How Do You Treat an Abscess in the Era of Increased Community-associated Methicillin-resistant Staphylococcus Aureus (MRSA)
Schmitz GR et al.– In light of the data currently available, antibiotics and decolonization should be used selectively, not routinely, for treatment of most uncomplicated abscesses. Wound cultures are generally not necessary in the emergency department (ED), and all patients should be given return precautions for worsening symptoms. read more
Mupirocin Resistance in Staphylococcus aureus Causing Recurrent Skin and Soft Tissue Infections in Children
McNeil JC et al. – Staphylococcus aureus resistance to mupirocin is often caused by acquisition of a novel isoleucyl–tRNA synthetase encoded on the plasmid gene mupA. The authors tested S. aureus isolates from children at Texas Children’s Hospital with recurrent skin and soft tissue infections for mupirocin resistance and mupA. Of 136 isolates, 20 were resistant to mupirocin. 15 isolates carried mupA, and the gene was more common in methicillin–susceptible S. aureus than methicillin–resistant S. aureus. Seven of 20 mupirocin–resistant isolates displayed clindamycin resistance. read more
Differing risk factors for vancomycin resistant and sensitive enterococcal bacteraemia
Peel T et al. – The absence of substantial overlap of risk factors for vancomycin resistant enterococcus and vancomycin susceptible enterococcus argues towards differences in pathogenesis. These data suggest that environmental sources are more important in vancomycin resistant enterococcus bacteraemia. Endogenous sources, particularly gastrointestinal tract, play a pivotal role in vancomycin susceptible enterococcus bacteraemia. This study highlights the importance of infection control protocols to reduce the risk of vancomycin resistant enterococcus bacteraemia. read more
Infection Control Rate of Irrigation and Debridement for Periprosthetic Joint Infection
Koyonos L et al. – Irrigation and débridement is unlikely to control periprosthetic joint infection, including acute infections. The authors data suggest surgeons should be cautious using this procedure as a routine means to address periprosthetic joint infection. For most patients, authors recommend irrigation and débridement be reserved for an immunologically optimized host infected acutely with a non–Staphylococcal organism. read more
Candidemic complications in patients with intravascular catheters colonized with Candida species: an indication for preemptive antifungal therapy
Leenders NHJ et al. – Intravascular catheter tip colonization in patients without preceding blood cultures with Candida is associated with candidemia in from 4% of patients (definite candidemia) up to 12% of patients (definite and possible candidemia combined). Considering the adverse prognosis associated with delayed treatment of candidemia, preemptive treatment based on catheter tip cultures might outweigh the disadvantages of costs and side effects of antifungal therapy.
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