Treatment of Methicillin-Resistant Staphylococcus aureus Surgical Site Infections

Santayana, Elena M.; Jourjy, Jacqueline

doi:10.1097/nci.0b013e3181ef86fe2049019

Cited by 2 publications

(2 citation statements)

References 37 publications

(27 reference statements)

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“…However, it is necessary to raise the awareness of the resistance of vancomycin since there has been evidence suggesting the observed rise in minimum inhibitory concentrations (MICs) of vancomycin from less than 0.5μg/mL in 2005 to 1.0 μg/mL in 2010 [ 26 ]. Linezolid is the first available oxazolidinone antibiotic, which uniquely inhibits bacterial protein synthesis by preventing formation of 70S initiation complex [ 27 ]. Although surveillance data on linezolid was absent, one of 94 MRSA isolates in our findings was resistant to linezolid.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, clindamycin and erythromycin, inhibiting protein synthesis by their effect on ribosome function and commonly used in clinical practice for MRSA SSIs [ 27 , 29 ], may have a doubtful effectiveness. The proportion of MRSA resistant to clindamycin in our findings (79.9%) was also similarly suggested in the surveillance system for nosocomial infections—78.9% (1,137/1,445) [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Proportions of Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus in Patients with Surgical Site Infections in Mainland China: A Systematic Review and Meta-Analysis

Yang

Wang

et al. 2015

PLoS ONE

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BackgroundSufficient details have not been specified for the epidemiological characteristics of Staphylococcus aureus (S. aureus) and methicillin-resistant Staphylococcus aureus (MRSA) among surgical site infections (SSIs) in mainland China. This systematic review aimed to estimate proportions of S. aureus and MRSA in SSIs through available published studies.MethodsPubMed, Embase and four Chinese electronic databases were searched to identify relevant primary studies published between 2007 and 2012. Meta-analysis was conducted on the basis of logit-transformed metric for proportions of S. aureus and MRSA, followed by pre-defined subgroup meta-analysis. Random-effects meta-regression was also conducted to explore the impact of possible factors on S. aureus proportions.Results106 studies were included, of which 38 studies involved MRSA. S. aureus accounted for 19.1% (95%CI 17.2-21.0%; I2 = 84.1%) of all isolates in SSIs, which was roughly parallel to 18.5% in the United States (US) (P-value = 0.57) but significantly exceeded those calculated through the surveillance system in China (P-value<0.001). In subgroup analysis, S. aureus in patients with thoracic surgery (41.1%, 95%CI 26.3-57.7%; I2 = 74.4%) was more common than in those with gynecologic surgery (20.1%, 95%CI 15.6-25.6%; I2 = 33.0%) or abdominal surgery (13.8%, 95%CI 10.3-18.4%; I2 = 70.0%). Similar results were found in meta-regression. MRSA accounted for 41.3% (95%CI 36.5-46.3%; I2 = 64.6%) of S. aureus, significantly lower than that in the US (P-value = 0.001). MRSA was sensitive to vancomycin (522/522) and linezolid (93/94), while 79.9% (95%CI 67.4-88.4%; I2 = 0%) and 92.0% (95%CI 80.2-97.0%; I2 = 0%) of MRSA was resistant to clindamycin and erythromycin respectively.ConclusionThe overall proportion of S. aureus among SSIs in China was similar to that in the US but seemed higher than those reported through the Chinese national surveillance system. Proportions of S. aureus SSIs may vary with different surgery types. Commonly seen in SSIs, MRSA tended to be highly sensitive to vancomycin and linezolid but mostly resistant to clindamycin and erythromycin.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%