Posts filed under ‘Resistencia bacteriana’

Highlights From International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases

Infectious Diseases in Clinical Practice July 2011 V.19 N.4 P.282-283

Clinical Guidelines

File, Thomas M. Jr

A panel of international experts was convened by the Infectious Diseases Society of America in collaboration with the European Society for Microbiology and Infectious Diseases to update the 1999 uncomplicated urinary tract infection (UTI) guidelines.

The focus of the recommendations is on women with uncomplicated cystitis and pyelonephritis.

Since the 1999 guideline, antimicrobial resistance among uropathogens causing urinary tract infections has increased, and newer agents and different duration of therapy have been studied.

This update reflects many of the changes since the 1999 guideline.





December 7, 2018 at 9:31 am

Staphylococcus aureus Bacteremia and Endocarditis: Making an Impact on Outcomes: The Role of the Patient and the Organism

Infectious Diseases in Clinical Practice July 2011 V.19 N.4 P.238-242

NFID Clinical Updates

Weinstein, Robert A.

Three scientific approaches to infectious disease-case series, epidemiologic investigation, and molecular analysis-have aided researchers in understanding the evolution of pathogen activity.

Four eras of pathogen activity have occurred from 1920 to the present (streptococcus, staphylococci, gram-negative rods, and multidrug-resistant organisms).

The emergence of health care-associated and community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) infections has resulted in the blurred distinction among the entities.

In addition, there are several virulence factors that contribute significantly to the pathogenicity of the organism, and single nucleotide polymorphisms (SNPs) play an important role in determining an individual’s response to infection.

Health outcomes are significantly worse in MRSA patients compared with uninfected patients or those infected with methicillin-susceptible S. aureus (MSSA).

Ongoing molecular research will continue to elucidate mechanisms associated with virulence of MRSA.



December 7, 2018 at 9:30 am

Highlights From Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children

Infectious Diseases in Clinical Practice May 2011 V.19 N.3 P.207-20

Clinical Guidelines

File, Thomas M. Jr

Recently, the Infectious Diseases Society published evidence-based guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections.

The guideline discusses the management of a variety of infections including skin infections, bacteremia and endocarditis, pneumonia, and osteomyelitis and joint infections.



December 7, 2018 at 9:28 am

Managing an Elusive Pathogen: Treatment of Methicillin-Resistant Staphylococcus aureus Infections in a Variety of Care Settings

Infectious Diseases in Clinical Practice May 2011 V.19 N.3 P.150-155

NFID Clinical Updates

Poretz, Donald M.; Rehm, Susan J.

Methicillin-resistant Staphylococcus aureus (MRSA) infections continue to be a major problem both within hospitals (hospital-acquired MRSA) and increasingly in community settings (community-acquired MRSA), leading to well-publicized media reports and, as a result, greater public awareness of this problem.

Clinically, it is difficult to distinguish between a MRSA and a methicillin-sensitive S. aureus skin and soft tissue infection, and this should be taken into consideration when initiating empiric therapy.

There are several oral and intravenous antibiotics available to treat MRSA infections, some of which are inexpensive, whereas others are extremely costly; all have potential adverse effects and possible drug-drug interactions with which the prescriber should be familiar.

Careful monitoring of patients who receive outpatient intravenous antibiotics and an understanding of various intravenous devices and their associated possible complications in addition to knowledge of the economics involved are essential to make cost-effective decisions.



December 7, 2018 at 9:24 am

Neisseria gonorrhoeae — Rising Infection Rates, Dwindling Treatment Options

N Engl J Med November 8, 2018 V.379 P.1795

Blank and D.C. Daskalakis

Gnorrhea infection is the second most commonly reported notifiable condition in the United States, and case rates have been increasing since 2009. In 2017, a total of 555,608 cases of gonorrhea were reported nationally, the largest number since 1991 and an 18.6% increase over 2016 (see graph).1

In 2015, the Obama administration deemed Clostridium difficile, carbapenem-resistant Enterobacteriaceae, and Neisseria gonorrhoeae the most urgent infectious public health threats to national security, given the accelerating emergence of antibiotic resistance in these organisms.2 Though gonorrhea ranked third on this list, the number of cases of gonorrhea dwarfs those of the other two infections. Worldwide, gonorrhea cases have persistently affected young adults. Without a concerted global effort to mitigate antibiotic resistance, infected persons (primarily, sexually active young adults, who tend to be otherwise healthy) may require extended hospital stays and additional follow-up visits for an infection that can currently be managed on an outpatient basis. Such a shift could impose a serious burden on health care systems and societal productivity internationally. In the United States, this concern is compounded by the fact that for decades, gonorrhea infections have disproportionately affected black Americans, American Indians and Alaska Natives, Native Hawaiians and other Pacific Islanders, and Hispanic Americans….



December 4, 2018 at 7:00 pm

Rapid diagnostics for bloodstream infections: A primer for infection preventionists

American Journal of Infection Control September 2018 V.46 N.9 P.1060–1068

Charles E. Edmiston, Robert Garcia, Marsha Barnden, Barbara DeBaun, Helen Boehm Johnson

Accurate and rapid antimicrobial susceptibility testing with pathogen identification in bloodstream infections is critical to life results for early sepsis intervention. Advancements in rapid diagnostics have shortened the time to results from days to hours and have had positive effects on clinical outcomes and on efforts to combat antimicrobial resistance when paired with robust antimicrobial stewardship programs. This article provides infection preventionists with a working knowledge of available rapid diagnostics for bloodstream infections.



December 3, 2018 at 7:37 am

Evaluation of the Revised Ceftaroline Disk Diffusion Breakpoints When Testing a Challenge Collection of Methicillin-Resistant Staphylococcus aureus Isolates

Clin. Microbiol. December 2018 V.56 N.12

Helio S. Sader, Paul R. Rhomberg, Timothy B. Doyle, Robert K. Flamm and Rodrigo E. Mendes

We assessed ceftaroline disk diffusion breakpoints for Staphylococcus aureus when applying revised Clinical and Laboratory Standards Institute (CLSI) ceftaroline MIC breakpoints. Disk-MIC correlation was evaluated by testing a challenge collection (n = 158) of methicillin-resistant S. aureus (MRSA) isolates composed of 106 randomly selected isolates plus 52 isolates with decreased susceptibility to ceftaroline (MIC, 1 to 16 μg/ml). Disk diffusion was performed with 30-μg disks and Mueller-Hinton agar from 2 manufacturers each. Revised CLSI susceptible (S)/susceptible dose-dependent (SDD)/resistant (R) MIC breakpoints of ≤1/2 to 4/≥8 μg/ml were applied. The disk breakpoints that provided the lowest error rates were CLSI S/R breakpoints of ≥25 mm/≤19 mm, with no very major (VM) or major (Ma) errors and with minor (Mi) error rates of 0.0% for ≥2 doubling dilutions above the I or SDD (≥I + 2), 22.1% for I or SDD plus or minus 1 doubling dilution (I ± 1), and 2.3% for ≤2 doubling dilutions below the I or SDD ≤I − 2 (overall Mi error rate, 16.5%). No mutation in the penicillin-binding protein 2a (PBP2a) was observed in 5 of 15 isolates with a ceftaroline MIC of 2 μg/ml; 3 of 11 isolates with a ceftaroline MIC of 1 μg/ml exhibited mutations in the penicillin-binding domain (PBD; 1 isolate) or in the non-PBD (2 isolates). All isolates except 1, with a ceftaroline MIC of ≥4 μg/ml, showed ≥1 mutation in the PBD and/or non-PBD. In summary, results from the disk diffusion method showed a good correlation with those from the reference broth microdilution method. Our results also showed that the ceftaroline MIC distribution of isolates with no mutations in the PBP2a goes up to 4 μg/ml, and reference broth microdilution and disk diffusion methods do not properly separate wild-type from non-wild-type isolates.



November 28, 2018 at 3:14 pm

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