The Empirical Combination of Vancomycin and a  -Lactam for Staphylococcal Bacteremia

McConeghy, Kevin W.; Bleasdale, Susan C; Rodvold, Keith A.

doi:10.1093/cid/cit560

Cited by 74 publications

(56 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An analysis of the literature, however, compared the use of empirical combination of vancomycin and antistaphylococcal β-lactam therapy with vancomycin alone and demonstrated the superiority of β-lactam-containing regimens over vancomycin monotherapy for bacteremic MSSA infections, including IE. 153 This differential outcome included studies in which there was an early shift from empirical vancomycin to β-lactam therapy as soon as blood cultures yielded MSSA (not MRSA). The meta-analysis included small, retrospective studies, however, which limits support for initial combination therapy by some experts.…”

Section: Ie In Non-idusmentioning

confidence: 99%

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

Baddour¹,

Wilson²,

Bayer³

et al. 2015

Circulation

2,479

1,421

View full text Add to dashboard Cite

Background— Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today’s myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances. Methods and Results— This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It includes an evidence-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations. Conclusions— Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management.

show abstract

Section: Ie In Non-idusmentioning

confidence: 99%

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

Baddour¹,

Wilson²,

Bayer³

et al. 2015

Circulation

2,479

1,421

View full text Add to dashboard Cite

show abstract

“…In patients with methicillinsusceptible S aureus (MSSA) or group A streptococcal (GAS) infection, a change from either vancomycin or clindamycin to a β-lactam agent would be considered appropriate, based on clinical data and expert opinion. [14][15][16][17][18] Furthermore, vancomycin cannot be continued at our institution beyond 48 hours when alternative antibiotics are effective without approval of the antibiotic stewardship program. Antibiotic pretreatment was regarded as ≥1 dose of intravenous antibiotics administered ≥1 h before the obtainment of operating room (OR) or IR-guided cultures.…”

Section: Defi Nitionsmentioning

confidence: 99%

Role of Operative or Interventional Radiology-Guided Cultures for Osteomyelitis

et al. 2016

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Acute hematogenous osteomyelitis (AHO) is a severe infection in children. Drainage of purulent collections in bones provides specimens for culture as well as therapeutic benefit. Interventional radiology (IR)-guided procedures may serve as a less invasive means of culture in select patients. We examined the impact of IR and surgically obtained cultures in the diagnosis and management of AHO.

show abstract

“…Although a negative PBP2a result is not currently reported by our laboratory, consideration is given to continuation of a combination of vancomycin and a relevant anti-staphylococcal penicillin (oxacillin and nafcillin) or cephalosporin, as vancomycin single therapy still appears inferior to initial b-lactam therapy for MSSA (McConeghy et al, 2013;Mongkolrattanothai et al, 2009). If a positive result is obtained, de-escalation to vancomycin as a single agent is warranted.…”

Section: Discussionmentioning

confidence: 90%

“…There may be clinical benefit demonstrated in such randomized control studies as the treatment of a MSSA with vancomycin alone is clearly associated with a more complicated disease prognosis (McConeghy et al, 2013;Mongkolrattanothai et al, 2009). If such an approach is adopted, the SIMI/CCT may be of benefit for either discontinuing the b-lactam with a positive result or discontinuing vancomycin in the case of a negative result.…”

Section: Discussionmentioning

confidence: 99%

Rapid detection of meticillin-resistant Staphylococcus aureus bacteraemia using combined three-hour short-incubation matrix-assisted laser desorption/ionization time-of-flight MS identification and Alere Culture Colony PBP2a detection test

Delport

Mohorovic

Burn

et al. 2016

Journal of Medical Microbiology

View full text Add to dashboard Cite

Meticillin-resistant Staphylococcus aureus (MRSA) bloodstream infection is responsible for significant morbidity, with mortality rates as high as 60 % if not treated appropriately. We describe a rapid method to detect MRSA in blood cultures using a combined three-hour shortincubation BRUKER matrix-assisted laser desorption/ionization time-of-flight MS BioTyper protocol and a qualitative immunochromatographic assay, the Alere Culture Colony Test PBP2a detection test. We compared this combined method with a molecular method detecting the nuc and mecA genes currently performed in our laboratory. One hundred and seventeen S. aureus blood cultures were tested of which 35 were MRSA and 82 were meticillin-sensitive S. aureus (MSSA). The rapid combined test correctly identified 100 % (82/82) of the MSSA and 85.7 % (30/35) of the MRSA after 3 h. There were five false negative results where the isolates were correctly identified as S. aureus, but PBP2a was not detected by the Culture Colony Test. The combined method has a sensitivity of 87.5 %, specificity of 100 %, a positive predictive value of 100 % and a negative predictive value of 94.3 % with the prevalence of MRSA in our S. aureus blood cultures. The combined rapid method offers a significant benefit to early detection of MRSA in positive blood cultures. INTRODUCTIONStaphylococcus aureus is a clinically important pathogen that causes a wide variety of diseases and accounts for more than 50 % of nosocomial infections in intensive care units (NNIS System, 1999). S. aureus bacteraemia (SAB) is an infection of the blood associated with a mortality rate in excess of 20 % (Klevens et al., 2006;Lowy, 1998) while meticillin-resistant S. aureus (MRSA) bacteraemia is associated with mortality rates as high as 60 % (Cluff et al., 1968;Julander, 1985).Until the 1980s, MRSA was almost exclusively limited to nosocomial settings and community strains were largely considered meticillin susceptible (Thompson et al., 1982). However, a decade later there was a measurable increase in community-acquired meticillin-resistant S. aureus (CA-MRSA) infections in people with no known risk factors and an overall increase in CA-MRSA infections in general (Layton et al., 1995). In Canada, there was a 17-fold increase in CA-MRSA infections from 1995 to (Simor et al., 2010. In London, Ontario, the all-cause mortality Abbreviations: BAP, blood agar plate; CA-MRSA, community-acquired meticillin-resistant Staphylococcus aureus; CCT, Alere PBP2a Culture Colony Test; CI, confidence interval; MALDI-ToF, matrix-assisted laser desorption/ionization time-of-flight; MRSA, meticillin-resistant S. aureus; MSSA, meticillin-sensitive S. aureus; OR, odds ratio; SAB, S. aureus bacteraemia; SIMI, short-incubation MALDI-ToF MS identification. Cavassini et al., 1999). Some of these methods depend on well-defined colony morphology and can be very time and labour intensive. To the best of our knowledge, a combined rapid, 3 h procedure, using a shortincubationThe objective of this study was to determine the ability t...

show abstract

The Empirical Combination of Vancomycin and a -Lactam for Staphylococcal Bacteremia

Cited by 74 publications

References 47 publications

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

Role of Operative or Interventional Radiology-Guided Cultures for Osteomyelitis

Rapid detection of meticillin-resistant Staphylococcus aureus bacteraemia using combined three-hour short-incubation matrix-assisted laser desorption/ionization time-of-flight MS identification and Alere Culture Colony PBP2a detection test

Contact Info

Product

Resources

About