Tuesday, December 30, 2008
Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry?
Clin Oral Investig. 2008 Dec 23
Zimmerli M, Widmer AF, Dangel M, Filippi A, Frei R, Meyer J.
Department of Oral Surgery, Oral Radiology and Oral Medicine, School of Dental Medicine, University of Basel, Basel, Switzerland.
We assessed the frequency of carriers of methicillin-resistant Staphylococcus aureus (MRSA) among 500 dental patients of a university clinic. From each participant, two specimens were taken from the anterior nares and the pharynx and analysed by culture. The participants completed a questionnaire on possible risk factors of MRSA infection. Two hundred ten individuals carried S. aureus, 90 in the nares only, 51 in the throat only and 69 in nares and throat. Isolates of 208 patients were methicillin-sensitive; two isolates were methicillin-resistant, both carried in the throat exclusively. In conclusion, the frequency of nasal and/or throat carriers of MRSA among dental patients was low and suggests few opportunities of exposure in the dental clinic assessed.
Top HIV Med. 2008 Dec-2009
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 website.
Topics in HIV Medicine
Spine J. 2008 Dec 26
Department of Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH 45409, USA.
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is increasingly common. Treatment with vancomycin-based therapy is often unsuccessful. Daptomycin is a relatively new lipopeptide antibiotic with potent activity against MRSA.
PURPOSE: To describe the successful management of MRSA infection involving the spine.
STUDY DESIGN: Two case reports of MRSA infection, one involving epidural and lumbar subdural abscesses, the other with osteomyelitis and discitis.
METHODS: Two cases are described, one with lumbar epidural and subdural abscesses and the other with osteomyelitis and discitis of the spine. Switching from vancomycin to daptomycin plus rifampin-based therapy resulted in patient improvement that allowed discharge from the hospital.
RESULTS: Both patients recovered fully from their infection.
CONCLUSIONS: Daptomycin is a safe and effective option for the treatment of MRSA infection involving the spine.
PMID: 19112049 [PubMed - as supplied by publisher]