scholarly journals Successful Clearance of Persistent Methicillin-Resistant Staphylococcus aureus Bacteremia with Daptomycin, Linezolid, and Meropenem Salvage Therapy

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Grant Shaddix ◽  
Kalindi Patel ◽  
Matthew Simmons ◽  
Kelsie Burner
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Salvage Therapy ◽  
Blood Cultures ◽  
Empiric Antibiotic Therapy ◽  
White Female ◽  
Salvage Regimen ◽  
Methicillin Resistant ◽  
Staphylococcus Aureus Bacteremia ◽  
Empiric Antibiotic

Staphylococcus aureus is one of the most virulent Gram-positive organisms responsible for a multitude of infections, including bacteremia. Methicillin-resistant Staphylococcus aureus (MRSA) is of special concern in patients with bacteremia. Due to its associated poor clinical outcomes, morbidity, and mortality, the superlative salvage regimen for persistent MRSA bacteremia remains uncertain. An 85-year-old white female presented with persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Empiric antibiotic therapy with linezolid was initiated prior to blood culture results. Once MRSA bacteremia was confirmed, alternative antibiotic therapy with daptomycin was initiated. Blood cultures remained positive for MRSA despite three days of daptomycin therapy after which ceftaroline was added to the antibiotic regimen. Blood cultures remained positive for MRSA despite seven days of combination therapy with daptomycin and ceftaroline. Salvage therapy was then initiated with daptomycin, linezolid, and meropenem. One day following initiation of salvage therapy, blood cultures revealed no bacterial growth for the remainder of the length of stay. This report supports the effectiveness of salvage therapy consisting of daptomycin, linezolid, and meropenem in patients with persistent MRSA bacteremia.

scholarly journals Targeted Surveillance of Methicillin-Resistant Staphylococcus aureus and Its Potential Use To Guide Empiric Antibiotic Therapy

2010 ◽  
Vol 54 (8) ◽  
pp. 3143-3148 ◽  
Author(s):  
Anthony D. Harris ◽  
Jon P. Furuno ◽  
Mary-Claire Roghmann ◽  
Jennifer K. Johnson ◽  
Laurie J. Conway ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
High Risk ◽  
Antibiotic Therapy ◽  
Active Surveillance ◽  
Empiric Antibiotic Therapy ◽  
Surveillance Culture ◽  
Methicillin Resistant ◽  
Clinical Culture ◽  
Empiric Antibiotic ◽  
Mrsa Colonization

ABSTRACT The present study aimed to determine the frequency of methicillin-resistant Staphylococcus aureus (MRSA)-positive clinical culture among hospitalized adults in different risk categories of a targeted MRSA active surveillance screening program and to assess the utility of screening in guiding empiric antibiotic therapy. We completed a prospective cohort study in which all adults admitted to non-intensive-care-unit locations who had no history of MRSA colonization or infection received targeted screening for MRSA colonization upon hospital admission. Anterior nares swab specimens were obtained from all high-risk patients, defined as those who self-reported admission to a health care facility within the previous 12 months or who had an active skin infection on admission. Data were analyzed for the subcohort of patients in whom an infection was suspected, determined by (i) receipt of antibiotics within 48 h of admission and/or (ii) the result of culture of a sample for clinical analysis (clinical culture) obtained within 48 h of admission. Overall, 29,978 patients were screened and 12,080 patients had suspected infections. A total of 46.4% were deemed to be at high risk on the basis of the definition presented above, and 11.1% of these were MRSA screening positive (colonized). Among the screening-positive patients, 23.8% had a sample positive for MRSA by clinical culture. Only 2.4% of patients deemed to be at high risk but found to be screening negative had a sample positive for MRSA by clinical culture, and 1.6% of patients deemed to be at low risk had a sample positive for MRSA by clinical culture. The risk of MRSA infection was far higher in those who were deemed to be at high risk and who were surveillance culture positive. Targeted MRSA active surveillance may be beneficial in guiding empiric anti-MRSA therapy.

Recurrent Methicillin-Resistant Staphylococcus Aureus Osteomyelitis: Combination Antibiotic Therapy with Evaluation by Serum Bactericidal Titers

1995 ◽  
Vol 29 (7-8) ◽  
pp. 694-697 ◽  
Author(s):  
Sherrie L Aspinall ◽  
David M Friedland ◽  
Victor L Yu ◽  
John D Rihs ◽  
Robert R Muder
Keyword(s):  
Staphylococcus Aureus ◽  
Back Pain ◽  
Antibiotic Therapy ◽  
Sedimentation Rate ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Blood Cultures ◽  
Low Back ◽  
Methicillin Resistant ◽  
Trough Concentrations

Objective: To report on a patient with recurrent methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis and bacteremia successfully treated with combination antibiotic therapy. Case Summary: Two sets of blood cultures from a 55-year-old man with fever, malaise, and low back pain grew MRSA. Radiologic studies of the spine showed bony changes consistent with osteomyelitis. Soon after completing 6 weeks of vancomycin, the patient experienced a recurrence of back pain. Laboratory values included an increase in the sedimentation rate to 53 mm/h and positive blood cultures for MRSA. Vancomycin, gentamicin, and rifampin were administered for 8 weeks. Serum inhibitory and bactericidal titers were more than 1:1024 for both the peak and trough concentrations. Radiologic studies of the spine showed healing osteomyelitis. Two years after completion of antibiotic therapy, the infection has not recurred. Discussion: Antibiotic therapy alone was attempted because the patient was considered a risky surgical candidate. Serum inhibitory and bactericidal titers documented the high in vivo activity of the vancomycin, gentamicin, and rifampin combination. Initiation of vancomycin therapy led to disappearance of the fever and back pain. Cure was documented by sustained normalization of the erythrocyte sedimentation rate and radiologic evidence of healing. Conclusions: Combination antibiotic therapy with vancomycin, rifampin, and low-dose gentamicin (1 mg/kg q12h) may be useful for deep-seated tissue infection caused by MRSA.

Empiric Antibiotic Therapy for Staphylococcus aureus Septic Shock: Is Vancomycin Indicated?

2020 ◽  
Vol 48 (12) ◽  
pp. e1370-e1371 ◽  
Author(s):  
Ruben D. Villanueva ◽  
Joseph A. Iovine ◽  
Scott G. Blair ◽  
Ryan O. Kennedy ◽  
Jasmeet S. Paul
Keyword(s):  
Staphylococcus Aureus ◽  
Septic Shock ◽  
Antibiotic Therapy ◽  
Empiric Antibiotic Therapy ◽  
Empiric Antibiotic
Sign in / Sign up

Export Citation Format

Share Document