methicillin-sensitive Staphylococcus aureus (MSSA)
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Introduction
Staphylococcus aureus sensitive to methicillin & oxacillin.
Epidemiology
- in the neonatal ICU, MSSA are more common than MRSA infections & result in higher mortality
- compared with MRSA carriers, risk of MRSA infection were 14 times lower for uncolonized patients & 125 times lower for MSSA carriers[5]
Management
- MSSA sepsis (bacteremia)
- 2nd generation penicillin or 1st generation cephalosporin
- cefazolin superior to nafcillin or oxacillin[3]
- lower 30 & 90 day mortality (37% & 23%, respectively)
- lower risk for endocarditis (4% vs 7%)
- add rifampin for osteomyelitis if orthopedic hardware cannot be removed[2]
- ceftriaxone inferior to nafcillin, oxacillin, or cefazolin in patients with sepsis[6]
- vancomycin
More general terms
References
- ↑ Ericson JE et al Burden of Invasive Staphylococcus aureus Infections in Hospitalized Infants. JAMA Pediatr. Published online October 19, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26502073 <Internet> http://archpedi.jamanetwork.com/article.aspx?articleid=2449666
Cantey JB, Ronchi A Spreading the Benefits of Infection Prevention in the Neonatal Intensive Care Unit. JAMA Pediatr. Published online October 19, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26501886 <Internet> http://archpedi.jamanetwork.com/article.aspx?articleid=2449664 - ↑ 2.0 2.1 2.2 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2021.
- ↑ 3.0 3.1 McDanel JS, Roghmann MC, Perencevich EN et al. Comparative effectiveness of cefazolin versus nafcillin or oxacillin for treatment of methicillin-susceptible Staphylococcus aureus infections complicated by bacteremia: A nationwide cohort study. Clin Infect Dis 2017 Mar 31 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28379314
Karchmer AW. Definitive treatment for methicillin-sensitive Staphylococcus aureus bacteremia: Data versus a definitive answer? Clin Infect Dis 2017 Mar 31 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28379366 - ↑ 4.0 4.1 4.2 Sullivan SB, Austin ED, Stump S et al. Reduced vancomycin susceptibility of methicillin-susceptible Staphylococcus aureus has no significant impact on mortality but results in an increase in complicated infection. Antimicrob Agents Chemother 2017 Jul; 61:e00316 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28507105 <Internet> http://aac.asm.org/content/61/7/e00316-17
- ↑ 5.0 5.1 Shrestha NK, Fraser TG, Gordon SM. Methicillin resistance in Staphylococcus aureus infections among patients colonized with methicillin-susceptible Staphylococcus aureus. Clin Microbiol Infect 2018 Apr 10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29649598
- ↑ 6.0 6.1 Yetmar ZA et al. Post-treatment outcomes of ceftriaxone versus antistaphylococcal penicillins or cefazolin for definitive therapy of methicillin-susceptible Staphylococcus aureus bacteremia. Eur J Clin Microbiol Infect Dis 2023 Apr; 42:423. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36800065 https://link.springer.com/article/10.1007/s10096-023-04575-z
Buis DTP et al. Comparative effectiveness of beta-lactams for empirical treatment of methicillin- susceptible Staphylococcus aureus bacteraemia: A prospective cohort study. J Antimicrob Chemother 2023 Mar 10; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/36897327 https://academic.oup.com/jac/advance-article/doi/10.1093/jac/dkad057/7075678