Our findings suggest...
Cefazolin and ertapenem have been shown to be an effective salvage regimen for refractory methicillin-susceptible Staphylococcus aureus bacteremia. Our findings suggest cefazolin plus ertapenem stimulates interleukin-1β release from peripheral blood monocytes both with and without S. aureus presence. This IL-1β augmentation was primarily driven by ertapenem. These findings support further exploration of cefazolin plus ertapenem in MSSA bacteremia and may partially explain its marked potency despite modest synergy .
Topics: Anti-Bacterial Agents; Bacteremia; Cefazolin; Ertapenem; Humans; Interleukin-1beta; Methicillin; Staphylococcal Infections; Staphylococcus aureus
PubMed: 34978891
DOI: 10.1128/aac.02166-21