- Email: [email protected]
Antibiotics Susceptibility Commonality for Community Acquired Methicillin-Resistant Staphylococcus aureus vs Hospital Acquired Methicillin-Resistant Staphylococcus aureus
E152
Vol. 34 No. 5
CONCLUSIONS: Clostridium difficile associated mortality has increased significantly. Although the RR of death associated with Clostridium difficile was . 1, statistical significance was not acheived. The higher death rate may reflect a combination of increased case load and greater virulence. Further study is clearly warranted. Enhanced attention to judicious antibiotic use in susceptable patients is imperative to reduce the frequency of this lethal illness.
Publication Number 21-186
Antibiotics Susceptibility Commonality for Community Acquired Methicillin-Resistant Staphylococcus aureus vs Hospital Acquired Methicillin-Resistant Staphylococcus aureus FD Valena, RN, MSN, CIC SM Smith, PhD, RHK Eng, MD MH McLeod-Douse, RN, MSN, MPA Department of Veterans Affair, New Health Care System, East Orange, NJ, USA ISSUE: Staphylococcus aureus is a major pathogenic microorganism with a wide spectrum of manifestations in clinical conditions, such as wound infections, pneumonia, septicemia, and endocarditis. Traditionally, Beta-lactam antibiotics were the drugs of choice for the treatment of Staphylococcus aureus. Since the introduction of methicillin into clinical use, Methicillin-resistant Staphylococcus aureus (MRSA) strains have emerged. Historically, MRSA was associated with health care facilities; however, there are increasing reports of MRSA being isolated from the community. The Center for Disease Control and Prevention (CDC) defines the community isolates as those acquired by persons who have not been recently (within the past year) hospitalized or, had an invasive medical procedure. Unlike hospital strains these community strains have tended to be susceptible to other antibiotic classes, and often are resistant only to beta-lactam antibiotics. The aim of this investigation was to identify commonality in antibiotic susceptibility in community acquired methicillin-resistant Staphylococcus. aureus (CA-MRSA). PROJECT: A retrospective review from January 2003 to December 2005 of patients in the VA New Jersey Health Care System diagnosed with MRSA was performed. One hundred and three cases were identified as CA-MRSA according to the CDC definition. The antibiotic susceptibility was then evaluated for commonality. RESULTS: Of the 103 cases 25% were found to be susceptible to Clindamycin. Of the other 75% the sensitivities were as follows: Vancomycin (Vanco)100%, Tetracycline((Tet) 88%, Trimethoprim-Sulfamethoxazole (Sxt) 85%, Erythromycin (Ery) 6%, Rifampin (Rif)79%, Ciprofloxacin (Cipro) 12% and Gatifloxacin (Gat) 14%. LESSONS LEARNED: Most CA-MRSA isolates seen at our facility were susceptible to multiple antimicrobial classes (includingTrimethoprim-sulfamethoxazole, Tetracyclines, Clindamycin), treatment of CA-MRSA infections should not routinely require the use of Vancomycin. Epidemiologically the CA-MRSA isolates were very resistant to the quinolones.
Antibiotics Susceptibility
HAMRSA CA-MRSA
# of cases
Clind
Tet
Ery
Rif
67 103
4% 25%
96% 88%
4% 6%
97% 79%
Cipro
Gat
3% 12%
5% 14%
Vol. 34 No. 5
CONCLUSIONS: Clostridium difficile associated mortality has increased significantly. Although the RR of death associated with Clostridium difficile was . 1, statistical significance was not acheived. The higher death rate may reflect a combination of increased case load and greater virulence. Further study is clearly warranted. Enhanced attention to judicious antibiotic use in susceptable patients is imperative to reduce the frequency of this lethal illness.
Publication Number 21-186
Antibiotics Susceptibility Commonality for Community Acquired Methicillin-Resistant Staphylococcus aureus vs Hospital Acquired Methicillin-Resistant Staphylococcus aureus FD Valena, RN, MSN, CIC SM Smith, PhD, RHK Eng, MD MH McLeod-Douse, RN, MSN, MPA Department of Veterans Affair, New Health Care System, East Orange, NJ, USA ISSUE: Staphylococcus aureus is a major pathogenic microorganism with a wide spectrum of manifestations in clinical conditions, such as wound infections, pneumonia, septicemia, and endocarditis. Traditionally, Beta-lactam antibiotics were the drugs of choice for the treatment of Staphylococcus aureus. Since the introduction of methicillin into clinical use, Methicillin-resistant Staphylococcus aureus (MRSA) strains have emerged. Historically, MRSA was associated with health care facilities; however, there are increasing reports of MRSA being isolated from the community. The Center for Disease Control and Prevention (CDC) defines the community isolates as those acquired by persons who have not been recently (within the past year) hospitalized or, had an invasive medical procedure. Unlike hospital strains these community strains have tended to be susceptible to other antibiotic classes, and often are resistant only to beta-lactam antibiotics. The aim of this investigation was to identify commonality in antibiotic susceptibility in community acquired methicillin-resistant Staphylococcus. aureus (CA-MRSA). PROJECT: A retrospective review from January 2003 to December 2005 of patients in the VA New Jersey Health Care System diagnosed with MRSA was performed. One hundred and three cases were identified as CA-MRSA according to the CDC definition. The antibiotic susceptibility was then evaluated for commonality. RESULTS: Of the 103 cases 25% were found to be susceptible to Clindamycin. Of the other 75% the sensitivities were as follows: Vancomycin (Vanco)100%, Tetracycline((Tet) 88%, Trimethoprim-Sulfamethoxazole (Sxt) 85%, Erythromycin (Ery) 6%, Rifampin (Rif)79%, Ciprofloxacin (Cipro) 12% and Gatifloxacin (Gat) 14%. LESSONS LEARNED: Most CA-MRSA isolates seen at our facility were susceptible to multiple antimicrobial classes (includingTrimethoprim-sulfamethoxazole, Tetracyclines, Clindamycin), treatment of CA-MRSA infections should not routinely require the use of Vancomycin. Epidemiologically the CA-MRSA isolates were very resistant to the quinolones.
Antibiotics Susceptibility
HAMRSA CA-MRSA
# of cases
Clind
Tet
Ery
Rif
67 103
4% 25%
96% 88%
4% 6%
97% 79%
Cipro
Gat
3% 12%
5% 14%