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Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus Aureus Infections in Adults and Children: Executive Summary

Department of Medicine, Division of Infectious Diseases, University of California-San Francisco, San Francisco, California 94102, USA.
Clinical Infectious Diseases (Impact Factor: 9.42). 02/2011; 52(3):285-92. DOI: 10.1093/cid/cir034
Source: PubMed

ABSTRACT Evidence-based guidelines for the management of patients with methicillin-resistant Staphylococcus aureus (MRSA) infections were prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). The guidelines are intended for use by health care providers who care for adult and pediatric patients with MRSA infections. The guidelines discuss the management of a variety of clinical syndromes associated with MRSA disease, including skin and soft tissue infections (SSTI), bacteremia and endocarditis, pneumonia, bone and joint infections, and central nervous system (CNS) infections. Recommendations are provided regarding vancomycin dosing and monitoring, management of infections due to MRSA strains with reduced susceptibility to vancomycin, and vancomycin treatment failures.

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    • "the management of these infections is still not consensual [12] [13]. Our aim is to report an adolescent with a severe, lifethreatening infection by a multiresistant PVL negative MRSA acquired in the community whose treatment was difficult, but successful. "
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    ABSTRACT: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging public health problem worldwide. Severe invasive infections have been described, mostly associated with the presence of Panton-Valentine leukocidin (PVL). In Portugal limited information exists regarding CA-MRSA infections. In this study we describe the case of a previously healthy 12-year-old female, sport athlete, who presented to the hospital with acetabulofemoral septic arthritis, myositis, fasciitis, acetabulum osteomyelitis, and pneumonia. The MRSA isolated from blood and synovial fluid was PVL negative and staphylococcal enterotoxin type P (SEP) and type L (SEL) positive, with a vancomycin MIC of 1.0 mg/L and resistant to clindamycin and ciprofloxacin. The patient was submitted to multiple surgical drainages and started on vancomycin, rifampicin, and gentamycin. Due to persistence of fever and no microbiological clearance, linezolid was started with improvement. This is one of the few reported cases of severe invasive infection caused by CA-MRSA in Portugal, which was successfully treated with linezolid. In spite of the severity of infection, the MRSA isolate did not produce PVL.
    02/2013; 2013:727824. DOI:10.1155/2013/727824
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    • "Sir, Vancomycin is commonly used intravenously to treat serious Gram-positive infections involving meticillin-resistant Staphylococcus aureus (MRSA) [1]. The wide interindividual variability in pharmacokinetics requires individualised dosing to achieve therapeutic targets. "
    International journal of antimicrobial agents 01/2013; 43(2). DOI:10.1016/j.ijantimicag.2013.10.007 · 4.26 Impact Factor
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    • "Hence, specific management based on the presence of PVL may not be required for mild infections, whereas it could be life-saving for more severe disease. Moreover, although recommendations for the management of PVL-associated disease and/or for CA-MRSA infections have been published by public health authorities in several countries [12] [13] [14], most of these diseases are recently identified entities and a 'gold standard' treatment based on comparative studies of different therapeutic options is lacking. Thus, recommendations are based on expert opinions, which are based on theory, in vitro data and analogies with other toxin-mediated diseases. "
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    ABSTRACT: Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus is associated with a broad spectrum of diseases, ranging from common uncomplicated soft tissue infections to severe diseases such as complicated soft tissue infections, extensive bone and joint infections, and necrotising pneumonia. Specialised management of infection based on the presence of PVL may not be required for mild infections, whereas it could be lifesaving in other settings. Moreover, most severe PVL diseases are recently identified entities and a 'gold standard' treatment from comparatives studies of different therapeutic options is lacking. Thus, recommendations are based on expert opinions, which are elaborated based on theory, in vitro data and analogies with other toxin-mediated diseases. In this review, we consider the potential need for specialised PVL-based management and, if required, which tools should be used to achieve optimal management.
    International journal of antimicrobial agents 07/2011; 38(6):457-64. DOI:10.1016/j.ijantimicag.2011.05.003 · 4.26 Impact Factor
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