scholarly journals Impact of empiric antibiotics for methicillin-resistant Staphylococcus aureus (MRSA) infection and associated Clostridioides difficile infection (CDI) risk: Secondary analysis of the CLEAR trial

2021 ◽  
pp. 1-4
Author(s):  
Anastasiia S. Weiland ◽  
Julia Y. Lu ◽  
Caleb S. Chen ◽  
Thomas Tjoa ◽  
Raveena Singh ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Secondary Analysis ◽  
Antibiotic Use ◽  
Methicillin Resistant ◽  
Empiric Antibiotics ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Secondary Analyses ◽  
Mrsa Infection

ABSTRACT We performed secondary analyses of a postdischarge decolonization trial of MRSA carriers that reduced MRSA infection and hospitalization by 30%. Hospitalized MRSA infection was associated with 7.9 days of non-MRSA antibiotics and CDI in 3.9%. Preventing MRSA infection and associated hospitalization may reduce antibiotic use and CDI incidence.

scholarly journals Clinical characteristics of breast abscesses induced by methicillin-resistant Staphylococcus aureus during lactation

2020 ◽  
Author(s):  
Yan Li ◽  
Xiangjun Ma ◽  
Xingping He
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Duration ◽  
Clinical Characteristics ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Manifestations ◽  
Antibiotic Use ◽  
Maximum Amount ◽  
Methicillin Resistant ◽  
Chi Squared ◽  
Mrsa Infection

Abstract Background This study aims to identify the differences in patients with breast abscesses in combination with the infection of methicillin-resistant Staphylococcus aureus (MRSA) or with methicillin-susceptible Staphylococcus aureus (MSSA) during lactation in the clinical characteristics, efficacy of puncture, antibiotic use, treatment duration, breastfeeding after illness and recurrence. Methods Clinical data of patients with breast abscesses during lactation who were treated in our hospital from January 2014 to February 2017 were reviewed. According to bacterial culture results, they were divided into MRSA (n = 260) and MSSA (n = 962) groups. The hospitalisation, postpartum time, age, location of abscess cavities, number of abscess cavities, maximum amount of punctured pus, frequency of punctures, failure of puncture, antibiotic use, treatment duration, delactation and recurrence were compared between groups using a t-test and a chi-squared test. Results The statistical analysis showed that only delactation was statistically significantly different between the groups (P = 0.018). Hospitalisation, postpartum time, age, location of abscess cavities, number of abscess cavities, maximum amount of punctured pus, frequency of punctures, failure of puncture, antibiotic use, treatment duration and recurrence showed no statistically significant differences (P = 0.488, P = 0.328, P = 0.494, P = 0.218, P = 0.088, P = 0.102, P = 0.712, P = 0.336, P = 0.512, P = 0.386 and P = 0.359, respectively). Conclusion Patients with breast abscesses combined with MRSA infection during lactation presented no significant differences in the clinical manifestations, efficacy of puncture, antibiotic use or treatment duration from those with MSSA infection. However, the patients infected with MRSA were more susceptible to delactation after illness.

scholarly journals Are Lactational Breast Abscesses caused by Methicillin-resistant Staphylococcus aureus Special?

2020 ◽  
Author(s):  
Yan Li ◽  
Xiangjun Ma ◽  
Xiangping He
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Duration ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Clinical Manifestations ◽  
Antibiotic Use ◽  
Needle Aspiration ◽  
Methicillin Resistant ◽  
Chi Squared ◽  
Mrsa Infection ◽  
Mssa Infection

Abstract Background: This study aimed to identify the differences in clinical characteristics, puncture efficacy, antibiotic use, treatment duration, breastfeeding postillness, and recurrence of patients with breast abscesses caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-susceptible Staphylococcus aureus (MSSA) infection during lactation.Methods: The clinical data of patients with breast abscesses during lactation who were treated in our hospital from January 2014 to February 2017 were reviewed. According to bacterial culture results, they were divided into MRSA (n = 260) and MSSA (n = 962) groups. Hospitalization (whether or not the patients were hospitalized), postpartum time, age, location of abscess cavities, number of abscess cavities, amount of pus, frequency of needle aspiration, failure of needle aspiration, antibiotic use, treatment duration, delactation and recurrence were compared between the two groups using a t-test and a chi-squared test.Results: We noted that only delactation was statistically significantly different between the two groups (P = 0.018). Hospitalization, postpartum time, age, location of abscess cavities, number of abscess cavities, amount of pus, frequency of needle aspiration, failure of needle aspiration, antibiotic use, treatment duration and recurrence showed no statistically significant differences (P = 0.488, P = 0.328, P = 0.494, P = 0.218, P = 0.088, P = 0.102, P = 0.712, P = 0.336, P = 0.512, P = 0.386 and P = 0.359, respectively). Conclusion: Patients with breast abscesses caused by MRSA infection during lactation presented no significant differences in the clinical manifestations, needle aspiration efficacy, antibiotic use or treatment duration compare with those caused by MSSA infection. However, patients with MRSA infected were more susceptible to delectation.

scholarly journals Utility of Methicillin-Resistant Staphylococcus aureus Nares Screening in Hospitalized Children with Acute Infectious Disease Syndromes

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1434
Author(s):  
Ashley Sands ◽  
Nicole Mulvey ◽  
Denise Iacono ◽  
Jane Cerise ◽  
Stefan H. F. Hagmann
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Hospitalized Children ◽  
Methicillin Resistant ◽  
Osteoarticular Infections ◽  
Clinical Culture ◽  
Acute Infectious Disease ◽  
Mrsa Infection ◽  
Age Range ◽  
Mrsa Colonization

Studies in adults support the use of a negative methicillin-resistant Staphylococcus aureus (MRSA) nares screening (MNS) to help limit empiric anti-MRSA antibiotic therapy. We aimed to evaluate the use of MNS for anti-MRSA antibiotic de-escalation in hospitalized children (<18 years). Records of patients admitted between 1 January 2015 and 31 December 2020 with a presumed infectious diagnosis who were started on anti-MRSA antibiotics, had a PCR-based MNS, and a clinical culture performed were retrospectively reviewed. A total of 95 children were included with a median age (range) of 2 (0–17) years. The top three diagnosis groups were skin and soft tissue infections (n = 38, 40%), toxin-mediated syndromes (n = 17, 17.9%), and osteoarticular infections (n = 14, 14.7%). Nasal MRSA colonization and growth of MRSA in clinical cultures was found in seven patients (7.4%) each. The specificity and the negative predictive value (NPV) of the MNS to predict a clinical MRSA infection were both 95.5%. About half (n = 55, 57.9%) had anti-MRSA antibiotics discontinued in-house. A quarter (n = 14, 25.5%) were de-escalated based on the negative MNS test alone, and another third (n = 21, 38.2%) after negative MNS test and negative culture results became available. A high NPV suggests that MNS may be useful for limiting unnecessary anti-MRSA therapy and thereby a useful antimicrobial stewardship tool for hospitalized children. Prospective studies are needed to further characterize the utility of MNS for specific infectious diagnoses.

scholarly journals Multimicrobial Pneumonia during the Early Stages of a Global Pandemic

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Jalal H ◽  
◽  
Henriksen G ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Acute Infection ◽  
Standard Of Care ◽  
Antibiotic Use ◽  
Lung Parenchyma ◽  
Community Acquired Pneumonia ◽  
Methicillin Resistant ◽  
Global Pandemic

Community-acquired pneumonia is an acute infection of lung parenchyma which causes local and systemic inflammatory changes via cytokines. Several bacteria and viruses are responsible for this type of pneumonia, and the most common bacterial cause is Streptococcus pneumoniae. The classic symptoms are cough, fever, and pleuritic chest pain. In the Winter of 2020, a new strain of coronavirus known as SARS-CoV-2 spread throughout the world and was responsible for a global pandemic that transformed the way we live our lives. A 93-year old female presented to the hospital with respiratory distress and was found to have not only COVID-19 pneumonia but also superimposed Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa pneumonia. Following the most up-to-date guidelines, she was determined to have community-acquired pneumonia. Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa are uncommon causes of communityacquired pneumonia. She was treated with the standard of care at the time, which included vancomycin, piperacillin-tazobactam, and hydroxychloroquine. This case highlights the rarity of this specific presentation of community acquired pneumonia in regards to microbial etiology. It showcases that patients may develop certain diseases despite not having any risk factors. A major takeaway point is that apt decision making is a critical and time sensitive matter when determining whether a bacterial co-infection is present since it can affect patient outcomes. Since co-infections are relatively infrequent, antibiotic use in COVID-19 positive patients needs to be tailored accordingly. At the same time, it is crucial to keep in mind that co-infections are associated with increased severity of COVID-19 as well as poorer outcomes.

Post-discharge decolonization of patients harboring methicillin-resistant Staphylococcus aureus (MRSA) USA300 strains: secondary analysis of the CLEAR Trial

2021 ◽  
pp. 1-4
Author(s):  
Gabrielle M. Gussin ◽  
Lauren Heim ◽  
Thomas Tjoa ◽  
James A. McKinnell ◽  
Loren G. Miller ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Discharge ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Secondary Analysis ◽  
Post Discharge ◽  
Methicillin Resistant ◽  
Usa300 Strain ◽  
Strain Type ◽  
Trial Participants

Abstract The CLEAR Trial recently found that decolonization reduced infections and hospitalizations in MRSA carriers in the year following hospital discharge. In this secondary analysis, we explored whether decolonization had a similar benefit in the subgroup of trial participants who harbored USA300, using two different definitions for the USA300 strain-type.

scholarly journals 1230. Epidemiology and Risk Factors for Recurrent Invasive Methicillin-Resistant Staphylococcus aureus Infection: nine US States, 2006–2013

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S374
Author(s):  
Ian Kracalik ◽  
Kelly Jackson ◽  
Joelle Nadle ◽  
Wendy Bamberg ◽  
Susan Petit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Infection Type ◽  
The United States ◽  
Emerging Infections ◽  
Methicillin Resistant ◽  
Initial Infection ◽  
Joint Infections ◽  
Mrsa Infection

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) causes &gt;70,000 invasive infections annually in the United States, and recurrent infections pose a major clinical challenge. We examined risk factors for recurrent MRSA infections. Methods We identified patients with an initial invasive MRSA infection (isolation from a normally sterile body site) from 2006 to 2013, through active, population-based surveillance in selected counties in nine states through the Emerging Infections Program. Recurrence was defined as invasive MRSA isolation &gt;30 days after initial isolation. We used logistic regression with backwards selection to evaluate adjusted odds ratios (aOR) associated with recurrence within 180 days, prior healthcare exposures, and initial infection type, controlling for patient demographics and comorbidities. Results Among 24,478 patients with invasive MRSA, 3,976 (16%) experienced a recurrence, including 61% (2,438) within 180 days. Risk factors for recurrence were: injection drug use (IDU) (aOR; 1.38, 95% confidence interval [CI]: 1.15–1.65), central venous catheters (aOR; 1.35, 95% CI: 1.22–1.51), dialysis (aOR; 2.00, 95% CI: 1.74–2.31), and history of MRSA colonization (aOR; 1.35, 95% CI: 1.22–1.51) (figure). Recurrence was more likely for bloodstream infections (BSI) without another infection (aOR; 2.08, 95% CI: 1.74–2.48), endocarditis (aOR; 1.46, 95% CI: 1.16–1.55), and bone/joint infections (aOR; 1.38, 95% CI: 1.20–1.59), and less likely for pneumonia (aOR: 0.75, 95% CI: 0.64–0.89), compared with other initial infection types. When assessed separately, the presence of a secondary BSI with another infection increased the odds of recurrence over that infection without a BSI (aOR: 1.96, 95% CI: 1.68–2.30). Conclusion Approximately one in six persons with invasive MRSA infection had recurrence. We identified potential opportunities to prevent recurrence through infection control (e.g., management and early removal of central catheters). Other possible areas for preventing recurrence include improving the management of patients with BSI and bone/joint infections (including both during and after antibiotic treatment) and mitigating risk of infection from IDU. Disclosures All authors: No reported disclosures.

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