Tuesday, December 30, 2008

Methicillin-Resistant Staphylococcus aureau Infections

Methicillin-Resistant Staphylococcus aureau Infections
Top HIV Med. 2008 Dec-2009

Bartlett JG.
The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection is epidemic in the community, differs from nosocomial MRSA in virulence, mechanisms, and antibiotic susceptibility, and exhibits diverse and often unique pathologic characteristics. The community-acquired MRSA USA 300 strains are transmitted largely by person-to-person contact and cause characteristic soft-tissue abscesses and, less commonly, other sometimes unusual and serious infections including a necrotizing pneumonia, and other necrotic infections such as necrotizing fasciitis, pelvic thrombophlebitis, and septic phlebitis. This MRSA 300 family remains susceptible to drugs active against nosocomial MRSA (ie, vancomycin, linezolid, daptomycin) and is often susceptible to trimethoprim-sulfamethoxazole, doxycycline, and clindamycin. Recent epidemiologic data indicate that nosocomial MRSA (eg, mainly USA 100) strains are also present in the community and that MRSA USA 300 strains are present in hospital settings, with both families found in intermediate frequency in health care-associated settings (eg, nursing homes, dialysis centers). More work is needed to identify effective barrier precautions to limit their spread. This article summarizes a presentation on MRSA made by John G. Bartlett, MD, at the 11th Annual Clinical Update for the Ryan White HIV/AIDS Program Clinicians held in August 2008 in Washington, DC. The original presentation is available as a Webcast at

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