National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011.
Raymund Dantes,Yi Mu,Ruth Belflower,Deborah Aragon,Ghinwa Dumyati,Lee H. Harrison,Fernanda C. Lessa,Ruth Lynfield,Joelle Nadle,Susan Petit,Susan M. Ray,William Schaffner,John M. Townes,Scott K. Fridkin +13 more
TLDR
An estimated 30,800 fewer invasive MRSA infections occurred in the United States in 2011 compared with 2005; in 2011 fewer infections occurred among patients during hospitalization than among persons in the community without recent health care exposures.Abstract:
Importance Estimating the US burden of methicillin-resistant Staphylococcus aureus (MRSA) infections is important for planning and tracking success of prevention strategies. Objective To describe updated national estimates and characteristics of health care– and community-associated invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in 2011. Design, Setting, and Participants Active laboratory-based case finding identified MRSA cultures in 9 US metropolitan areas from 2005 through 2011. Invasive infections (MRSA cultured from normally sterile body sites) were classified as health care–associated community-onset (HACO) infections (cultured ≤3 days after admission and/or prior year dialysis, hospitalization, surgery, long-term care residence, or central vascular catheter presence ≤2 days before culture); hospital-onset infections (cultured >3 days after admission); or community-associated infections if no other criteria were met. National estimates were adjusted using US census and US Renal Data System data. Main Outcomes and Measures National estimates of invasive HACO, hospital-onset, and community-associated MRSA infections using US census and US Renal Data System data as the denominator. Results An estimated 80 461 (95% CI, 69 515-93 914) invasive MRSA infections occurred nationally in 2011. Of these, 48 353 (95% CI, 40 195–58 642) were HACO infections; 14 156 (95% CI, 10 096-20 440) were hospital-onset infections; and 16 560 (95% CI, 12 806-21 811) were community-associated infections. Since 2005, adjusted national estimated incidence rates decreased among HACO infections by 27.7% and hospital-onset infections decreased by 54.2%; community-associated infections decreased by only 5.0%. Among recently hospitalized community-onset (nondialysis) infections, 64% occurred 3 months or less after discharge, and 32% of these were admitted from long-term care facilities. Conclusions and Relevance An estimated 30 800 fewer invasive MRSA infections occurred in the United States in 2011 compared with 2005; in 2011 fewer infections occurred among patients during hospitalization than among persons in the community without recent health care exposures. Effective strategies for preventing infections outside acute care settings will have the greatest impact on further reducing invasive MRSA infections nationally.read more
Citations
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Antibiotic resistance threats in the United States: stepping back from the brink.
TL;DR: The physician's role in this effort to prevent and controlling resistance is singularly important and requires the engagement of many different sectors of society.
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TL;DR: This review focuses on antibacterial resistance (ABR), which represents at the moment the major problem, both for the high rates of resistance observed in bacteria that cause common infections and for the complexity of the consequences of ABR.
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Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research.
Nicholas A Turner,Batu K. Sharma-Kuinkel,Stacey A. Maskarinec,Emily M. Eichenberger,Pratik Shah,Manuela Carugati,Manuela Carugati,Thomas L. Holland,Vance G. Fowler,Vance G. Fowler +9 more
TL;DR: An overview of basic and clinical MRSA research is provided and the expansive body of literature on the epidemiology, transmission, genetic diversity, evolution, surveillance and treatment of MRSA is explored.
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Antimicrobial resistance in ESKAPE pathogens
David M. P. De Oliveira,Brian M. Forde,Timothy J. Kidd,Patrick N A Harris,Mark A. Schembri,Scott A. Beatson,David L. Paterson,Mark J. Walker +7 more
TL;DR: The acquisition of antimicrobial resistance genes by ESKAPE pathogens has reduced the treatment options for serious infections, increased the burden of disease, and increased death rates due to treatment failure and requires a coordinated global response for antim antibiotic resistance surveillance.
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Methicillin-resistant Staphylococcus aureus.
Andie S Lee,Andie S Lee,Hermínia de Lencastre,Hermínia de Lencastre,Javier Garau,Jan Kluytmans,Surbhi Malhotra-Kumar,Andreas Peschel,Stéphan Juergen Harbarth +8 more
TL;DR: The success of MRSA is a consequence of the extensive arsenal of virulence factors produced by S. aureus combined with β-lactam resistance and, for most clones, resistance to other antibiotic classes as discussed by the authors.
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Clinical Practice Guidelines by the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections in Adults and Children
Catherine Liu,Arnold S. Bayer,Sara E. Cosgrove,Robert S. Daum,Scott K. Fridkin,Rachel J. Gorwitz,Sheldon L. Kaplan,Adolf W. Karchmer,Donald P. Levine,Barbara E. Murray,Michael J. Rybak,Henry F. Chambers +11 more
TL;DR: These guidelines discuss the management of a variety of clinical syndromes associated with MRSA disease, including skin and soft tissue infections (SSTI), bacteremia and endocarditis, pneumonia, bone and joint infections, and central nervous system infections.