Control of MSSA and MRSA in the United States: protocols, policies, risk adjustment and excuses

Abstract

Data released by the U.S. Centers for Disease Control and Prevention (CDC) on March 5, 2019 showed that Staph aureus infections are a major problem in the United States, with 119,000 infections and almost 20,000 deaths in 2017. Rates of decline for hospital-onset MRSA have slowed since 2012 and the United States is not on track for meeting the 2015 U.S. Dept. of Health and Human Services’ goal of a 50% reduction by 2020. There is a need for improved standards for control of dangerous pathogens. Currently, the World Health Organization’s recommendation of preoperatively screening patients for Staph aureus has not become a standard of care in the United States. The U.S. Veterans Health Administration also released data which found a much larger decrease in hospital-onset MRSA infections as opposed to hospital-onset MSSA using various infectious disease bundles that all included universal MRSA surveillance and isolation for MRSA carriers. These results mirror the results obtained by the United Kingdom’s National Health Service. These findings support the contention that the marked decline in hospital-onset MRSA infections observed in these studies is due to interventions which are specifically targeted towards MRSA. A case is made that concerns with the integrity of healthcare policy research, along with industrial conflicts-of-interest have inhibited effective formulation of infectious disease policy in the United States. Because MRSA has become endemic in the general U.S. population (approximately 2%), the author advocates that universal facility-wide screening of MRSA on admission be included in infection prevention bundles used at U.S. hospital.

Pathogenicity and virulence of Staphylococcus aureus

“…Some MSSA lineages such as sequence type (ST) 398 can have high virulence, causing fatal infections [13,14]. MSSA infections are not monitored as closely as MRSA infections and recently implemented anti-MRSA measures did not cause a similar decrease in MSSA infections, as reported for example in the U.S. and U.K [15].…”

5‐Benzylidene‐4‐Oxazolidinones Are Synergistic with Antibiotics for the Treatment of Staphylococcus aureus Biofilms

“…), which were identified by the Centers for Disease Control and Prevention as posing the greatest threat to human health, are primary targets for antibiotic development . Although significant focus has been directed to Gram‐negative ESKAPE pathogens in recent years, Gram‐positive pathogens such as S. aureus and methicillin‐resistant S. aureus (MRSA) remain a serious clinical issue, with some strains exhibiting resistance to all known classes of antibiotics . The rapid development of resistance to even recently developed antibiotics and the lack of novel antibiotic scaffolds under development represents an opportunity for not only the identification of new antibiotic scaffolds, but also the exploration of nontraditional approaches to overcome antibiotic failure …”

Synergistic Effects of Thiosemicarbazides with Clinical Drugs against S. aureus

“…Antimicrobial resistance spurred by the overuse and misuse of antibiotics is a major global health concern, and of the Gram positive bacteria, S. aureus is a leading cause of mortality and morbidity [1][2][3][4][5][6][7]. The important clinical S. aureus infections are bacteraemia, infective endocarditis, as well as skin and soft tissue, osteoarticular, pleuropulmonary, and device-related infections.…”