scholarly journals Increased Methicillin-Resistant Staphylococcus aureus Septicemia and Illicit Intravenous Drug Use in the South

2018 ◽  
Vol 67 (2) ◽  
pp. 319-320 ◽  
Author(s):  
Forest W Arnold ◽  
Leslie A Beavin
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Use ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
The South ◽  
Methicillin Resistant

Community-Acquired Methicillin-Resistant Staphylococcus Aureus Infections in Otolaryngology

1992 ◽  
Vol 107 (3) ◽  
pp. 434-437 ◽  
Author(s):  
Ron D. Gottlieb ◽  
Mahendra K. Shah ◽  
David C. Perlman ◽  
Charles P. Kimmelman
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Methicillin Resistant ◽  
Mrsa Strains ◽  
Hospital Acquired ◽  
Susceptibility And Resistance ◽  
Multiple Antibiotics

Soon after the introduction of methicillin, strains of Staphylococcus aureus resistant to methicillin were reported. Methicillin-resistant Staphylococcus aureus (MRSA) has become a common hospital pathogen, often resistant to multiple antibiotics, while causing significant morbidity and mortality. Community-acquired MRSA infections have been infrequently documented. Most reports have been associated with intravenous drug abuse. This report reviews 15 patients with community-acquired MRSA infections of the head and neck. None admitted to intravenous drug use. Additionally, no patient was known to be a healthcare worker. The MRSA strains showed antibiotic susceptibility and resistance profiles different from typical hospital-acquired MRSA isolates. All but one infection resolved with adequate surgical or appropriate antibiotic therapy. Clinicians should become aware of the possibility of community-acquired MRSA in the patient who has had continued infection despite antibiotic therapy.

scholarly journals Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Eddie Y. Liu ◽  
Jennifer Crawford ◽  
Haissam Haddad
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Mycotic Aneurysm ◽  
Rare Complication ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Methicillin Resistant

We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.

scholarly journals Frequent Methicillin-Resistant Staphylococcus aureus Introductions Into an Inner-city Jail: Indications of Community Transmission Networks

2019 ◽  
Vol 71 (2) ◽  
pp. 323-331 ◽  
Author(s):  
Kyle J Popovich ◽  
Evan S Snitkin ◽  
Chad Zawitz ◽  
Alla Aroutcheva ◽  
Darjai Payne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Molecular Epidemiology ◽  
Skin Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Transmission Networks ◽  
Methicillin Resistant ◽  
Community Transmission ◽  
Mrsa Colonization

Abstract Background Jails may facilitate spread of methicillin-resistant Staphylococcus aureus (MRSA) in urban areas. We examined MRSA colonization upon entrance to a large urban jail to determine if there are MRSA transmission networks preceding incarceration. Methods Males incarcerated in Cook County Jail (Chicago) were enrolled, with enrichment for people living with human immunodeficiency virus (PLHIV), within 72 hours of intake. Surveillance cultures assessed prevalence of MRSA colonization. Whole-genome sequencing (WGS) identified preincarceration transmission networks. We examined methicillin-resistant Staphylococcus aureus (MRSA) isolates to determine if there are transmission networks that precede incarceration. A large proportion of individuals enter jail colonized with MRSA. Molecular epidemiology and colonization risk factors provide clues to community reservoirs for MRSA. Results There were 718 individuals (800 incarcerations) enrolled; 58% were PLHIV. The prevalence of MRSA colonization at intake was 19%. In multivariate analysis, methamphetamine use, unstable housing, current/recent skin infection, and recent injection drug use were predictors of MRSA. Among PLHIV, recent injection drug use, current skin infection, and HIV care at outpatient clinic A that emphasizes comprehensive care to the lesbian, gay, bisexual, transgender community were predictors of MRSA. Fourteen (45%) of 31 detainees with care at clinic A had colonization. WGS revealed that this prevalence was not due to clonal spread in clinic but rather to an intermingling of distinct community transmission networks. In contrast, genomic analysis supported spread of USA500 strains within a network. Members of this USA500 network were more likely to be PLHIV (P < .01), men who have sex with men (P < .001), and methamphetamine users (P < .001). Conclusions A large proportion of individuals enter jail colonized with MRSA. Molecular epidemiology and colonization risk factors provide clues to identify colonized detainees entering jail and potential community reservoirs of MRSA.

scholarly journals 393. Changing Trends, Risk Factors, and Treatment Challenges in Staphylococcus aureus Septic Arthritis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S202-S202
Author(s):  
Valerie Gobao ◽  
Mostafa Alfishawy ◽  
Neel Shah ◽  
Karin Byers ◽  
Mohamed Yassin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Positive Result ◽  
Septic Arthritis ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Retrospective Case ◽  
Factors Associated ◽  
Rule Out

Abstract Background Staphylococcus aureus is a common organism in native septic arthritis. It is traditionally believed to be self-limited with rapid and aggressive debridement and appropriate antibiotic selection. The incidence of S. aureus septic arthritis is increasing, and further characterization is needed to improve diagnosis and treatment. For patients presenting with native S. aureus septic arthritis, we evaluated the reliability of methicillin-resistant S. aureus (MRSA) screening as a predictor to rule out MRSA septic arthritis, the risk factors associated with this disease, and the treatment and surgical outcomes. Methods A retrospective case–control study of patients diagnosed with septic arthritis in the UPMC health system (Pittsburgh, PA) between 2012 and 2016 was completed. The primary outcomes of interest were surgical intervention and the need to alter antibiotic treatment. Patient demographics, characteristics, and outcomes were recorded. Results A total of 215 cases of septic arthritis were identified, and 64% (n = 138) had S. aureus cultured. In this set, 36% (50/138) of these patients were identified with MRSA. Of the patients diagnosed with MRSA septic arthritis, 50% screened prior to admission had a positive result (8/16) and 48% screened during admission had a positive result (14/29). Compared with septic arthritis with other organisms, risk factors associated with S. aureus included history of intravenous drug use (OR: 4.3, CI: 1.7 to 10.8, P = 0.002) and being immunocompetent (OR: 0.3, CI: 0.1 to 0.6, P = 0.002). These infections were associated with concurrent infections of the spine (OR: 5.7, CI: 2.1 to 15.1, P = 0.0005). As compared with other organisms, there was a high probability of switching antibiotics during treatment (OR: 3.7, CI: 1.1 to 13.0, P = 0.04) and relapse of infection (OR: 4.2, CI: 1.2 to 14.6, P = 0.02). Conclusion S. aureus septic arthritis is associated with intravenous drug use, and not with immunosuppression. A negative MRSA screen does not rule out this organism. Concurrent spine infections are common. There is a high likelihood of infection relapse and that antibiotics will need to be altered during treatment. With the opioid epidemic, the incidence is likely to increase further. More work is needed to improve diagnosis and overcome treatment challenges. Disclosures All authors: No reported disclosures.

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