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MRSA
Methicillin-resistant Staphylococcus aureus (MRSA) pathogens have been isolated with increasing frequency from wound and skin infections that commonly affect the wounds of patients with diabetes. MRSA has been associated with an increased risk of amputations and infection-related mortality. See below for related articles on MRSA.
Understanding The Impact Of MRSA On Limb Preservation
Given the increasing prevalence of methicillin resistant Staphylococcus aureus (MRSA), these authors discuss the differences between HA-MRSA and CA-MRSA, what the literature reveals about antibiotic therapy and keys to the diagnostic workup of these patients.
Featured Content from Podiatry Today
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Point-Counterpoint: Should You Cover MRSA?
Yes. Given the increasing incidence of methicillin-resistant Staphylococcus aureus, Guy R. Pupp, DPM, and Mark A. Kachan, DPM say one should consider empiric coverage against MRSA in high-risk patients with infected ulcerations in the lower extremity. Not necessarily. Warren S. Joseph, DPM, says the current evidence does not support routine coverage of MRSA in the bulk of uncomplicated skin and skin structure infections of the lower extremity.
Featured Content from Podiatry Today
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The Health Care Worker, Resistant Bacteria (MRSA), and Preventing Contagion
Drug-resistant bacterial pathogens are increasingly common in the modern era of widespread, sometimes indiscriminate antimicrobial therapy. This article examines the problem of methicillin-resistant Staphylococcus aureus (MRSA) precautions once patients leave the hospital.
Featured Content from Clinical Geriatrics
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Use of Infection Control Procedures in an Out-Patient Clinic for Leg Ulcers and the Rate of Contamination with Methicillin-Resistant Staphylococcus aureus
Abstract: There is a gradual, worldwide increase in the development of resistant bacteria. The presence of resistant species on an ulcer bed has specific ramifications with regard to the risk of their environmental spread, as well as to the healing of the affected ulcer. Objective: The objective of this study was to evaluate the efficacy of accepted infection-control procedures in a clinic for cutaneous ulcers. Main outcome measure: Presence of methicillin-resistant Staphylococcus aureus (MRSA) was the main outcome measure of the study. Methods: Patients with leg ulcers of various etiology were included in the study. Since June of 1999, strict implementation of infection-control procedures, according to the United States Centers for Disease Control and Prevention (CDC) guidelines valid at that time, have been carried out in the Out-Patient Clinic for Leg Ulcers of Soroka University Medical Center in Beer-Sheba, Israel. Up to June of 1999, the infection control policy had been rather inconsistent. Two groups of patients were included. The first group included 34 patients, treated from January, 1996, to December, 1998; the second group included 83 patients, treated from January, 2000, to December, 2002. Swabs for bacterial cultures were taken from the ulcer bed from each patient at 2- to 4-week intervals. We compared the two groups with respect to number of patients with positive MRSA isolation, time until MRSA isolation, and presence of risk factors for colonization of MRSA. Results: In the first group (1996?1998), 5 of 34 patients (14.7%) were contaminated with MRSA during their visits to the clinic. In these five patients the mean time from their visit until MRSA isolation was 21 months. In the second group (2000?2002), in 7 of 83 patients (8.4%) were contaminated with MRSA during their visits to the clinic. In these seven patients the mean time from their visit until MRSA isolation was 13.2 months. No statistically significant differences were identified when comparing risk factors for MRSA colonization betwe
Featured Content from Wounds Research
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The Independent Evolution Of Healthcare-Associated And Community-Acquired MRSA
The Independent Evolution Of Healthcare-Associated And Community-Acquired MRSA Feature: The Independent Evolution Of Healthcare-Associated And Community-Acquired MRSA - Prevalence And Risk Factors For MRSA Infections The incidence of Staphylococcus aureus has increased dramatically throughout the United States as a cause of nosocomial infections. SSTIs were more common among CA-MRSA patients (75%) than among HA-MRSA patients (37%). Respiratory tract infections were more common in HA-MRSA (22...
Featured Content from Podiatry Today
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MRSA: Where Do We Go From Here?
Given the rising increase of methicillin resistant Staph aureus (MRSA) in diabetic foot infections, this author offers a thorough review of the literature on the subject and offers his insights on surgical care and emerging antibiotics.
Featured Content from Podiatry Today
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The Effects of Salt Concentration and Growth Phase on MRSA Solar and Germicidal Ultraviolet Radiation Resistance
The extensive use of antimicrobial drugs has led to the widespread emergence of resistant bacterial strains. One such organism, methicillin-resistant Staphylococcus aureus, is now found extensively in both healthcare facilities and diverse community settings such as households, correctional facilities, and athletic teams. The importance of ultraviolet radiation as an adjunctive therapy to reduce bioburden and improve wound status in patients has been documented. An in vitro study to assess the effects of different types of ultraviolet radiation on antibiotic-resistant strains was conducted to provide information that will aid in the development of rational UV irradiation medical protocols. Methicillin-resistant Staphylococcus aureus was found to be sensitive to both germicidal (ultraviolet C) and solar (ultraviolet A and B) ultraviolet radiation (ultraviolet C substantially more lethal). For both types of ultraviolet radiation, as the medium concentration of sodium chloride increased, the methicillin-resistant Staphylococcus aureus cells exhibited increased sensitivity. It also was shown for both types of ultraviolet radiation that kill curves were comparable for log and stationary phase methicillin-resistant Staphylococcus aureus cells. Photoreactivation was observed for Pseudomonas aeruginosa PAO-1 but not for methicillin-resistant Staphylococcus aureus when ultraviolet C was applied to log phase cells. The Gram-negative Pseudomonas aeruginosa PAO-1 was considerably more sensitive than the Gram-positive methicillin-resistant Staphylococcus aureus to ultraviolet C radiation. The experiments reveal that medium composition exerts a substantial effect on methicillin-resistant Staphylococcus aureus ultraviolet resistance and that this species lacks photoreactivation capacity. This suggests that in a clinical setting, eradication of the bacterium may be achieved at far lower doses of ultraviolet radiation than would be indicated by treatment protocols that do not account for ionic conditions. KEYWORDS: wound in
Featured Content from Ostomy Wound Management
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Antimicrobial Susceptibility Patterns of Staphylococcus aureus and Characterization of MRSA in Southwestern Nigeria
Abstract: The authors report the antibiotic susceptibility of 200 non-duplicate Staphylococcus aureus isolates from clinical samples and characterization of methicillin-resistant S aureus (MRSA) in Southwestern Nigeria. All the isolates were susceptible to teicoplanin, vancomycin, fusidic acid, and rifampicin, and less than 3% were resistant to erythromycin, clindamycin, neomycin, and minocycline. The high rates of methicillin-sensitive S aureus (MSSA) resistance to sulfonamides and tetracycline could be attributed to widespread use of these antibacterial agents in Nigeria. Only 3 isolates were confirmed as MRSA based on the detection of the mecA gene. Clonal relatedness of 1 MRSA strain in Southwestern Nigeria with epidemic MRSA-15 was confirmed by pulsed field gel electrophoresis. The identification of multi-resistant MSSA and 1 high-level mupirocin-resistant S aureus indicates that strict antibiotic and infection control policies are important factors to be considered in health institutions in Southwestern Nigeria. Continuous surveillance on antibiotic susceptibility of S aureus and characterization of MRSA are essential in understanding the epidemiology of this pathogen in Nigeria.
Featured Content from Wounds Research
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Newer Antistaphylococcal Agents: In-Vitro Studies and Emerging Trends in Staphylococcus aureus Resistance
Abstract: Although remarkable advances in the development of antibacterial agents for infections caused by Staphylococcus aureus began in the 1940s, treatment of this pathogen is still a challenge for clinicians. The emergence of S aureus strains with resistance to penicillin and methicillin in 1948 and 1961 and the recent reports of vancomycin-resistant strains indicate that the battle against this versatile pathogen is not yet over. This review discusses the newly developed antimicrobial agents, mechanisms of action, in-vitro studies, and emerging trends in S aureus resistance to these antibacterial agents. The availability of linezolid in intravenous and oral form is an advantage for the treatment of pneumonia and skin and soft tissue infection. Daptomycin is recommended for the treatment of deep-seated infections, such as endocarditis or osteomyelitis caused by methicillin-resistant S aureus. Tigecycline is a promising antibacterial agent in cases of complicated intra-abdominal infections and complicated skin infections in adults. Novel cephalosporins, quinolones, and conjugate vaccines are currently being developed. Rational antimicrobial usage along with effective infection control measures are required to avert the rapid emergence of resistant strains of S aureus to these new agents.
Featured Content from Wounds Research
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Ultraviolet Light C in the Treatment of Chronic Wounds with MRSA: A Case Study
The prevalence of antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus is rapidly increasing in healthcare facilities and spreading to the community. Methicillin-resistant S. aureus colonize the skin and open wounds and can interfere with wound healing. Recent studies have shown that ultraviolet light C can kill antibiotic-resistant strains of bacteria such as methicillin-resistant S. aureus in both laboratory cultures and animal tissue. This clinical report describes the effects of ultraviolet light C on wound bioburden and closure in three people with chronic ulcers infected with methicillin-resistant S. aureus. In all three patients, ultraviolet light C treatment reduced wound bioburden and facilitated wound healing. Two patients had complete wound closure following 1 week of ultraviolet light C treatment. This case study suggests that ultraviolet light C is a promising adjunctive therapy for chronic wounds containing antibiotic-resistant bacteria such as methicillin-resistant S. aureus.
Featured Content from Ostomy Wound Management
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