Featured Research

from universities, journals, and other organizations

Study examines ICU outbreak of staph aureus with resistance to methicillin and linezolid

Date:
October 6, 2010
Source:
JAMA and Archives Journals
Summary:
An outbreak of infection due to linezolid and methicillin-resistant Staphylococcus aureus (LRSA) in 12 intensive care unit patients in Spain was associated with transmission within the hospital and extensive usage of the antibiotic linezolid, often used for the treatment of serious infections, with reductions in linezolid use and infection-control measures associated with resolution of the outbreak, according to a new study.

An outbreak of infection due to linezolid and methicillin-resistant Staphylococcus aureus (LRSA) in 12 intensive care unit patients in Spain was associated with transmission within the hospital and extensive usage of the antibiotic linezolid, often used for the treatment of serious infections, with reductions in linezolid use and infection-control measures associated with resolution of the outbreak, according to a study in the June 9 issue of JAMA.

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of health care-associated infection. Therapeutic options for severe MRSA infections are limited (e.g., only linezolid and glycopeptides [a class of peptides] are recommended to treat ventilator-associated pneumonia). Linezolid is widely used in critical care because of its antimicrobial spectrum, favorable short-term safety profile, pharmacokinetics/pharmacodynamics, and effectiveness, according to background information in the article. Linezolid resistance is extremely uncommon in S aureus.

Miguel Sanchez Garcia, M.D., Ph.D., of the Hospital Clinico San Carlos and Universidad Complutense, Madrid, Spain, and colleagues examined an outbreak of LRSA and the infection-control measures that were applied. The study included critically ill patients colonized and/or infected with LRSA at an intensive care department of a 1,000-bed tertiary care university teaching hospital in Madrid, Spain. Patients were placed under strict contact isolation. Daily updates of outbreak data and recommendations for the use of linezolid were issued. Extensive environmental sampling and screening of the hands of health care workers were performed.

Between April 13 and June 26, 2008, 12 patients with LRSA were identified. In 6 patients, LRSA caused ventilator-associated pneumonia and in 3 patients it caused bacteremia. Linezolid resistance linked to the gene cfr was demonstrated in all isolates. "Potential hospital staff carriers and environmental samples were negative except for one. Six patients died, 5 of them in the intensive care unit, with 1 death attributed to LRSA infection. Linezolid use decreased from 202 defined daily doses in April 2008 to 25 defined daily doses in July 2008. Between July 2008 and April 2010, no new cases have been identified in the weekly surveillance cultures or diagnostic samples," the authors write.

"The outbreak involving 12 patients in the ICU is the first, to our knowledge, with LRSA to be reported, and the first with cfr gene-mediated linezolid resistance," they write. "The apparent risk factor is prior administration of linezolid."

"In view of the current increase of community-acquired MRSA infections, our data have important implications for both hospitalized patients and outpatients. Combination therapy with [the antibiotics] rifampin and fusidic acid still needs to be evaluated in the clinical setting."

Editorial: Preserving the Effectiveness of Antibiotics

In an accompanying editorial, Robert P. Gaynes, M.D., of the Emory University School of Medicine and Atlanta VA Medical Center, Atlanta, writes that there is a need for controls over antibiotic use.

"Efforts at the Centers for Disease Control and Prevention to reinvigorate national surveillance of antibiotic use through the National Healthcare Safety Network are under way. In the United States, mandatory and public reporting of health care-associated infection rates has generated considerable interest and some controversy. Developing measures for appropriate antibiotic use will occur soon and will likely become public. Some measures may become mandatory, similar to time to first antibiotic dose for community-acquired pneumonia. The goal should be to ensure that additional quality measures will improve patient outcomes without unintended consequences. To be sure, quality measures of antibiotic use are necessary and of critical importance. Increasing antibiotic resistance is a problem largely because of indiscriminate antibiotic use. Every clinician must do a better job to preserve the effectiveness of these essential therapies."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. M. Sanchez Garcia, M. A. De la Torre, G. Morales, B. Pelaez, M. J. Tolon, S. Domingo, F. J. Candel, R. Andrade, A. Arribi, N. Garcia, F. Martinez Sagasti, J. Fereres, J. Picazo. Clinical Outbreak of Linezolid-Resistant Staphylococcus aureus in an Intensive Care Unit. JAMA: The Journal of the American Medical Association, 2010; 303 (22): 2260 DOI: 10.1001/jama.2010.757
  2. Robert P. Gaynes. Preserving the Effectiveness of Antibiotics. JAMA: The Journal of the American Medical Association, 2010; 303 (22): 2293 [link]

Cite This Page:

JAMA and Archives Journals. "Study examines ICU outbreak of staph aureus with resistance to methicillin and linezolid." ScienceDaily. ScienceDaily, 6 October 2010. <www.sciencedaily.com/releases/2010/06/100608162236.htm>.
JAMA and Archives Journals. (2010, October 6). Study examines ICU outbreak of staph aureus with resistance to methicillin and linezolid. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2010/06/100608162236.htm
JAMA and Archives Journals. "Study examines ICU outbreak of staph aureus with resistance to methicillin and linezolid." ScienceDaily. www.sciencedaily.com/releases/2010/06/100608162236.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
CDC Calls for New Ebola Safety Guidelines

CDC Calls for New Ebola Safety Guidelines

AP (Oct. 20, 2014) Centers for Disease Control and Prevention Director Dr. Tom Frieden laid out new guidelines for health care workers when dealing with the deadly Ebola virus including new precautions when taking off personal protective equipment. (Oct. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins