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Methicillin-Resistant Staphylococcus aureus: HELP
Articles from University of Texas Houston
Based on 105 articles published since 2009
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These are the 105 published articles about Methicillin-Resistant Staphylococcus aureus that originated from University of Texas Houston during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Review Gram-Positive Bacterial Infections: Research Priorities, Accomplishments, and Future Directions of the Antibacterial Resistance Leadership Group. 2017

Doernberg, Sarah B / Lodise, Thomas P / Thaden, Joshua T / Munita, Jose M / Cosgrove, Sara E / Arias, Cesar A / Boucher, Helen W / Corey, G Ralph / Lowy, Franklin D / Murray, Barbara / Miller, Loren G / Holland, Thomas L / Anonymous3940901. ·Division of Infectious Diseases, University of California, San Francisco. · Albany College of Pharmacy and Health Sciences, New York. · Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina. · Division of Infectious Diseases, University of Texas Health Sciences Center, Houston. · Clinica Alemana, Universidad del Desarrollo, Chile. · Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland. · Center for Antimicrobial Resistance and Microbial Genomics, Division of Infectious Diseases, University of Texas Health Sciences Center, Houston. · Division of Infectious Diseases, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts. · Division of Infectious Diseases, Columbia University Medical Center, New York, New York. · Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California; and. · Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina. ·Clin Infect Dis · Pubmed #28350900.

ABSTRACT: Antimicrobial resistance in gram-positive bacteria remains a challenge in infectious diseases. The mission of the Gram-Positive Committee of the Antibacterial Resistance Leadership Group (ARLG) is to advance knowledge in the prevention, management, and treatment of these challenging infections to improve patient outcomes. Our committee has prioritized projects involving methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) due to the scope of the medical threat posed by these pathogens. Approved ARLG projects involving gram-positive pathogens include (1) a pharmacokinetics/pharmacodynamics study to evaluate the impact of vancomycin dosing on patient outcome in MRSA bloodstream infection (BSI); (2) defining, testing, and validating innovative assessments of patient outcomes for clinical trials of MRSA-BSI; (3) testing new strategies for "step-down" antibiotic therapy for MRSA-BSI; (4) management of staphylococcal BSIs in neonatal intensive care units; and (5) defining the impact of VRE bacteremia and daptomycin susceptibility on patient outcomes. This article outlines accomplishments, priorities, and challenges for research of infections caused by gram-positive organisms.

2 Review Mechanism of Action and Resistance to Daptomycin in Staphylococcus aureus and Enterococci. 2016

Miller, William R / Bayer, Arnold S / Arias, Cesar A. ·University of Texas Medical School at Houston, Department of Internal Medicine, Division of Infectious Diseases, Houston, Texas 77030. · Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California 90502. · David Geffen School of Medicine at UCLA, Los Angeles, California 90095. · Department of Microbiology and Molecular Genetics, Houston, Texas 77030. · Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia. · International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. ·Cold Spring Harb Perspect Med · Pubmed #27580748.

ABSTRACT: Lipopeptides are natural product antibiotics that consist of a peptide core with a lipid tail with a diverse array of target organisms and mechanisms of action. Daptomycin (DAP) is an example of these compounds with specific activity against Gram-positive organisms. DAP has become increasingly important to combat infections caused by Gram-positive bacteria because of the presence of multidrug resistance in these organisms, particularly in methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). However, emergence of resistance to DAP during therapy is a well-described phenomenon that threatens the clinical use of this antibiotic, limiting further the therapeutic options against both MRSA and VRE. This work will review the historical aspects of the development of DAP, as well as the current knowledge on its mechanism of action and pathways to resistance in a clinically relevant context.

3 Review Shoe soles as a potential vector for pathogen transmission: a systematic review. 2016

Rashid, T / VonVille, H M / Hasan, I / Garey, K W. ·University of Houston College of Pharmacy, Houston, TX, USA. · The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA. · University of Edinburgh, Edinburgh, UK. · University of Houston College of Pharmacy, Houston, TX, USA. kgarey@uh.edu. · The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA. kgarey@uh.edu. ·J Appl Microbiol · Pubmed #27495010.

ABSTRACT: Shoe soles are possible vectors for infectious diseases. Although studies have been performed to assess the prevalence of infectious pathogens on shoe soles and decontamination techniques, no systematic review has ever occurred. The aim of this study was to perform a systematic review of the literature to determine the prevalence of infectious agents on shoe bottoms and possible decontamination strategies. Three electronic bibliographic databases were searched using a predefined search strategy evaluating prevalence of infectious pathogens on shoe bottoms and decontamination strategies. Quality assessment was performed independently by two reviews with disagreements resolved by consensus. Thirteen studies were identified that supported the hypothesis that shoe soles are a vector for infectious pathogens. Methicillin-resistant Staphylococcus aureus, Clostridium difficile and multidrug-resistant Gram-negative species among other pathogens were documented on shoe bottoms in the health care setting, in the community and among food workers. Fifteen studies were identified that investigated decontamination strategies for shoe soles. A number of decontamination strategies have been studied of which none have been shown to be consistently successful at disinfecting shoe soles. In conclusion, a high prevalence of microbiological pathogens was identified from shoe soles studied in the health care, community and animal worker setting. An effective decontamination strategy for shoe soles was not identified. Studies are needed to assess the potential for contaminated shoes to contribute to the transmission of infectious pathogens.

4 Review Right-Sided Infective Endocarditis and Pulmonary Infiltrates: An Update. 2016

Chahoud, Jad / Sharif Yakan, Ahmad / Saad, Hala / Kanj, Souha S. ·From the *Department of Internal Medicine, School of Medicine, University of Texas Health Science Center, Houston, TX; †Division of Cardiology, Department of Internal Medicine, University Hospital Rostock, Rostock, Germany; and ‡Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. ·Cardiol Rev · Pubmed #26501991.

ABSTRACT: Sixty years after its initial description, right-sided infective endocarditis (RSIE) still poses a challenge to all medical practitioners. Epidemiological data reveal a rising incidence attributable to the global surge in the number of intravenous drug users and the increased use of central vascular catheters and implantable cardiac devices. RSIE differs from left-sided infective endocarditis in more than just the location of the involved cardiac valve. They have different clinical presentations, diagnostic findings, and prognoses; hence, they require different management strategies. Cardiac murmurs and systemic emboli are usually absent in RSIE, whereas pulmonary embolism and its related complications dominate the clinical picture. Diagnostic delay of RSIE is secondary to the similarity in its initial presentation to other entities. Complications may ensue as a result of this delay. Diagnosis can be initially confirmed by using transthoracic echocardiography, except in patients with implanted cardioverter defibrillator, where a transesophageal echocardiogram is necessary. Various factors may increase mortality and morbidity in RSIE such as tricuspid valve vegetation size, fungal etiology, and low CD4 cell count in HIV patients. Oxacillin and vancomycin had been the traditionally used agents for the treatment of methicillin-susceptible and methicillin-resistant Staphylococcus aureus, respectively. More recently, daptomycin has shown promising results, which has led to its Food and Drug Administration (FDA) approval for the treatment of S. aureus bacteremia and associated RSIE. The aim of this article is to provide a comprehensive update on RSIE including epidemiology, pathogenesis, microbiology, diagnosis, management, and prognosis.

5 Review Low-shear force associated with modeled microgravity and spaceflight does not similarly impact the virulence of notable bacterial pathogens. 2014

Rosenzweig, Jason A / Ahmed, Sandeel / Eunson, John / Chopra, Ashok K. ·Department of Biology and Center for Bionanotechnology and Environmental Research, Texas Southern University, 3100 Cleburne Street, Houston, TX, 77004, USA, rosenzweigja@tsu.edu. ·Appl Microbiol Biotechnol · Pubmed #25149449.

ABSTRACT: As their environments change, microbes experience various threats and stressors, and in the hypercompetitive microbial world, dynamism and the ability to rapidly respond to such changes allow microbes to outcompete their nutrient-seeking neighbors. Viewed in that light, the very difference between microbial life and death depends on effective stress response mechanisms. In addition to the more commonly studied temperature, nutritional, and chemical stressors, research has begun to characterize microbial responses to physical stress, namely low-shear stress. In fact, microbial responses to low-shear modeled microgravity (LSMMG), which emulates the microgravity experienced in space, have been studied quite widely in both prokaryotes and eukaryotes. Interestingly, LSMMG-induced changes in the virulence potential of several Gram-negative enteric bacteria, e.g., an increased enterotoxigenic Escherichia coli-mediated fluid secretion in ligated ileal loops of mice, an increased adherent invasive E. coli-mediated infectivity of Caco-2 cells, an increased Salmonella typhimurium-mediated invasion of both epithelial and macrophage cells, and S. typhimurium hypervirulence phenotype in BALB/c mice when infected by the intraperitoneal route. Although these were some examples where virulence of the bacteria was increased, there are instances where organisms became less virulent under LSMMG, e.g., hypovirulence of Yersinia pestis in cell culture infections and hypovirulence of methicillin-resistant Staphylococcus aureus, Enterococcus faecalis, and Listeria monocytogenes in a Caenorhabditis elegans infection model. In general, a number of LSMMG-exposed bacteria (but not all) seemed better equipped to handle subsequent stressors such as osmotic shock, acid shock, heat shock, and exposure to chemotherapeutics. This mini-review primarily discusses both LSMMG-induced as well as bona fide spaceflight-specific alterations in bacterial virulence potential, demonstrating that pathogens' responses to low-shear forces vary dramatically. Ultimately, a careful characterization of numerous bacterial pathogens' responses to low-shear forces is necessary to evaluate a more complete picture of how this physical stress impacts bacterial virulence since a "one-size-fits-all" response is clearly not the case.

6 Review [Resistance to "last resort" antibiotics in Gram-positive cocci: The post-vancomycin era]. 2014

Rincón, Sandra / Panesso, Diana / Díaz, Lorena / Carvajal, Lina P / Reyes, Jinnethe / Munita, José M / Arias, César A. ·Unidad de Genética y Resistencia Antimicrobiana (UGRA), Universidad El Bosque, Bogotá, D.C, Colombia. · University of Texas Medical School at Houston, Houston, TX, USA. · Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago de Chile, Chile. ·Biomedica · Pubmed #24968051.

ABSTRACT: New therapeutic alternatives have been developed in the last years for the treatment of multidrug-resistant Gram-positive infections. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are considered a therapeutic challenge due to failures and lack of reliable antimicrobial options. Despite concerns related to the use of vancomycin in the treatment of severe MRSA infections in specific clinical scenarios, there is a paucity of solid clinical evidence that support the use of alternative agents (when compared to vancomycin). Linezolid, daptomycin and tigecycline are antibiotics approved in the last decade and newer cephalosporins (such as ceftaroline and ceftobiprole) and novel glycopeptides (dalvavancin, telavancin and oritavancin) have reached clinical approval or are in the late stages of clinical development. This review focuses on discussing these newer antibiotics used in the "post-vancomycin" era with emphasis on relevant chemical characteristics, spectrum of antimicrobial activity, mechanisms of action and resistance, as well as their clinical utility.

7 Review Intravenous antibiotics used in dermatology. 2012

Sambrano, Brittany / Gordon, Rachel / Mays, Rana / Lapolla, Whitney / Scheinfeld, Noah. ·University of Texas Medical School at Houston, Houston, Texas, USA. ·Dermatol Ther · Pubmed #22591500.

ABSTRACT: It is not common for dermatologists to use intravenous antibiotics in daily practice. However, there are several serious infections that may come to the attention of a dermatologist because of cutaneous signs and symptoms. It is important for dermatologists to be familiar with the presenting symptoms, various stages of disease, and treatment for such infections, as good outcomes are achieved by early recognition and use of appropriate therapy. The following section reviews the treatment, with a focus on intravenous antimicrobial therapy, for several serious infections important to dermatologists: syphilis, Rocky Mountain spotted fever, Lyme disease, cellulitis, methicillin-resistant Staphylococcus aureus, Vibrio vulnificans, and necrotizing fasciitis.

8 Review Retapamulin: what is the role of this topical antimicrobial in the treatment of bacterial infections in atopic dermatitis? 2010

Moody, M N / Morrison, L K / Tyring, S K. ·University of Texas Medical School at Houston, Houston, TX, USA. ·Skin Therapy Lett · Pubmed #20066388.

ABSTRACT: In atopic dermatitis (AD), the stratum corneum of patients appears to have alterations that predispose them to colonization and invasion by various bacteria, most notably Staphylococcus aureus (S. aureus). This bacterial co-existence is accepted to be an important factor in AD disease activity. Exactly when to initiate antimicrobial treatment is controversial, but such intervention, when warranted, has repeatedly been demonstrated to improve the course of AD. However, the increase in antibiotic resistance presents a therapeutic challenge in the management of AD patients, which highlights the need for novel mechanism topical antibacterial agents. Retapamulin is a relatively new pleuromutilin antibiotic designed for topical use. In vitro studies have demonstrated its low potential for the development of antibacterial resistance and high degree of potency against Gram-positive bacteria found in skin infections, including many S. aureus strains that are resistant to methicillin, fusidic acid, and mupirocin. Clinical studies exploring the treatment of secondarily infected dermatitis reveal that the efficacy of topical retapamulin is comparable to a 10-day course of oral cephalexin or to topical fusidic acid. Retapamulin appears to be a much needed antimicrobial option for treating the AD population due to their common carriage of bacterial pathogens and frequency of infectious complications.

9 Review Empyema necessitans and acute osteomyelitis associated with community-acquired methicillin-resistant Staphylococcus aureus in an infant. 2009

Contreras, Germán A / Pérez, Norma / Murphy, James R / Cleary, Thomas G / Heresi, Gloria P. ·Division of Pediatrics Infectious Diseases, Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX, USA. ·Biomedica · Pubmed #20440448.

ABSTRACT: Staphylococcus aureus is a well recognized pathogen with global distribution. In recent years community-associated, methicillin-resistant S. aureus has emerged as an increasing cause of severe infections among adults and children. Herein, a case is reported of a previously healthy, 19-month-old male, who presented with empyema necessitans and acute osteomyelitis due to a community-associated, methicillin-resistant, S. aureus strain. This report highlights the evolving epidemiology of S. aureus, as important pathogen in the community as well as the hospital setting, and the importance of establishing appropriate guidelines for diagnosis, management and surveillance of this public health problem.

10 Clinical Trial Methicillin-Resistant Staphylococcus aureus USA300 Latin American Variant in Patients Undergoing Hemodialysis and HIV Infected in a Hospital in Bogotá, Colombia. 2015

Hidalgo, Marylin / Carvajal, Lina P / Rincón, Sandra / Faccini-Martínez, Álvaro A / Tres Palacios, Alba A / Mercado, Marcela / Palomá, Sandra L / Rayo, Leidy X / Acevedo, Jessica A / Reyes, Jinnethe / Panesso, Diana / García-Padilla, Paola / Alvarez, Carlos / Arias, Cesar A. ·Department of Microbiology, Pontificia Universidad Javeriana, Bogotá, Colombia. · Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia. · Dirección de Vigilancia y análisis de Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia. · Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá, Colombia; Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical School at Houston, Houston, Texas, United States of America. · Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia. ·PLoS One · Pubmed #26474075.

ABSTRACT: We aimed to determine the prevalence of MRSA colonization and examine the molecular characteristics of colonizing isolates in patients receiving hemodialysis and HIV-infected in a Colombian hospital. Patients on hemodialysis and HIV-infected were prospectively followed between July 2011 and June 2012 in Bogota, Colombia. Nasal and axillary swabs were obtained and cultured. Colonizing S. aureus isolates were identified by standard and molecular techniques. Molecular typing was performed by using pulse-field gel electrophoresis and evaluating the presence of lukF-PV/lukS-PV by PCR. A total of 29% (n = 82) of HIV-infected and 45.5% (n = 15) of patients on hemodialysis exhibited S. aureus colonization. MSSA/MRSA colonization was observed in 28% and 3.6% of the HIV patients, respectively and in 42.4% and 13.3% of the hemodialysis patients, respectively. Staphylococcal cassette chromosome mec typing showed that four MRSA isolates harbored the type IV cassette, and one type I. In the hemodialysis group, two MRSA isolates were classified as belonging to the USA300-LV genetic lineage. Conversely, in the HIV infected group, no colonizing isolates belonging to the USA300-Latin American Variant (UDA300-LV) lineage were identified. Colonizing isolates recovered from the HIV-infected group belonged to the prevalent hospital-associated clones circulating in Latin America (Chilean [n = 1] and Pediatric [n = 2]). The prevalence of MRSA colonization in the study groups was 3.6% (HIV) and 13.3% (hemodialysis). Surveillance programs should be implemented in this group of patients in order to understand the dynamics of colonization and infection in high-risk patients.

11 Article Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in erythrodermic cutaneous T-cell lymphoma (CTCL) patients. 2019

Emge, Drew A / Bassett, Roland L / Duvic, Madeleine / Huen, Auris O. ·Department of Internal Medicine, Baylor College of Medicine, Houston, TX, 77030, USA. emgedrew@gmail.com. · , 1110 Orchard Oriole Lane, Durham, NC, 27713, USA. emgedrew@gmail.com. · Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. · Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. ·Arch Dermatol Res · Pubmed #31776647.

ABSTRACT: Erythroderma can occur in cutaneous T-cell lymphoma (CTCL). Staphylococcus aureus (S. aureus) prevalence is increased in CTCL patients and contributes to CTCL disease flares. Our primary aim was to describe S. aureus infections, including resistance patterns and the antibiotic treatment regimens used, in erythrodermic CTCL patients. This was a retrospective chart review of erythrodermic CTCL patients who had S. aureus infection or colonization and were treated at the UT MD Anderson Cancer Center's Melanoma Skin Center between 2012 and 2016. Twenty-six erythrodermic CTCL patients had 50 documented S. aureus colonization or infection events. Patients had an improvement in body surface area (BSA) or modified Severity Weighted Assessment Tool (mSWAT) in 53% events treated for S. aureus. Seventeen of the 50 (34%) events were due to methicillin-resistant S. aureus (MRSA). One-third (33%) of MRSA events were initially treated with dicloxacillin. The MRSA isolates were sensitive to trimethoprim-sulfamethoxazole (92%) and doxycycline (88%). Patients treated in the outpatient setting (OR 0.073; 95% CI 0.008-0.627; p = 0.017) and patients with a previous history of topical anti-S. aureus decolonization treatments before S. aureus event as stand-alone (OR 0.125; 95% CI 0.018-0.887; p = 0.038) or in combination treatment with systemic antibiotics (OR 0.094; 95% CI 0.009-0.944; p = 0.045) were less likely to see improvement in BSA or mSWAT from S. aureus treatment. Treatment of S. aureus improved CTCL skin score in a high number of erythrodermic patients. The MRSA prevalence was high in erythrodermic CTCL patients. Clinicians should consider using empiric MRSA antibiotic coverage for these patients.

12 Article Cefazolin and Ertapenem Salvage Therapy Rapidly Clears Persistent Methicillin-Susceptible Staphylococcus aureus Bacteremia. 2019

Ulloa, Erlinda R / Singh, Kavindra V / Geriak, Matthew / Haddad, Fadi / Murray, Barbara E / Nizet, Victor / Sakoulas, George. ·Collaborative to Halt Antibiotic-Resistant Microbes, Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, California, USA. · Division of Infectious Disease, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. · Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA. · Center for Antimicrobial Resistance and Microbial Genomics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA. · Sharp Memorial Hospital, San Diego, California, USA. · Sharp Grossmont Hospital, La Mesa, California, USA. · Skaggs School of Pharmacy, University of California, San Diego, La Jolla, California, USA. ·Clin Infect Dis · Pubmed #31773134.

ABSTRACT: Cefazolin and ertapenem combination therapy was used successfully to salvage 11 cases (6 endocarditis) of persistent methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, including immediate clearance (≤24 hours) in 8 cases. While in vitro synergy was modest, cefazolin plus ertapenem exhibited synergistic action in a rat model of MSSA endocarditis. The combination of cefazolin and ertapenem provides potent in vivo activity against MSSA beyond what is predicted in vitro and warrants further clinical study in the treatment of refractory MSSA bacteremia and endocarditis.

13 Article Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia. 2019

Valderrama-Beltrán, Sandra / Gualtero, Sandra / Álvarez-Moreno, Carlos / Gil, Fabian / Ruiz, Alvaro J / Rodríguez, José Yesid / Osorio, Johanna / Tenorio, Ivan / Gómez Quintero, Carlos / Mackenzie, Sebastián / Caro, María Alejandra / Zhong, Alberto / Arias, Gerson / Berrio, Indira / Martinez, Ernesto / Cortés, Gloria / De la Hoz, Alejandro / Arias, Cesar A. ·Division of Infectious Diseases, Department of Internal Medicine, Hospital Universitario San Ignacio, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia. Electronic address: slvalderrama@husi.org.co. · Division of Infectious Diseases, Department of Internal Medicine, Hospital Universitario San Ignacio, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia. · Department of Internal Medicine, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia; Clínica Universitaria Colombia, Bogotá, Colombia. · Department of Clinical Epidemiology, Pontificia Universidad Javeriana, Bogotá, Colombia. · Division of Infectious Diseases, Hospital Rosario Pumarejo Lopez, Valledupar, Colombia; Division of Infectious Diseases, Clínica Médicos LTDA, Clinica Laura Daniela, Valledupar, Colombia. · Division of Infectious Diseases, Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia. · Division of Infectious Diseases, Clínica Universitaria San Juan de Dios, Cartagena, Colombia. · Division of Infectious Diseases, Clínica de la Mujer, Bogota, Colombia. · Division of Infectious Diseases, Hospital Santa Clara, Bogotá, Colombia. · Division of Infectious Diseases, Clínica El Rosario, Hospital General de Medellin "Luz Castro de Gutiérrez" ESE, Medellín, Colombia. · Division of Infectious Diseases, Hospital Universitario del Valle, Cali, Colombia. · Division of Clinical Laboratory, Hospital Universitario San Ignacio, Bogotá, Colombia. · Division of Infectious Diseases, Department of Internal Medicine, Department of Microbiology and Molecular Genetics, UTHealth McGovern Medical School, Houston, TX, USA; Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia; Center for Infectious Diseases, UTHealth, School of Public Health, Houston, TX, USA. ·Int J Infect Dis · Pubmed #31330321.

ABSTRACT: OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) represent a major clinical problem in Colombia. The aim of this study was to evaluate the risk factors associated with MRSA SSTI in Colombia. METHODS: A multicenter cohort study with nested case-control design was performed. Patients with an SSTI with at least 48h of inpatient care were included. Patients with an MRSA SSTI were considered the case group and patients with either a non-MRSA SSTI or with an Methicillin-susceptible S. aureus (MSSA) SSTI were the control groups. A multivariate logistic regression approach was used to evaluate risk factors associated with MRSA SSTI with two different statistical models. RESULTS: A total 1134 patients were included. Cultures were positive for 498 patients, of which 52% (n=259) were Staphylococcus aureus. MRSA was confirmed in 68.3% of the S. aureus cultures. In the first model, independent risk factors for MRSA SSTI were identified as the presence of abscess (P<0.0001), cellulitis (P=0.0007), age 18-44 years (P=0.001), and previous outpatient treatment in the previous index visit (P=0.003); surgical site infection was a protective factor (P=0.008). In the second model, the main risk factor found was previous outpatient treatment in the previous index visit (P=0.013). CONCLUSIONS: Community-acquired SSTIs in Colombia are commonly caused by MRSA. Therefore, clinicians should consider MRSA when designing the initial empirical treatment for purulent SSTI in Colombia, although there seems to be low awareness of this fact.

14 Article A Multicenter Study To Evaluate Ceftaroline Breakpoints: Performance in an Area with High Prevalence of Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Lineage. 2019

Khan, Ayesha / Rivas, Lina M / Spencer, Maria / Martinez, Rodrigo / Lam, Marusella / Rojas, Pamela / Porte, Lorena / Silva, Francisco / Braun, Stephanie / Valdivieso, Francisca / Mv Lhauser, Margareta / Lafourcade, Mónica / Miller, William R / García, Patricia / Arias, Cesar A / Munita, Jose M. ·Center for Antimicrobial Resistance and Microbial Genomics and Division of Infectious Diseases, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA. · Department of Microbiology and Molecular Genetics, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA. · MD Anderson Cancer Center, UT Health Graduate School of Biomedical Sciences, Houston, Texas, USA. · Genomics and Resistant Microbes Group, Facultad de Medicina-Clinica Alemana, Universidad del Desarrollo, Santiago, Chile. · Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Millennium Science Initiative, Santiago, Chile. · Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. · Hospital Padre Hurtado, Santiago, Chile. · Hospital Clínico Universidad de Chile, Santiago, Chile. · Hospital Militar, Santiago, Chile. · Hospital Dr. Luis Calvo Mackenna, Santiago, Chile. · Hospital Dipreca, Santiago, Chile. · Clínica Santa María, Santiago, Chile. · Center for Antimicrobial Resistance and Microbial Genomics and Division of Infectious Diseases, University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA Cesar.Arias@uth.tmc.edu Jose.M.Munita@uth.tmc.edu. · Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogotá, Colombia. · Center for Infectious Diseases, University of Texas Health Science Center, School of Public Health, Houston, Texas, USA. ·J Clin Microbiol · Pubmed #31315958.

ABSTRACT: Ceftaroline (CPT) is a broad-spectrum agent with potent activity against methicillin-resistant

15 Article Skin and Soft Tissue Infection in People Living with HIV in a Large Urban Public Health Care System in Houston, TX, 2009-2014. 2019

Hemmige, Vagish / Arias, Cesar A / Pasalar, Siavash / Giordano, Thomas P. ·Division of Infectious Diseases, Montefiore Medical Center, Bronx, NY. · Albert Einstein College of Medicine, Bronx, NY. · Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, UTHealth McGovern Medical School, Houston, TX. · Center for Infectious Diseases, UTHealth, School of Public Health, Houston, TX. · Molecular Genetics and Antimicrobial Resistance Unit-International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. · Harris Health System, Houston, TX. · Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX. · Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX. ·Clin Infect Dis · Pubmed #31209457.

ABSTRACT: BACKGROUND: Skin and soft tissue infections (SSTIs) disproportionately impact patients with HIV.  Recent declines in the incidence of SSTIs have been noted in the non-HIV population.  We sought to study the epidemiology and microbiology of SSTIs in a population of 8,597 patients followed for HIV primary care in a large urban county system from January 2009 to December 2014. METHODS: SSTIs were identified from the electronic medical record (EMR) by use of ICD-9 billing codes.  Charts were reviewed to confirm the diagnosis of acute SSTI and abstract culture and susceptibility data.  We calculated yearly SSTI incidence using Poisson regression with clustering by patient. RESULTS: 2,202 SSTIs were identified. Of 503 (22.8%) cultured SSTIs, 332 (66.0%) recovered Staphylococcus aureus as a pathogen, of which 287/332 (86.4%) featured S. aureus as the sole isolated organism. Among the S. aureus isolates that exhibited antibiotic susceptibilities, 231/331 (69.8%) were methicillin resistant, and the proportion did not change by year. The observed incidence of SSTI was 78.0 per 1,000 person-years (95% CI 72.9-83.4) and declined from 96.0 infections per 1,000 person-years in 2009 to 56.5 infections per 1000 person-years in 2014 (p<0.001). Other significant predictors of SSTI incidence in both univariate as well as multivariate analysis included low CD4 count, high viral load, and not being a Spanish-speaking Hispanic. CONCLUSIONS: SSTIs remain a significant problem in the outpatient HIV-infected population, although rates of SSTI appear to have declined approximately 40% between 2009 and 2014.

16 Article Genomic and Epidemiological Evidence of a Dominant Panton-Valentine Leucocidin-Positive Methicillin Resistant 2019

McTavish, Sharla M / Snow, Sarah J / Cook, Ellie C / Pichon, Bruno / Coleman, Sarah / Coombs, Geoffrey W / Pang, Stanley / Arias, Cesar A / Díaz, Lorena / Boldock, Emma / Davies, Steve / Udukala, Mangala / Kearns, Angela Marie / Siribaddana, Sisira / de Silva, Thushan I. ·Healthcare Associated Infections and Antimicrobial Resistance AMR Division, National Infection Service, Public Health England, London, United Kingdom. · The Florey Institute for Host-Pathogen Interactions and Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom. · Department of Microbiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. · Antimicrobial Resistance and Infectious Diseases Research Laboratory, School of Veterinary Life Sciences, Murdoch University, Murdoch, WA, Australia. · Center for Antimicrobial Resistance and Microbial Genomics and Division of Infectious Diseases, UTHealth, McGovern Medical School, Houston, TX, United States. · Center for Infectious Diseases, UTHealth School of Public Health, Houston, TX, United States. · Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. · Anuradhapura Teaching Hospital, Anuradhapura, Sri Lanka. · Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Mihintale, Sri Lanka. · Department of Medicine, Wright Fleming Institute, Imperial College London, London, United Kingdom. ·Front Cell Infect Microbiol · Pubmed #31080781.

ABSTRACT:

17 Article Use of Ceftaroline Fosamil in Osteomyelitis: CAPTURE Study Experience. 2019

Johnson, Leonard B / Ramani, Ananthakrishnan / Guervil, David J. ·Ascension St. John Hospital and Medical Center and Wayne State University School of Medicine, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI, 48236, USA. Leonard.Johnson@ascension.org. · Columbia Memorial Hospital, Hudson, NY, USA. · Memorial Hermann-Texas Medical Center, Houston, TX, USA. ·BMC Infect Dis · Pubmed #30791894.

ABSTRACT: BACKGROUND: Osteomyelitis is often challenging to treat. This analysis examined the clinical experience of patients with gram-positive osteomyelitis treated with ceftaroline fosamil in the phase 4 Clinical Assessment Program and Teflaro® Utilization Registry (CAPTURE) study. METHODS: Data including patient demographics, past illnesses, risk factors, disease characteristics, antibiotic use, pathogens isolated, and clinical outcome were collected between September 2013 and February 2015 by review of randomly ordered patient charts from participating sites in the United States. Clinical success was defined as discontinuation of ceftaroline fosamil following clinical cure with no further need for antibiotics or clinical improvement with switch to another antibiotic treatment. RESULTS: A total of 150 patients with gram-positive osteomyelitis were treated with ceftaroline fosamil. Most patients (117/150; 78.0%) were treated with 600 mg ceftaroline fosamil per dose; 143/150 patients (95.3%) received a dose every 12 h. The majority (89/150 patients; 59.3%) had been previously diagnosed with diabetes mellitus or peripheral arterial disease. Osteomyelitis was associated with hardware in 32/150 patients (21.3%). Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA; MSSA) were the most commonly isolated pathogens, observed in 93/150 (62.0%) and 21/150 (14.0%) patients, respectively. Clinical success with ceftaroline fosamil therapy was observed in 139/150 (92.7%) patients overall, 81/89 (91.0%) patients with diabetes or peripheral arterial disease, and 18/20 (90.0%) patients who had hardware implanted before ceftaroline fosamil therapy (none had hardware removed during therapy). Patients who received prior antibiotic therapy or ceftaroline fosamil as monotherapy experienced clinical success rates of 93.9% (107/114) and 91% (91/100), respectively. Among patients who received concurrent antibiotic therapy, the clinical success rate was 96.0% (48/50). Patients who were infected with MRSA or MSSA had clinical success rates of 92.5% (86/93) and 100% (21/21), respectively. A total of 2/150 (1.3%) patients discontinued ceftaroline fosamil therapy because of adverse events. CONCLUSIONS: Clinical success rates with ceftaroline fosamil were high in patients with gram-positive osteomyelitis, including those with diabetes or peripheral arterial disease and those with MRSA or MSSA.

18 Article Efficacy of Tedizolid against Enterococci and Staphylococci, Including 2019

Singh, Kavindra V / Arias, Cesar A / Murray, Barbara E. ·Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA kavindra.singh@uth.tmc.edu. · UTHealth Center for Antimicrobial Resistance and Microbial Genomics (CARMiG), Houston, Texas, USA. · Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA. · Department of Microbiology and Molecular Genetics, University of Texas Medical School at Houston, Houston, Texas, USA. · Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogota, Colombia. · Center for Infectious Diseases, University of Texas Health Science Center, School of Public Health, Houston, Texas, USA. ·Antimicrob Agents Chemother · Pubmed #30670435.

ABSTRACT: In a mouse peritonitis model, tedizolid was comparable to linezolid and daptomycin against an

19 Article Adjuvant β-Lactam Therapy Combined with Vancomycin for Methicillin-Resistant 2019

Dilworth, Thomas J / Casapao, Anthony M / Ibrahim, Omar M / Jacobs, David M / Bowers, Dana R / Beyda, Nicholas D / Mercier, Renee-Claude. ·Aurora Health Care, Department of Pharmacy Services, Milwaukee, Wisconsin, USA thomas.dilworth@aurora.org. · University of Florida College of Pharmacy, Jacksonville, Florida, USA. · Independent Researcher, Gainesville, Florida, USA. · University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York, USA. · Washington State University College of Pharmacy and Pharmaceutical Sciences, Yakima, Washington, USA. · University of Houston College of Pharmacy, Houston, Texas, USA. · University of New Mexico College of Pharmacy, Albuquerque, New Mexico, USA. ·Antimicrob Agents Chemother · Pubmed #30617094.

ABSTRACT: We analyzed the impact of vancomycin (VAN) combined with adjuvant β-lactam therapy (Combo) on persistent (≥5 days) methicillin-resistant

20 Article Phylogenomic Classification and the Evolution of Clonal Complex 5 Methicillin-Resistant 2018

Challagundla, Lavanya / Reyes, Jinnethe / Rafiqullah, Iftekhar / Sordelli, Daniel O / Echaniz-Aviles, Gabriela / Velazquez-Meza, Maria E / Castillo-Ramírez, Santiago / Fittipaldi, Nahuel / Feldgarden, Michael / Chapman, Sinéad B / Calderwood, Michael S / Carvajal, Lina P / Rincon, Sandra / Hanson, Blake / Planet, Paul J / Arias, Cesar A / Diaz, Lorena / Robinson, D Ashley. ·Department of Data Science, University of Mississippi Medical Center, Jackson, MS, United States. · Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. · Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, United States. · Instituto de Investigaciones en Microbiología y Parasitología Médica, Universidad de Buenos Aires and Consejo Nacional de Investigaciones Ciencias y Tecnicas, Buenos Aires, Argentina. · Department of Vaccine Evaluation, Instituto Nacional de Salud Pública, Cuernavaca, Mexico. · Programa de Genómica Evolutiva, Centro de Ciencias Génomicas, Universidad Nacional Autónoma de México, Cuernavaca, Mexico. · Public Health Ontario Laboratory, Toronto, ON, Canada. · Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. · Department of Cell and Systems Biology, University of Toronto, Toronto, ON, Canada. · National Center for Biotechnology Information, National Institutes of Health, Bethesda, MD, United States. · Broad Institute of MIT and Harvard, Cambridge, MA, United States. · Section of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States. · Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Science Center, McGovern Medical School, Houston, TX, United States. · Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center, Houston, TX, United States. · Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States. ·Front Microbiol · Pubmed #30186248.

ABSTRACT: Clonal complex 5 methicillin-resistant

21 Article The Cefazolin Inoculum Effect Is Associated With Increased Mortality in Methicillin-Susceptible 2018

Miller, William R / Seas, Carlos / Carvajal, Lina P / Diaz, Lorena / Echeverri, Aura M / Ferro, Carolina / Rios, Rafael / Porras, Paola / Luna, Carlos / Gotuzzo, Eduardo / Munita, Jose M / Nannini, Esteban / Carcamo, Cesar / Reyes, Jinnethe / Arias, Cesar A. ·Center for Antimicrobial Resistance and Microbial Genomics, Houston, Texas. · Division of Infectious Diseases, Department of Internal Medicine, Houston, Texas. · Hospital Cayetano Heredia and Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru. · Molecular Genetics and Antimicrobial Resistance Unit and International Center for Antimicrobial Resistance, Universidad El Bosque, Bogota, Colombia. · Pulmonary Division, Department of Medicine, Jose de San Martin Hospital, Universidad de Buenos Aires, Buenos Aires, Argentina. · Genomics and Resistant Microbes (GeRM) group, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile. · Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina. · Department of Microbiology and Molecular Genetics, UTHealth McGovern Medical School, Houston, Texas. ·Open Forum Infect Dis · Pubmed #29977970.

ABSTRACT: Background: Recent studies have favored the use of cefazolin over nafcillin for the treatment of methicillin-susceptible Methods: We prospectively included patients from 3 Argentinian hospitals with Results: A total of 77 patients, contributing 89 MSSA isolates, were included in the study; 42 patients (54.5%) had isolates with the CzIE. In univariate analysis, patients with MSSA exhibiting the CzIE had increased 30-day mortality ( Conclusions: In patients with MSSA bacteremia where cephalosporins are used as firstline therapy, the CzIE was associated with increased 30-day mortality. Clinicians should be cautious when using cefazolin as firstline therapy for these infections.

22 Article Delayed Cerebral Injury in Adults With Bacterial Meningitis: A Novel Complication of Adjunctive Steroids? 2018

Gallegos, Cinthia / Tobolowsky, Farrell / Nigo, Masayuki / Hasbun, Rodrigo. ·All authors: Department of Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, Houston, TX. ·Crit Care Med · Pubmed #29746358.

ABSTRACT: OBJECTIVES: To report the prevalence of delayed cerebral injury in adults with bacterial meningitis and explore its association with adjunctive steroids. DESIGN: Retrospective analysis of adults with bacterial meningitis between 2005 and 2016. SETTING: Ten hospitals in the Greater Houston area. PATIENTS: Consecutive subjects with culture proven community-acquired bacterial meningitis. INTERVENTION: Subjects were categorized as receiving or not adjunctive steroids within 4 hours. MEASUREMENTS AND MAIN RESULTS: A total of 120 patients were identified who were admitted with community-acquired bacterial meningitis. Delayed cerebral injury was seen in five of 120 patients (4.1%); all five patients had fever and abnormal neurologic examinations. Adjunctive steroids within 4 hours were more likely given to those with delayed cerebral injury (5/5,100% vs 43/115, 37.5%; p = 0.01). Of the patients who developed delayed cerebral injury, three had Streptococcus pneumoniae, one had methicillin-resistant Staphylococcus aureus, and one had Listeria monocytogenes isolated. We observed an adverse clinical outcome as defined by the Glasgow Outcome Scale in four of the five patients (80%). CONCLUSIONS: Delayed cerebral injury occurred in 4.1% of adults with bacterial meningitis, and it was associated with the use of adjunctive steroids. Future studies should explore the etiology and prevention of this devastating complication.

23 Article Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction. 2018

Veve, Michael P / Greene, Joshua B / Williams, Amy M / Davis, Susan L / Lu, Nina / Shnayder, Yelizaveta / Li, David X / Noureldine, Salem I / Richmon, Jeremy D / Lin, Lawrence O / Hanasono, Matthew M / Pipkorn, Patrik / Jackson, Ryan S / Hornig, Joshua D / Light, Tyler / Wax, Mark K / Yiu, Yin / Bekeny, James / Old, Matthew / Hernandez, David / Patel, Urjeet A / Ghanem, Tamer A. ·1 Wayne State University, Detroit, Michigan, USA. · 2 Henry Ford Health System, Detroit, Michigan, USA. · 3 Department of Otolaryngology, School of Medicine, University of Kansas, Kansas City, Kansas, USA. · 4 Johns Hopkins University, Baltimore, Maryland, USA. · 5 The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. · 6 Washington University School of Medicine, St Louis, Missouri, USA. · 7 Medical University of South Carolina, Charleston, South Carolina, USA. · 8 Oregon Health Sciences University, Portland, Oregon, USA. · 9 The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. · 10 Northwestern University, Chicago, Illinois, USA. ·Otolaryngol Head Neck Surg · Pubmed #29513083.

ABSTRACT: Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.

24 Article Range Expansion and the Origin of USA300 North American Epidemic Methicillin-Resistant 2018

Challagundla, Lavanya / Luo, Xiao / Tickler, Isabella A / Didelot, Xavier / Coleman, David C / Shore, Anna C / Coombs, Geoffrey W / Sordelli, Daniel O / Brown, Eric L / Skov, Robert / Larsen, Anders Rhod / Reyes, Jinnethe / Robledo, Iraida E / Vazquez, Guillermo J / Rivera, Raul / Fey, Paul D / Stevenson, Kurt / Wang, Shu-Hua / Kreiswirth, Barry N / Mediavilla, Jose R / Arias, Cesar A / Planet, Paul J / Nolan, Rathel L / Tenover, Fred C / Goering, Richard V / Robinson, D Ashley. ·Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, Mississippi, USA. · Cepheid, Sunnyvale, California, USA. · Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom. · Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland. · School of Veterinary and Life Sciences, Murdoch University, Perth, Australia. · PathWest Laboratory Medicine-WA, Fiona Stanley Hospital, Perth, Australia. · Instituto de Investigaciones en Microbiología y Parasitología Médica, Universidad de Buenos Aires and CONICET, Buenos Aires, Argentina. · Center for Infectious Diseases, Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, Houston, Texas, USA. · Statens Serum Institut, Copenhagen, Denmark. · Molecular Genetics and Antimicrobial Resistance Unit, International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia. · Department of Microbiology and Medical Zoology, University of Puerto Rico, San Juan, Puerto Rico. · Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA. · Department of Internal Medicine, Division of Infectious Diseases, The Ohio State University, Columbus, Ohio, USA. · Public Health Research Institute of New Jersey Medical School, Rutgers University, Newark, New Jersey, USA. · Center for Antimicrobial Resistance and Microbial Genomics, University of Texas McGovern School of Medicine at Houston, Houston, Texas, USA. · Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Department of Internal Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi, USA. · Department of Medical Microbiology and Immunology, Creighton University, Omaha, Nebraska, USA. · Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, Mississippi, USA darobinson@umc.edu. ·MBio · Pubmed #29295910.

ABSTRACT: The USA300 North American epidemic (USA300-NAE) clone of methicillin-resistant

25 Article Pediatric Deep Venous Thrombosis Associated With Staphylococcal Infections: Single Institutional Experience. 2018

Citla Sridhar, Divyaswathi / Maher, Ossama M / Rodriguez, Nidra I. ·Department of Pediatric Hematology Oncology, Case Western Reserve University School of Medicine, Cleveland, OH. · Department of Pediatric Hematology Oncology, Nicklaus Children's Hospital, Miami, FL. · Department of Pediatrics, The University of Texas Health Science Center, Mc Govern Medical School, Houston, TX. ·J Pediatr Hematol Oncol · Pubmed #29200147.

ABSTRACT: Deep venous thrombosis (DVT) has been previously reported in children with methicillin-resistant Staphylococcus aureus (MRSA). This study reviews our institutional experience by evaluating characteristics and outcomes of children with DVT and staphylococcal infections. Retrospective clinical data from 16 pediatric patients with DVT and staphylococcal infections over a 5-year period was obtained via medical record abstraction. Sixteen patients with a median age at diagnosis of 8 years were included. The most common infection encountered was osteomyelitis (56%). The most common isolated organism was MRSA (63%). Central venous catheters were present in 50% of cases. All patients received anticoagulation with low molecular weight heparin except 1 patient with superficial venous thrombosis who was managed conservatively. Fifty percent of patients had complete resolution of DVT by the end of treatment, 25% of the patients had early disappearance of the thrombus at 7 to 10 days. Only 2 patients (12.5%) had persistent thrombus at 6 months. Staphylococcal infections may increase the risk of DVT in children. Therefore, a high index of suspicion for DVT is warranted in children with Staphylococcal infections (particularly MRSA) to promptly diagnose, treat and minimize complications. Prophylactic anticoagulation in presence of staphylococcal infection, particularly MRSA, may be considered in future studies.

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