1
|
Ruiz-Ripa L, Bellés A, García M, Torres C. Detection of a cfr-positive MRSA CC398 strain in a pig farmer in Spain. Enferm Infecc Microbiol Clin 2020; 39:139-141. [PMID: 32386788 DOI: 10.1016/j.eimc.2020.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To characterize one linezolid- and methicillin-resistant Staphylococcus aureus (MRSA) isolate recovered from a nasal sample of a pig farmer patient. METHODS The detection of linezolid resistance mechanisms was performed by PCR and sequencing. The antimicrobial resistance and virulence profile was investigated, and the molecular typing was performed by molecular techniques. The transference of cfr gene was assessed by conjugation experiments and its genetic environment was investigated by specific PCRs. RESULTS The linezolid-resistant MRSA isolate was typed as t011-ST398/CC398-SCCmecV-agrI and carried the cfr gene. The isolate was multidrug-resistant but lacked the virulence genes studied. The cfr gene was co-located with the fexA gene on a Tn558 variant and was successfully transferred by conjugation. CONCLUSION We report the first description of LA-MRSA-CC398 carrying the cfr gene in Spain. This finding highlights the importance of surveillance programmes to determine the presence and spread of the cfr gene in the livestock and clinical settings.
Collapse
Affiliation(s)
- Laura Ruiz-Ripa
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Alba Bellés
- Sección de Microbiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Mercè García
- Sección de Microbiología, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Carmen Torres
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain.
| |
Collapse
|
2
|
Aguilera-Alonso D, Escosa-García L, Goycochea-Valdivia WA, Soler-Palacín P, Saavedra-Lozano J, Rodrigo C, Cercenado E, Ramos JT, Baquero-Artigao F. [Position statement of the Spanish Association of Paediatrics-Spanish Society of Paediatric Infectious Diseases (AEP-SEIP) on the treatment of multidrug-resistant bacterial infections]. An Pediatr (Barc) 2019; 91:351.e1-351.e13. [PMID: 31635925 DOI: 10.1016/j.anpedi.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/29/2019] [Indexed: 12/16/2022] Open
Abstract
A progressive increase in the incidence of infections caused by multidrug-resistant microorganisms is being reported. Among these resistant microorganisms, the main threats are extended-spectrum β-lactamase-, AmpC-, and carbapenemase-producing Gram-negative bacilli, methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium. To address this important problem, it is essential to establish pediatric Antimicrobial Stewardship programs, perform active epidemiological surveillance and develop an adequate infection control policy. The therapeutic approach of these infections is often complex, frequently requiring antibiotics with less experience in children. In this position document made by the Spanish Association of Pediatrics and the Spanish Society of Pediatric Infectious Diseases, the epidemiology and treatment of these infections are reviewed according to the best available evidence.
Collapse
Affiliation(s)
- David Aguilera-Alonso
- Sección de Enfermedades Infecciosas, Servicio de Pediatría, Instituto de Investigación Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - Luis Escosa-García
- Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital La Paz, Universidad Autónoma de Madrid, Madrid, España
| | | | - Pere Soler-Palacín
- Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Hospital Vall d'Hebron, Universidad Autónoma de Barcelona, Barcelona, España
| | - Jesús Saavedra-Lozano
- Sección de Enfermedades Infecciosas, Servicio de Pediatría, Instituto de Investigación Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, España; Universidad Complutense de Madrid, España
| | - Carlos Rodrigo
- Servicio de Pediatría, Hospital Germans Trias i Pujol, Universidad Autónoma de Barcelona, Barcelona, España
| | - Emilia Cercenado
- Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España; CIBERES, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CB06/06/0058, Madrid, España
| | - José Tomás Ramos
- Servicio de Pediatría, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, España
| | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital La Paz, Universidad Autónoma de Madrid, Madrid, España
| |
Collapse
|
3
|
Leal AL, Ovalle MV, Cortés JA, Montañes AM, De la Rosa ZR, Rodríguez JY, Gualtero S, Ariza B, Sussman O, Torres MDP. In vitro activity of tedizolid and other comparator drugs in methicillin-resistant Staphylococcus aureus isolates in skin and soft tissue infections in seven Colombian hospitals. Biomedica 2018; 38:507-513. [PMID: 30653864 DOI: 10.7705/biomedica.v38i4.4022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 05/09/2018] [Indexed: 06/09/2023]
Abstract
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) causes severe skin and soft tissue infections in hospitals and, more recently, in the community. Tedizolid is a new second-generation oxazolidinone derivative having greater in vitro potency than linezolid against this type of microorganism. Objectives: To evaluate the antimicrobial activity of tedizolid and other comparator antibiotics in MRSA isolates causing skin and soft tissue infections in Colombian hospitals. Materials and methods: We conducted a prospective, multi-center descriptive study in seven tertiary-level hospitals in Colombia along a 12-month period. MRSA isolates were collected from adult patients with skin and soft tissue infections. Tedizolid, linezolid, vancomycin, daptomycin, trimethoprim-sulfamethoxazole, and clindamycin minimum inhibitory concentration (MIC) was determined by ETEST® (bioMérieux). Results: MRSA isolates were obtained from 102 patients with an average age of 46.8 years of whom 56 (54.9%) were men. Infection was community-acquired in 77 cases (75.4%). Abscess-related samples predominated (69 patients: 67.6%). All isolates were susceptible to tedizolid, linezolid, daptomycin, trimethoprim-sulfamethoxazole, and vancomycin. Tedizolid had greater in vitro activity than linezolid. Tedizolid MIC intervals ranged from 0.125 μg/mL to 0.5 μg/mL while those of linezolid ranged from 1μg/mL to 2μg/mL. Conclusions: MRSA strains circulating in Colombia are highly susceptible to tedizolid and can be considered a therapeutic alternative for hospitals and/or community-acquired skin and soft tissue infections.
Collapse
Affiliation(s)
- Aura Lucía Leal
- Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia Grupo para el Control de la Resistencia Bacteriana de Bogotá, Grebo, Bogotá, D.C., Colombia Departamento de Patología y Laboratorios, Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia Departamento de Medicina Interna, Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Galán-Sánchez F, Pérez-Eslava M, Machuca J, Trujillo-Soto T, Arca-Suarez J, Rodríguez-Iglesias M. Staphylococcus aureus carriage in older populations in community residential care homes: Prevalence and molecular characterization of MRSA isolates. Enferm Infecc Microbiol Clin 2018; 37:172-175. [PMID: 29935797 DOI: 10.1016/j.eimc.2018.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 04/25/2018] [Accepted: 05/02/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The epidemiology of S. aureus depends on conditions in specific populations. Few studies of S. aureus colonization in the older population have been performed in Spain. The aim of this study was to determine the prevalence of methicillin-resistant S. aureus (MRSA) colonization and its molecular epidemiological characteristics in an institutionalized population in community residential care homes in Cadiz, Spain. METHODS A cross-sectional epidemiological study was conducted in three residential care homes for older people. Axilla and nostril samples were tested. Identification of S. aureus and antimicrobial susceptibility testing were by MALDI-TOF and MicroScan panels. MRSA strains were subjected to SCCmec typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The presence of Panton-Valentine leukocidin (PVL) genes was determined by PCR in all S. aureus strains. RESULTS A total of 293 residents were included. Fifty-one residents (17.4%) were colonized with methicillin-sensitive S. aureus (MSSA) and 11 (3.8%) with MRSA. Resistance to at least two aminoglycosides was observed in 25.4% of MSSA and 90.9% and of MRSA isolates, and resistance to levofloxacin in 80.3% of MSSA and 100% of MRSA isolates. SCCmecIV was detected in all isolates and all except one (ST-125) were ST-8. None of the S. aureus isolates were positive for PVL. CONCLUSIONS A low rate of S. aureus carriage was detected and the prevalence of MRSA was very low. ST8-MRSA-IVc was the dominant clone, and only one strain belonged to ST125-MRSA-IVc. We found MRSA transmission within the residential care homes and a very high rate of quinolone resistance in MSSA and MRSA.
Collapse
Affiliation(s)
| | | | - Jesús Machuca
- Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena y Virgen del Rocío, Sevilla, Spain
| | | | - Jorge Arca-Suarez
- UGC Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | |
Collapse
|
5
|
Rodríguez Acosta F, Basualdo Acuña WD, Castro H, Campuzano A, Macchi ML, Ortellado de Canese J, Almada P, Rodríguez M, Grau L, Velázquez G, Espínola C, Samudio Domínguez GC, Gómez G, Carpinelli L, Guillén Fretes RM. [MLVA analysis and virulence profile of community-acquired methicillin-resistant Staphylococcus aureus causing infections in Paraguayan children]. Rev Argent Microbiol 2018; 50:151-6. [PMID: 29054550 DOI: 10.1016/j.ram.2017.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/07/2017] [Accepted: 03/16/2017] [Indexed: 11/21/2022] Open
Abstract
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is one of the first causes of skin and soft tissue infections, and can also produce severe diseases such as osteomyelitis and pneumonia. The aim of this descriptive study was to determine the SCCmec type and virulence profile and to study the genetic diversity by MLVA analysis of 21 CA-MRSA isolates that infected Paraguayan children in 2010. The SCCmec type and virulence factors were performed by PCR and genetic diversity by MLVA (multiple locus variable analysis). All the isolates carried SCCmec cassette iv. hla, hlb and sea genes were detected in 28,6%, 9,5% and 4,8% respectively. The MLVA analysis showed high genetic diversity with congruent antibiotic resistance and virulence profiles. This study revealed the presence of CA-MRSA harbouring SCCmeciv with high genetic diversity, providing information not available in our country.
Collapse
|
6
|
Boncompain CA, Suárez CA, Morbidoni HR. Staphylococcus aureus nasal carriage in health care workers: First report from a major public hospital in Argentina. Rev Argent Microbiol 2017; 49:125-131. [PMID: 28343857 DOI: 10.1016/j.ram.2016.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 10/26/2016] [Accepted: 12/19/2016] [Indexed: 01/28/2023] Open
Abstract
Staphylococcus aureus causes numerous mild to severe infections in humans, both in health facilities and in the community. Patients and health care workers (HCWs) may disseminate strains during regular medical examinations or hospitalization. The aim of this study was to determine the nasal carriage rate of methicillin-susceptible and methicillin-resistant S. aureus among health care workers at Hospital Provincial del Centenario, a public general hospital in Rosario, Argentina. A transversal study was conducted on 320 health care workers. Nasal swabs were taken and presumptive S. aureus colonies were isolated. Bacterial identity and methicillin resistance status were confirmed by amplification of the nuc and mec genes. Chi square test and Fisher exact test were used for statistical analysis. Of 320 HCWs, 96 (30%) were nasal carriers of S. aureus, 20 of whom (6.3%) carried methicillin-resistant S. aureus (MRSA) and 76 (23.7%) methicillin-susceptible S. aureus (MSSA). Carriage was within thepublished values for physicians (30%) and higher for technicians (57%). Accompanying resistance (62/96, 64.6%) was detected, including resistance to fluoroquinolones (23/96, 24%), aminoglucosides (13/96, 13.5%) or to macrolides (33/96, 34.4%). All the strains were susceptible to vancomycin whereas only 3.1% (3/96), all of them on MSSA strains, were resistant to mupirocin. This study is the first one of its kind in Argentina and one of the few performed in South America, to highlight the relevance of nasal carriage of MRSA and MSSA in health care personnel and brings to light the need for consensus recommendations for regular S. aureus carriage screening as well as for decolonization strategies.
Collapse
Affiliation(s)
- Carina Andrea Boncompain
- Laboratorio de Microbiología Molecular, Cátedra de Microbiología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Cristian Alejandro Suárez
- Laboratorio de Microbiología Molecular, Cátedra de Microbiología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina; Consejo Nacional de Investigaciones Científicas y Tecnológicas, CONICET, Argentina
| | - Héctor Ricardo Morbidoni
- Laboratorio de Microbiología Molecular, Cátedra de Microbiología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina; Consejo de Investigaciones, Universidad Nacional de Rosario, Rosario, Argentina.
| |
Collapse
|
7
|
Varona-Barquín A, Iglesias-Losada JJ, Ezpeleta G, Eraso E, Quindós G. Vancomycin heteroresistant community associated methicillin-resistant Staphylococcus aureus ST72-SCCmecIVa strain colonizing the nostrils of a five-year-old Spanish girl. Enferm Infecc Microbiol Clin 2016; 35:148-152. [PMID: 27590877 DOI: 10.1016/j.eimc.2016.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/27/2016] [Accepted: 07/29/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES During a community methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization study, an MRSA strain with vancomycin hetero-resistance (h-VISA) was isolated from a five year-old girl with tetralogy of Fallot without previous exposure to vancomycin. An extended nasal colonization study was performed on all her close relatives. RESULTS Only the patient and her sister were colonized by an h-VISA MRSA strain (clone USA 700, ST72, t148, agr 1 and SCCmec IVa). Mupirocin decolonisation was effective in the elder sister. A new nasal decolonisation in the younger girl using fusidic acid was also successful. However, after decolonisation both sisters were colonized by a methicillin-susceptible S. aureus (ST30, t012 and agr 3) previously isolated from their mother's nostrils. CONCLUSION As S. aureus have a great capacity to spread among people in close contact, knowledge of a patients' colonization status, tracing contacts, and a correct management are critical issues for the successful containment of multiresistant staphylococci.
Collapse
Affiliation(s)
- Aketza Varona-Barquín
- Laboratorio de Micología Médica, UFI 11/25 'Microbios y Salud', Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, Bilbao, Spain
| | | | - Guillermo Ezpeleta
- Departamento de Medicina Preventiva y Salud Pública, UFI 11/25 'Microbios y Salud', Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, Bilbao, Spain; Servicio de Medicina Preventiva e Higiene Hospitalaria, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Elena Eraso
- Laboratorio de Micología Médica, UFI 11/25 'Microbios y Salud', Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, Bilbao, Spain
| | - Guillermo Quindós
- Laboratorio de Micología Médica, UFI 11/25 'Microbios y Salud', Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, Bilbao, Spain.
| |
Collapse
|
8
|
Del Rosario-Quintana C, Tosco-Núñez T, Lorenzo L, Martín-Sánchez AM, Molina-Cabrillana J. [Prevalence and risk factors of multi-drug resistant organism colonization among long-term care facilities in Gran Canaria (Spain)]. Rev Esp Geriatr Gerontol 2015; 50:232-6. [PMID: 25576447 DOI: 10.1016/j.regg.2014.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/20/2014] [Accepted: 11/24/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Multidrug resistant organisms (MDRO) are an important cause of nosocomial infections, with complicated clinical-therapeutic management and elevated morbidity-mortality, and an increase in healthcare costs. In long term care facilities (LTCFs) colonization/infection by MDRO among residents is increasing, and they may act as reservoirs and vehicles for the dissemination and production of outbreaks by resistant strains in acute hospitals. This study aimed at determining the prevalence of carriers of some common MDRO, and identifying factors associated with carrier state. MATERIAL AND METHODS A cross-sectional prevalence study was conducted on 235 residents in two LTCFs in the province of Las Palmas de Gran Canaria (Canary Islands, Spain) between October and November of 2012. The presence of MMR was investigated in nasal, pharyngeal and rectal swabs using selective media. Risk factors associated with carrier state were calculated using univariate and multivariate analysis. RESULTS More than one-third (36.2%) of residents were found to be carriers of ≥ 1 distinct MDROs. More than one-quarter (26.6%) were carriers of ESBL producing Enterobacteriaceae, and 10.2% were MRSA carriers. Factors found to be associated with colonization by any MDRO were: prior colonization or infection by MDRO, hospitalization in the past 3 months, recurrent infections of the urinary tract, and peripheral arterial disease. CONCLUSIONS The prevalence of MDRO in the LTCFs settings studied is greater than that found in the literature, and in particular ESBL producing Enterobacteriaceae. Due to the high prevalence of infection/colonization by MDRO, it is possible that residents of LTCFs could act as important reservoirs of MDRO, and facilitate their spread into the acute care setting.
Collapse
Affiliation(s)
| | - Tomás Tosco-Núñez
- Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - Leticia Lorenzo
- Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | | | - Jesús Molina-Cabrillana
- Servicio de Medicina Preventiva, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| |
Collapse
|
9
|
Canut A, Martínez-Martínez L. [Ceftaroline breakpoints]. Enferm Infecc Microbiol Clin 2014; 32 Suppl 2:21-6. [PMID: 24702975 DOI: 10.1016/s0213-005x(14)70154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ceftaroline is a new cephalosporin for parenteral use. Notable among its microbiological properties is its ability to inhibit penicillin-binding protein 2a of methicillin-resistant Staphylococcus aureus and its good in vitro activity against several microorganisms of clinical interest. The European Committee of Antimicrobial Susceptibility Testing (EUCAST) has defined both epidemiological breakpoints (defining wild-type populations that lack known acquired mechanisms of resistance) and clinical breakpoints for this compound. The Clinical and Laboratory Standards Institute (CLSI) has also defined clinical breakpoints. Based on the microbiological activity of ceftaroline, clinical categories have been defined for enterobacteria, S. aureus, Haemophilus influenzae, Streptococcus pneumoniae, and beta-hemolytic Streptococcus. EUCAST has also established breakpoints based on pharmacokinetic-pharmacodynamic criteria.
Collapse
Affiliation(s)
- Andrés Canut
- Servicio de Microbiología, Hospital Universitario de Álava, Vitoria, España
| | - Luis Martínez-Martínez
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Departamento de Biología Molecular, Universidad de Cantabria, Santander, España.
| |
Collapse
|
10
|
Calbo E, Zaragoza R. [Ceftaroline fosamil in community-acquired and nosocomial pneumonia]. Enferm Infecc Microbiol Clin 2014; 32 Suppl 2:38-43. [PMID: 24702978 DOI: 10.1016/s0213-005x(14)70157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Community-acquired pneumonia (CAP) is a common infection in developed countries and causes a large number of hospital admissions and deaths. In recent years, the incidence of this disease has increased, caused by progressive population aging. Following the introduction of the conjugate vaccine against Streptococcus pneumoniae, there have been significant epidemiological changes that require close monitoring because of the possible emergence of new patterns of resistance. This article aims to review the role of ceftaroline fosamil, a new parenteral cephalosporin with antibacterial activity against Gram-negative and Gram-positive pathogens, in the treatment of pneumonia. Several in vitro and in vivo studies have shown the efficacy of ceftaroline fosamil against penicillin-resistant S. pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA). Additionally, ceftaroline has shown similar efficacy and safety to ceftriaxone in the treatment of community-acquired pneumonia with severe prognosis (prognostic severity index III and IV) in two phase III clinical trials. Although a non-inferiority design was used for these clinical trials, some data suggest a superior efficacy of ceftaroline, with earlier clinical response and higher cure rate in infections caused by S. pneumoniae, making this drug particularly interesting for critically-ill patients admitted to the intensive care unit. Ceftaroline may also be considered for empirical and directed treatment of MRSA pneumonia.
Collapse
Affiliation(s)
- Esther Calbo
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Universitario Mutua de Terrassa, Terrassa, Barcelona, España; Universidad Internacional de Catalunya, Valencia, España.
| | - Rafael Zaragoza
- Servicio de Medicina Intensiva, Hospital Universitario Dr. Peset, Valencia, España; Coordinador del Programa Interdisciplinar de Atención en la Sepsis Grave, Hospital Universitario Dr. Peset, Valencia, España
| |
Collapse
|
11
|
Pulido Pérez A, Baniandrés Rodríguez O, Ceballos Rodríguez MC, Mendoza Cembranos MD, Campos Domínguez M, Suárez Fernández R. Skin infections caused by community-acquired methicillin-resistant Staphylococcus aureus: clinical and microbiological characteristics of 11 cases. Actas Dermosifiliogr 2013; 105:150-8. [PMID: 24182658 DOI: 10.1016/j.ad.2013.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 09/04/2013] [Accepted: 09/04/2013] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen that causes skin and soft-tissue infections. OBJECTIVE To describe the clinical characteristics of skin infections caused by CA-MRSA and correlations with the available demographic and microbiological data. MATERIAL AND METHODS This was a descriptive study of patients with a microbiologically confirmed diagnosis of CA-MRSA infection treated in a dermatology department between June 2009 and December 2011. We recorded demographic details, the clinical characteristics of lesions, and the treatments used. RESULTS We studied 11 patients (5 men and 6 women); 91% were under 40 years of age and had no relevant past medical history. The most common presentation was a skin abscess (with or without cellulitis). In all such cases, marked tissue necrosis and little or no purulent exudate was observed when the abscess was drained. Fifty percent of these abscesses had been treated previously with β-lactam antibiotics, and in all cases the lesions resolved after surgical drainage, which was combined in 63% of cases with quinolones or cotrimoxazole. CONCLUSIONS Today, skin infections due to CA-MRSA affect healthy young athletes who have no contact with healthcare settings. The most common presentation is a skin abscess characterized by marked tissue necrosis and little or no purulent exudate. In cases with these characteristics in susceptible patients, the involvement of CA-MRSA as the causative agent should be suspected. The abscesses should be drained whenever possible and, if necessary, antibiotic treatment should be prescribed; empirical use of β-lactam antibiotics should be avoided.
Collapse
Affiliation(s)
- A Pulido Pérez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - O Baniandrés Rodríguez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M C Ceballos Rodríguez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M D Mendoza Cembranos
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M Campos Domínguez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R Suárez Fernández
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| |
Collapse
|