Pneumonia caused by oxacillin-resistant Staphylococcus aureus treated with glycopeptides*

Rello, Jordi; Solé‐Violán, Jordi; Sa-Borges, Marcio; Garnacho-Montero, José; Muñoz, Emma; Sirgo, G.; Olona, Montserrat; Dı́az, Emili

doi:10.1097/01.ccm.0000178180.61305.1d

Cited by 137 publications

(76 citation statements)

References 24 publications

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“…Compared to matched ICU controls, an estimated excess mortality of 22.7% was observed in Spanish ICU patients with MRSA VAP [37]; this was despite appropriate glycopeptide therapy [37]. In the same study, cases with MRSA VAP also had an increased length of ICU stay compared with controls (median 33 and 21 days, respectively) [23,37].…”

Section: Hap and Vapsupporting

confidence: 50%

MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia

Defres¹,

Marwick²,

Nathwani³

2009

European Respiratory Journal

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Staphylococcus aureus has been recognised as a cause of community-acquired pneumonia, albeit uncommon, and an important cause of healthcare-associated (HA) pneumonia, including ventilator-associated pneumonia. Resistance of S. aureus to methicillin developed shortly after its introduction into clinical practice. Since then, methicillin-resistant S. aureus (MRSA) has predominantly been a feature of hospital-acquired, or latterly HA, infections as the boundaries became more blurred between the community and hospital environments.However, more recently true community-acquired (CA)-MRSA infections have been detected and are becoming increasingly common, especially in the USA. Europe has not been immune to the development of MRSA in healthcare settings and although the prevalence of CA-MRSA is currently relatively low, there is the risk of wider spread. These new CA-MRSA strains appear to behave differently to HA-MRSA strains. Although predominantly causing skin and soft tissue infections, mainly as boils and abscesses requiring drainage, life threatening invasive infections including necrotising pneumonia can also occur. This article summarises the pathogenesis and clinical presentations of MRSA-related lung infections.

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Section: Hap and Vapsupporting

confidence: 50%

MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia

Defres¹,

Marwick²,

Nathwani³

2009

European Respiratory Journal

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show abstract

“…Therefore, its administration by CI would be a reasonable mode of administration. CI of vancomycin in a pig lung model showed evidence for increased efficacy [53], but clinical experience is limited [54,55]. A clinical trial in intensive care unit (ICU) patients did not show better outcome using CI but it was associated with an earlier achievement of desired trough concentrations, and concentrations were more stable over time [56].…”

Section: Heteroresistancementioning

confidence: 99%

Treatment options for methicillin-resistant Staphylococcus aureus (MRSA) infection: Where are we now?

Edwards

Andini

Esposito

et al. 2014

Journal of Global Antimicrobial Resistance

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“…7 These striking differences in fatality rates can be explained by differences in study methods (eg matching criteria), target population (eg, age, immune status), causative microorganisms and their antibiotic susceptibility patterns, and appropriateness of antimicrobial therapy. [8][9][10][11][12][13] Other issues that might affect outcome in VAP patients, such as the role of specific nursing protocols, the value of advanced nurse practitioners in the treatment of VAP, compliance with guidelines of the Surviving Sepsis Campaign, and so on, have not been studied extensively.…”

Section: Methodsmentioning

confidence: 99%

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

Blot

Llauradó-Serra²,

Koulenti³

et al. 2010

American Journal of Critical Care

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Objective To determine how the patient to nurse ratio affects risk for ventilator-associated pneumonia. Methods Data from an earlier study in 27 intensive care units in 9 European countries were examined in a secondary analysis. The initial cohort included 2585 consecutive patients who had mechanical ventilation (1) after admission for treatment of pneumonia or (2) for more than 48 hours irrespective of the diagnosis at admission. In units with variable staffing levels, the highest patient to nurse ratio in a 24-hour period was considered. Patients from 6 units that did not provide data on nurse staffing levels were excluded from the analysis. Results Ventilator-associated pneumonia developed in 393 of the 1658 patients (23.7%) in the secondary cohort. In units with patient to nurse ratios of 1 to 1, 2 to 1, 2.5 to 1, and 3 to 1, rates were 9.3%, 25.7%, 18.7%, and 24.2%, respectively (P = .003). Rates were significantly lower (P = .002) in units with a ratio of 1 to 1 (9.3%) than in units with a ratio of more than 1 patient to 1 nurse (24.4%). After adjustments for confounding covariates, ratios of more than 1 patient to 1 nurse were no longer associated with increased risk for ventilator-associated pneumonia. Conclusions A patient to nurse ratio of 1 to 1 appears to be associated with a lower risk for ventilator-associated pneumonia, but after adjustments for confounding covariates, the difference is not significant.

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Pneumonia caused by oxacillin-resistant Staphylococcus aureus treated with glycopeptides*

Abstract: Despite appropriate glycopeptide therapy, there is an increased attributable mortality for pneumonia by ORSA, after careful adjustment for disease severity and diagnostic category.

Cited by 137 publications

References 24 publications

MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia

MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia

Treatment options for methicillin-resistant Staphylococcus aureus (MRSA) infection: Where are we now?

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

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