Treatment of methicillin-resistant Staphylococcus aureus in Latin America

Abstract

The global spread of methicillin-resistant Staphylococcus aureus (MRSA) means it is now a pathogen of worldwide public health concern. Within Latin America, MRSA is highly prevalent, with the proportion of S. aureus isolates that are methicillin-resistant on the rise, yet resources for managing the infection are limited. While several guidelines exist for the treatment of MRSA infections, many are written for the North American or European setting and need adaptation for use in Latin America. In this article, we aim to emphasize the importance of appropriate treatment of MRSA in the healthcare and community settings of Latin America. We present a summary of the available guidelines and antibiotics, and discuss particular considerations for clinicians treating MRSA in Latin America.

Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients

“…These results agree with those reported in other countries, however, in studies performed with patients treated at the hospital 28,34 . It was observed that oxacillin-resistant S. aureus has an associated resistance to ciprofloxacin (53.1%), sulfamethoxazole-trimethoprim (53.5%) and rifampicin (24.8%) 25 .…”

“…Classic MRSA strains are associated with the production of PBP2a or mecA gene mediated PBP2' 20,28 . There is a scarcity of studies on Staphylococcus sp.…”

“…isolated from venous ulcers of patients treated in outpatient clinics in Brazil as well as in other countries. On the other hand, the prevalence of the identified pathogens ranges significantly in the health centers of different countries and in the same region [26][27][28][29][30][31] . Different services have different conditions, and, for this reason, comparisons are not pertinent.…”

“…The oral therapies commonly used to treat community MRSA are tetracycline, rifampicin, clindamycin, linezolida and sulfamethoxazoletrimethoprim. It is recommended that a combined therapy be used when rifampicin is chosen, in order to avoid mutant strains 28,35 . In this study, 34.8% of the MRSA and 28.6% of the MRCoNS isolates were resistant to rifampicin.…”

“…Skin and soft tissue infections, alone, are risk factors for the transmission of MDROs S. aureus and coagulase-negative Staphylococcus in the population 6 . These infections account for most infections by MRSA in the community 28 , which are usually treated in outpatient clinic settings.…”