Antimicrobial treatment of nosocomial meticillin-resistant Staphylococcus aureus (MRSA) pneumonia: current and future options
Welte T et al. – Meticillin–resistant Staphylococcus aureus is a frequent cause of nosocomial pneumonia. Inadequate or inappropriate antimicrobial therapy, often caused by antimicrobial resistance, is associated with increased mortality for these infections. Agents currently recommended for the treatment of meticillin–resistant Staphylococcus aureus pneumonia include vancomycin and linezolid in the USA, and vancomycin, linezolid, teicoplanin and quinupristin/dalfopristin in Europe. Antimicrobials such as tigecycline and daptomycin, although approved for the treatment of some MRSA infections, have not demonstrated efficacy equivalent to the approved agents for meticillin–resistant Staphylococcus aureus pneumonia. Further agents lack data from randomised controlled trials (e.g. fosfomycin, fusidic acid or rifampicin in combination with vancomycin). read more
Benefit and harm of iodine in wound care: a systematic review
Vermeulen H et al. – Nowadays many products are available to combat infections and thus to promote wound healing. Iodine is one of these products, but reports are conflicting as to the effectiveness and adverse effects of iodine in the treatment of wounds. A systematic review was performed of 27 randomised clinical trials, reporting on chronic, acute, burn wounds, pressure sores, and skin grafts. Main outcome parameters were wound healing, bacterial count, and adverse effects. Iodine did not lead to a reduction or prolongation of wound–healing time compared with other (antiseptic) wound dressings or agents. In individual trials, iodine was significantly superior to other antiseptic agents (such as silver sulfadiazine cream) and non–antiseptic dressings, but seemed inferior to a local antibiotic (Rifamycin SV MMX) and, when combined with alcohol, to crude honey in reducing bacterial count and/or wound size.
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Risk factors associated with mupirocin resistance in meticillin-resistant Staphylococcus aureus
Caffrey AR et al. – Implementation of meticillin–resistant Staphylococcus aureus decolonisation programmes has been increasing and the emergence of mupirocin resistance has been reported. However, the patient–level risk factors associated with mupirocin resistance are not clear. In this study, independent predictors of mupirocin resistance in meticillin–resistant Staphylococcus aureus among Providence Veterans Affairs Medical Center patients with meticillin–resistant Staphylococcus aureus–positive culture dates between 1 July 2004 and 30 June 2008 were identified using a frequency–matched case–control study. read more
Association of methicillin-resistant Staphylococcus aureus (MRSA) USA300 genotype with mortality in MRSA Bacteremia
Kempker RR et al. – USA300 genotype is the predominant methicillin–resistant Staphylococcus aureus strain causing community–associated infections and may be associated with increased virulence. This study demonstrated an association of USA300 strains with increased in–hospital mortality compared with non–USA300 strains, particularly USA100, in persons with methicillin–resistant Staphylococcus aureus bacteremia. read more
Patient-Associated Risk Factors for Acquisition of Methicillin-Resistant Staphylococcus aureus in a Tertiary Care Hospital
Salangsang JAM et al. – Among the factors associated with increased risk, few are modifiable. Patients with at–risk conditions could be targeted for intensive surveillance to detect acquisition sooner. The association of methicillin–Resistant Staphylococcus aureus acquisition with target unit exposure argues for rigorous application of hand hygiene, appropriate barriers, environmental control, and strict aseptic technique for all procedures performed on such patients. The authors findings support focusing efforts to prevent methicillin–Resistant Staphylococcus aureus transmission and restriction of ciprofloxacin use. read more
