Drug Topics - January 2009 - (Page 32) Continuing Education AN ONGOING CE PROGRAM OF THE UNIVERSITY OF FLORIDA COLLEGE OF PHARMACY AND DRUG TOPICS Communityacquired MRSA infections Sarah M. Kemink, PharmD, Pharmacy Practice Resident, Borgess Medical Center Tracey L. Mersfelder, PharmD, Associate Professor, College of Pharmacy, Ferris State University Michael E. Klepser, PharmD, Professor, College of Pharmacy, Ferris State University his article discusses communityacquired methicillin-resistant Staphylococcus aureus, its risk factors, and its resistance patterns. Current treatment options are also addressed. T Staph Spot magnified 20000x Network SEE INDEX PAGE 10 Clinical For more info on this topic, see www.drugtopics.com 32 DRUG TOPICS Januar y 2009 W W W.D R U GTO P I C S .C O M COURTESY CDC / JANICE CARR / GETTY IMAGES / DIGITAL VISION / ALEXANDER WALTER Introduction As a result of decades of antibiotic pressure, drug-resistant S. aureus has emerged as a significant healthcare concern. Shortly after the introduction of penicillin in the 1940s, penicillin-resistant isolates of S. aureus evolved and quickly became a problematic nosocomial pathogen. Similarly, the first case reports of methicillinresistant S. aureus (MRSA) surfaced less than one year after the approval of methicillin in the 1960s. In the 1980s, MRSA began to appear in the community. Its isolates seemed to be similar to those seen in hospital settings and were considered to have spread from hospitals. Patients, although in the community, typically had chronic conditions and frequent healthcare contacts that would place them at risk for healthcare-associated MRSA (HA-MRSA) infections. Over the past decade, however, clinicians began to observe MRSA infections in the community becoming increasingly widespread among healthy individuals. Furthermore, contact with healthcare systems and traditional risk factors for acquisition of MRSA appeared to be absent. Now commonly referred to as community-associated or communityacquired MRSA (CA-MRSA), these strains are distinct from HA-MRSA in their genetic background, epidemiology, clinical spectrum, and antimicrobial susceptibility patterns. Outbreaks of CA-MRSA have been reported among athletes, military recruits, inmates, children in daycare, homosexual men, and institutionalized adults. Spread of this pathogen may be facilitated by close physical contact and conditions that foster poor hygienic conditions. These were considered some of the initial risk factors for CA-MRSA. Recently, however, CA-MRSA has been linked with nosocomial infections. Surprisingly, some of these cases involve patients without traditional risk factors for CA-MRSA infection. Thus, the lines between community-associated and healthcare-associated MRSA are beginning to blur. This observation is important, as CA-MRSA strains tend to be more virulent than HA-MRSA strains and the inpatient population may be considerably more compromised than those in the community. The clinical and societal impact of CA-MRSA in both community and hospital settings is alarming. Historically, patients infected with HA-MRSA have had a worse prognosis than those infected with methicillin-susceptible strains. These patients have lengthier hospitalizations, incur higher inpatient treatment costs, and are at increased risk of death. The continued spread of CA-MRSA is likely to increase individual and societal burdens in communities and hospitals. http://www.drugtopics.com http://WWW.DRUGTOPICS.COM
Table of Contents Feed for the Digital Edition of Drug Topics - January 2009 Drug Topics - January 2009 Contents Letters Up Front Up Front in Depth Community Practice Drug Pipeline: What to Watch in 2009 OTC Community-Aquired MRSA Infections New Products Viewpoint Drug Topics - January 2009 Drug Topics - January 2009 - Drug Topics - January 2009 (Page Cover1) Drug Topics - January 2009 - Drug Topics - January 2009 (Page Cover2) Drug Topics - January 2009 - Drug Topics - January 2009 (Page 1) Drug Topics - January 2009 - Drug Topics - January 2009 (Page 2) Drug Topics - January 2009 - Drug Topics - January 2009 (Page 3) Drug Topics - January 2009 - Contents (Page 4) Drug Topics - January 2009 - Contents (Page 5) Drug Topics - January 2009 - Contents (Page 6) Drug Topics - January 2009 - Contents (Page 7) Drug Topics - January 2009 - Contents (Page 8) Drug Topics - January 2009 - Contents (Page 9) Drug Topics - January 2009 - Contents (Page 10) Drug Topics - January 2009 - Contents (Page 11) Drug Topics - January 2009 - Letters (Page 12) Drug Topics - January 2009 - Letters (Page H1) Drug Topics - January 2009 - Letters (Page H2) Drug Topics - January 2009 - Letters (Page H3) Drug Topics - January 2009 - Letters (Page H4) Drug Topics - January 2009 - Letters (Page H5) Drug Topics - January 2009 - Letters (Page H6) Drug Topics - January 2009 - Letters (Page H7) Drug Topics - January 2009 - Letters (Page H8) Drug Topics - January 2009 - Letters (Page 13) Drug Topics - January 2009 - Up Front (Page 14) Drug Topics - January 2009 - Up Front (Page 15) Drug Topics - January 2009 - Up Front (Page 16) Drug Topics - January 2009 - Up Front (Page 17) Drug Topics - January 2009 - Up Front in Depth (Page 18) Drug Topics - January 2009 - Up Front in Depth (Page 19) Drug Topics - January 2009 - Community Practice (Page 20) Drug Topics - January 2009 - Community Practice (Page 20a) Drug Topics - January 2009 - Community Practice (Page 20b) Drug Topics - January 2009 - Community Practice (Page 21) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 22) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 23) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 24) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 25) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 26) Drug Topics - January 2009 - Drug Pipeline: What to Watch in 2009 (Page 27) Drug Topics - January 2009 - OTC (Page 28) Drug Topics - January 2009 - OTC (Page 29) Drug Topics - January 2009 - OTC (Page 30) Drug Topics - January 2009 - OTC (Page 31) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 32) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 33) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 34) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 35) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 36) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 37) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 38) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 39) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 40) Drug Topics - January 2009 - Community-Aquired MRSA Infections (Page 41) Drug Topics - January 2009 - New Products (Page 42) Drug Topics - January 2009 - New Products (Page 43) Drug Topics - January 2009 - New Products (Page 44) Drug Topics - January 2009 - New Products (Page 45) Drug Topics - January 2009 - New Products (Page 46) Drug Topics - January 2009 - New Products (Page 47) Drug Topics - January 2009 - Viewpoint (Page 48) Drug Topics - January 2009 - Viewpoint (Page Cover3) Drug Topics - January 2009 - Viewpoint (Page Cover4)
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