Pharmacy and Therapeutics - January 2008 - (Page 5) Today’s complicated skin infections: More layers of complexity Changing pathogens MRSA rates are rising dramatically, and gram negatives are predominant bacteria in complicated skin infections.1 According to North American SENTRY data, they accounted for more than half of the causative pathogens in 20041: • 25% for MRSA • 27% for Pseudomonas aeruginosa and Enterobacteriaceae Evolving risk factors Patients with healthcare-associated risk factors have an increased risk of infection with problematic pathogens, including MRSA.2-9 These risk factors include2-9: • Residence in long-term-care settings • Recent hospitalization • Recent IV antibiotics • Dialysis • Home wound care Are you covered? Visit www.meetinginfectionchallenges.com to learn more. References: 1. Moet GJ, Jones RN, Biedenbach DJ, Stilwell MG, Fritsche TR. Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: report from the SENTRY antimicrobial surveillance program (1998-2004). Diagn Microbiol Infect Dis. 2007;57:7-13. 2. Nicolle LE. Infection control in long-term care facilities. Clin Infect Dis. 2000;31:752-756. 3. Lipsky BA. Empirical therapy for diabetic foot infections: are there clinical clues to guide antibiotic selection? Clin Microbiol Infect. 2007;13:351-353. 4. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005;41:1373-1406. 5. Cohen PR. Community-acquired methicillin-resistant Staphylococcus aureus skin infections: a review of epidemiology, clinical features, management, and prevention. Int J Dermatol. 2007;46:1-11. 6. Miller LG, Perdreau-Remington F, Bayer AS, et al. Clinical and epidemiologic characteristics cannot distinguish communityassociated methicillin-resistant Staphylococcus aureus infection from methicillin-susceptible S. aureus infection: a prospective investigation. Clin Infect Dis. 2007;44:471-482. 7. Naimi TS, LeDell KH, Como-Sabetti K, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290: 2976-2984. 8. American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005;171:388-416. 9. Friedman ND, Kaye KS, Stout JE, et al. Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med. 2002;137:791-797. © Ortho-McNeil, Inc 2007 October 2007 02G034 http://www.meetinginfectionchallenges.com
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