Archive for August 24, 2016

High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus.

Emerg Infect Dis. 2016 Jun;22(6):1057-66.

San-Juan R, Viedma E, Chaves F, Lalueza A, Fortún J, Loza E, Pujol M, Ardanuy C, Morales I, de Cueto M, Resino-Foz E, Morales-Cartagena A, Rico A, Romero MP, Orellana MÁ, López-Medrano F, Fernández-Ruiz M, Aguado JM.

Abstract

We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011-June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 μg/mL and 0.5 μg/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2-5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1-5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880091/pdf/15-1709.pdf

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August 24, 2016 at 8:37 am

Comparison of outcomes in patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia who are treated with β-lactam vs vancomycin empiric therapy: a retrospective cohort study.

BMC Infect Dis. 2016 May 23;16(1):224.

Wong D1, Wong T2,3, Romney M2,4, Leung V2,4.

Author information

1PGY-V Infectious Diseases Residency Training Program, University of British Columbia, Vancouver General Hospital, D 452 Heather Pavilion, 2733 Heather Street, Vancouver, BC, V5Z 1 M9, Canada. wongdavi@mail.ubc.ca.

2Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.

3Division of Medical Microbiology and Infection Control, Vancouver General Hospital, JPPN1, Medical Microbiology Laboratory, 899 W 12th Ave, Vancouver, BC, V5Z 1 M9, Canada.

4Division of Medical Microbiology, St. Paul’s Hospital, Medical Microbiology Laboratory, 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada.

Abstract

BACKGROUND:

Prior studies suggested that vancomycin may be inferior to β-lactams for the empiric treatment of methicillin-susceptible S. aureus (MSSA) bacteremia. We assessed whether empiric therapy with β-lactams compared to vancomycin was associated with differences in clinical outcomes in patients with MSSA bacteremia.

METHODS:

We conducted a retrospective cohort study of adult inpatients with their first episode of MSSA bacteremia at two tertiary care hospitals in Vancouver, Canada, between 2007 and 2014. Exposure was either empiric β-lactam or vancomycin therapy. All patients received definitive treatment with cloxacillin or cefazolin. The primary outcome was 28-day mortality. Secondary outcomes were 90-day mortality, recurrent infection at 6 months, duration of bacteremia and hospital length-of-stay. Outcomes were adjusted using multivariable logistic regression.

RESULTS:

Of 814 patients identified, 400 met inclusion criteria (β-lactam = 200, vancomycin = 200). Overall 28-day mortality was 8.5 % (n=34). There were more cases of infective endocarditis in the β-lactam than in the vancomycin group [45 (22.5 %) vs 23 (11.5 %), p < 0.01]. Adjusted mortality at 28 days was similar between the two groups (OR: 1.14; 95 % CI: 0.49-2.64). No differences in secondary outcomes were observed. Transition to cloxacillin or cefazolin occurred within a median of 67.8 h in the vancomycin group.

CONCLUSIONS:

Empiric therapy with β-lactams was not associated with differences in all-cause mortality, recurrent infection, microbiological cure or hospital length-of-stay compared to vancomycin. Vancomycin monotherapy may be appropriate for the empiric treatment of MSSA bacteremia if definitive therapy with cloxacillin or cefazolin can be initiated within 3 days

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878066/pdf/12879_2016_Article_1564.pdf

August 24, 2016 at 8:36 am

Update on Tick-Borne Rickettsioses around the World: a Geographic Approach

Clin. Microbiol. Rev. October 2013 26(4): 657-702

Philippe Parola, Christopher D. Paddock, Cristina Socolovschi, Marcelo B. Labruna, Oleg Mediannikov, Tahar Kernif, Mohammad Yazid Abdad, John Stenos, Idir Bitam, Pierre-Edouard Fournier, and Didier Raoult

Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, WHO Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases, Faculté de Médecine, Marseille, Francea

Centers for Disease Control and Prevention, Atlanta, Georgia, USAb

Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia Universidade de São Paulo, Cidade Universitária, São Paulo, SP, Brazilc

Service d’Ecologie des Systèmes Vectoriels, Institut Pasteur d’Algérie, Algiers, Algeriad

Division of Veterinary and Biomedical Science, Murdoch University, Australian Rickettsial Reference Laboratory, Barwon Health, Geelong, Victoria, Australiae

University of Boumerdes, Boumerdes, Algeriaf

Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted fever group of the genus Rickettsia. These zoonoses are among the oldest known vector-borne diseases. However, in the past 25 years, the scope and importance of the recognized tick-associated rickettsial pathogens have increased dramatically, making this complex of diseases an ideal paradigm for the understanding of emerging and reemerging infections. Several species of tick-borne rickettsiae that were considered nonpathogenic for decades are now associated with human infections, and novel Rickettsia species of undetermined pathogenicity continue to be detected in or isolated from ticks around the world. This remarkable expansion of information has been driven largely by the use of molecular techniques that have facilitated the identification of novel and previously recognized rickettsiae in ticks. New approaches, such as swabbing of eschars to obtain material to be tested by PCR, have emerged in recent years and have played a role in describing emerging tick-borne rickettsioses. Here, we present the current knowledge on tick-borne rickettsiae and rickettsioses using a geographic approach toward the epidemiology of these diseases.

PDF

http://cmr.asm.org/content/26/4/657.full.pdf+html

 

ERRATUM

Page 672, column 1, line 33: “DQ34462” should read “DQ344620.”

 

Page 672, column 1, line 39: “EF68975.1” should read “EF689735.”

 

Page 672, column 2, line 10: “AY63102” should read “AY763102.”

 

http://cmr.asm.org/content/27/1/166.short

August 24, 2016 at 8:33 am


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